Pharmacy 4.0 – Applying Industry 4.0 Principles to Create the Smart Pharmacy

Posted on December 5, 2017

By Craig Boyce, Director of Professional Services

Does your morning pharmacy management report include issues with errors and turn-around time, new budget cuts and regulatory standards, more supply shortages, and holes in every shift because of sick calls?  If you look at industrial manufacturing, you might be surprised to see the same list – none of these are unique to the practice of pharmacy.  Every industry faces similar challenges, and pharmacy adds the additional challenge of ensuring safety 24/7/365 for our patients.  A single point of failure in the pharmacy operations chain can have serious consequences.

If we look at how manufacturing has addressed these problems, we find that achieving reliably high quality at the lowest cost has entailed a continuous evolution process.  Manufacturing has seen four revolutions in process – from the first revolution that introduced simple mechanization through more complex methods to reach today’s fourth revolution. Automated production systems introduced in the third revolution are becoming increasingly interlinked and generate huge amounts of data related to accuracy, productivity, efficiency, and cost.  The Industry 4.0 concept uses data analytics and cyber physical systems to create Smart Factories that have autonomous control of production and yield high-quality output that is responsive to market demands and at a cost that provides greater value to the company than traditional manufacturing methods.

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Pharmacy and manufacturing share many core characteristics because both transform raw materials into finished goods. Both pharmacy and manufacturing are driven by demand for a particular product which varies seasonally and the process must be able to respond quickly to changes in demand.  Both use complex processes that require raw materials and labor to be readily available.  Both need the end product to have a high degree of reliability (accuracy) and precision.  Finally, all this must be accomplished at the lowest possible cost.

Automation is one of the key parts in the manufacturing evolution, but it is vital to understand that automation is only an enabler of the goals.  Along with automation, some of the other components include changing workflows, quality-driven process designs, active use of analytics, and flexibility to meet changing demands.  An important feature is the concept of “information” which is aggregated data and contextual details that enables problem-solving and decision-making.   Industry 4.0 is founded on four principles that when combined enable a system that is agile and efficient without requiring constant human guidance.

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  • System Interoperability – Ability of humans and machines to seamlessly communicate information (data analyzed within its context) in a meaningful manner
  • Information Transparency – a digital representation of the physical world by integrating sensors and real-time data with contextual information
  • Technical Assistance – Use of automation to perform tasks and create information about the process for human decision-making
  • Decentralized decisions – Ability of systems to perform autonomously without direction from humans and adjust outputs or processes in response to new information

If pharmacy and manufacturing have strong similarities, could we apply the Industry 4.0 principles to create a Pharmacy 4.0 model for the Smart Pharmacy?   Let’s take a high level view of the sterile preparation process to consider this possibility.  The pharmacy needs to have medications at the patient location when they are needed for administration.  Ideally, the preparation occurs as close as possible to the time that the delivery needs to leave the pharmacy.  To make this happen, planning and scheduling is used to have materials and labor on hand to prepare and deliver the doses just when they are needed.  For faster turn-around time, common preparations are batched in advance and stored in a ready-to-dispense condition.

Each of these processes today may occur in isolation and using disparate systems that are unaware of each other.  In the Pharmacy 4.0 world, these interconnected processes would occur based on data and feedback from the multiple systems we already use today – electronic health records that contain active and future orders, smart infusion pumps, IV workflow management and automated compounding systems, location-aware robotic delivery systems, and automated inventory control systems.  With Pharmacy 4.0, the process might look like this:

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This Pharmacy 4.0 model uses automation and analytics to constantly update the processes in real time to ensure medications are where they should be when needed for administration, and that the supplies to prepare the doses are at hand in the right place at the right time.  The automation systems to enable Pharmacy 4.0 are already in existence and the technology to tie the disparate systems together are well-established in both healthcare and other industries.  Like other industries, health care today is under pressure to contain costs, improve quality, and become more flexible in delivery of services.  By adopting the Pharmacy 4.0 model, the benefits that have been seen in manufacturing can be realized in health care.  We already have adopted “best practices” for clinical care of patients and now it is time to embrace “next practices” for pharmacy operations.

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