Historical Perspective
Pharmacy practice has undergone a major transformation in recent decades, driven largely by advancements in technology and automation. The shift from paper charts to electronic health records (EHR), from handwritten prescriptions to computerized provider order entry (CPOE) systems, and from manual medication carts to automated dispensing cabinets (ADCs) has completely reshaped the pharmacist workflow.
Pharmacy automation can be traced back to the mid-twentieth century when early attempts at automating the dispensing process began. However, the adoption of technology within pharmacies did not begin until the arrival of computers in the 1970s and 1980s. This shift toward digital solutions would later gain momentum in the early 2000s with the widespread adoption of EHRs and CPOE systems. These technologies paved the way for modern innovations such as ADCs and barcode medication administration (BCMA), significantly enhancing both safety and efficiency.
Can We Further Improve?
Although technological innovations have brought remarkable improvements to pharmacy practice, inefficiencies and medication errors persist. Per the National Academy of Medicine, hospitalized patients experience 1 medication error per day during admission.1 Although a margin of error is to be expected in any process, the nature of pharmacy work demands that we strive for perfection—however unachievable that may be. A seemingly benign mistake can be fatal, and thus our goal should not be to reduce but rather eradicate medication errors.
One can look to the aviation industry, for example, where a fatal accident only occurs once for every 16.3 million flight hours.2 This is not a perfect comparison, but it is imperative that we focus on the similarities and learn from them. Discovering that pilot error causes nearly 80% of all fatal accidents, the aviation industry has all but eliminated human error from the process. By taking a proactive approach, targeting improved collaboration and transparency, and leaning heavily on automation, it has been able to achieve what no other industry has—before or since.
Similarly, human error is responsible for many medication errors, as reported by the World Health Organization (WHO).3 Like aviation, we too must rely more on the newest technology and less on manual processes.
Pharmacy Automation Today and the Evolution of the Pharmacist
Some of the most impactful and widely used technological innovations in pharmacy today are ADCs, unit-dose packaging machines, carousel systems, and BCMA scanners. The integration of pharmacy automation has seen steady growth over the past few decades. A 2013 survey of US hospital pharmacies found that 97% had implemented automation technology within their medication use process.4,5
Pharmacy automation has not only improved workflow but also revolutionized the field. By automating routine tasks, the pharmacist role has shifted away from the traditional dispensing to more academic and clinical work. In March of 2023, the American Society of Health-System Pharmacists reported that the number of pharmacy residency positions had grown by a remarkable 12% (5127 to 5832) in less than 5 years.6 We are also seeing a growing number of pharmacists becoming involved in direct patient care activities such as consultations, chronic disease management, and medication therapy management.7 This shift not only enhances patient outcomes but also improves job satisfaction among pharmacists.8
