Technological advancements in the world within the last 50 years have brought society to a place that one could only dream of some years back. The pharmacy field is no stranger to technology and has shown tremendous changes and progress in this area. Only fifteen years ago, many facilities still utilized faxing of paper orders and manual processes during central pharmacy dispensing. IV admixture did not include barcoding; a pull-back method (where a pharmacy technician would compound an admixture and simply fill used syringe barrel with an air, setting the plunger to the mark of supposedly used volume) was a daily practice.

Today, pharmacy operations rely heavily on automated processes. The main reason for this transition is safety, efficiency and reliability. It is a known fact that robotic machinery has a significantly lesser chance of error, as compared to manual fills in medication dispensing. It is also known that barcode scanning while dispensing a medication, or restocking automated a cabinet, significantly reduces chances of mislabeled medications leaving the pharmacy and reaching patients.

When evaluating a new automation system, it is important to consider how it will perform during downtime. Key questions to ask the vendor include:

• Will the equipment use Active Directory login, and if so, will network outages prevent end users from logging in?
• How easily accessible is the medication inventory during downtime?
• Will the equipment remember transactions during downtime, and can these transactions be reconciled later?
• How user-friendly is the system, and can an average technician or pharmacist service it without difficulty?
• How resilient is the equipment to cyber incidents, and will it continue to function during a ransomware attack?

Asking these questions helps build robust processes and ensure system reliability.

The above concept of emergency preparedness was put to the test during the recent CrowdStrike incident. A faulty software update resulted in a devastating downtime event, affecting not only the healthcare industry but also airlines, large and small businesses, and people around the world.

Many hospitals across the country had to delay or cancel their surgical procedures and business operations reverted to paper. This incident exposed the internal vulnerabilities of many automation systems in the pharmacy world, including automated medication dispensing cabinets. The importance of timely, yet controlled software updates come to mind. For the system to operate safely and reliably – scheduled software updates are needed. It is advisable to have those updates manually pushed to medication dispensing cabinets, on schedule, rather than allowed to be automatically loaded. Software feature enhancements should always be carefully reviewed by the designated end-users, prior to load. It is best to have automated updates on medication dispensing cabinets and other vital equipment (such as infusion pumps, robotics, carousels, anesthesia carts) applied manually, on schedule, in collaboration with the facility’s information technology department support.

In today’s pharmacy, automation is used every step of the way from purchasing, to receiving medications, to dispensing, packaging, processing, and administering. Ensuring procedures are in place to enhance patient safety, data integrity, and business continuity is a step that every facility should be working on daily.