UCSF Automated Robotic Pharmacy

Started by FutureDO2016
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FutureDO2016

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UCSF has implemented the automated robotic pharmacy recently and here is the video:

http://www.youtube.com/watch?feature=player_embedded&v=oumlYbwfAsI

How will this impact the role of the pharmacist in the years to come?

When will this technology spread? 30 years? 50 years?

Maybe pharmacists will counsel more since there is less verifying...

http://www.slate.com/articles/technology/robot_invasion/2011/09/will_robots_steal_your_job_2.html

Another interesting read...
 
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Old news. Robots and automated systems have been around for years, luckily our profession had the foresight to move away from dispensing roles and move toward clinical decision support and consultation roles.

Robots don't manage antibiotic therapy nor do they dictate/chart notes, and they don't interact well with other providers. I'm not talking about simple "hey is X compatible with Y" questions from nursing, either.

We have highly automated systems at my hospital and it makes my life easier, I'd want more automation if I had my way. More more more more more.

What I DO foresee is a Watson-like system that acts as surveillance when attached to large hospital systems that can root out patterns that are not conducive to care. You can tease out which prescribers aren't really following guidelines, which prescribers are not "within the norm" and perhaps even have it make recommendations for care in a more individualized way. Of course, for liability purposes, these robots/computers can't act independently...unless laws are changed, they will simply be tools, nothing more.
 
Robots can and will eventually be trained to do anything, they will even take over the role of highly self-esteemed physicians.

Didn't you watch the matrix?:naughty:
 
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And robots can do unassisted surgeries, what's your point? Should surgeons be shaking in their booties?
 
Watson can take the place of most MDs, so much cheaper and probably misdiagnose less. Just need to pass the laws so that Watson can prescribe.
 
Nothing will replace these brilliant pharmacists. They have earned their "doctorate" with hard work, years of research and clinical experience. :meanie:
 
Robots can't diagnose, treat, or perform surgeries although they can be useful tools in surgery. Ultimately, physicians and surgeons are irreplaceable but robotic dispensing systems can replace the pharmacist as in UCSF. Thus, the role of the pharmacist is evolving to do more patient counseling but even that should be done by a well trained doctor who has more knowledge in pathology, pharmacology and microbiology.
 
I absolutely love these things from both a tech/nerd perspective and from a pharmacist perspective as well. The especially cool ones can use arms to grab pill containers (cassettes) from a shelf, load themselves and then count and dispense the drug in unit dose blisters. So you don't have to even worry about basically anything when it comes to the dispensing process. When I started in pharmacy , pharmacist spent significant amount of time checking the techs unit dose packaging .. now, 8 years later, many hospitals have unit dose packaging machines and they don't typically make any mistakes.. some academic centers have fully automated dispensing which I imagine is even more awesome.

Automation in pharmacy is one of the better parts imho. Frees up pharmacist time to do clinical work and cuts expenses at the same time. On the retail side, I would rather have 2 techs and a robot (ie script pro) than 3-4 techs to supervise who might make mistakes and slow down my workflow. Robots also don't take much time off , don't get distracted and can't really be yelled at by customers. . Also you can berate them or blame them pretty easily when you need to let off steam lol.

Based on what you see in japan and other tech-intensive economies, ie rx vending machines, I think robots will probably make the pharmacy technician a thing of the past within a decade or 2.

Pharmacists and physicians, who actually need to make clinical judgements that can affect peoples lives in a real way will be replaced by robots too (maybe 50 years out still , who knows) but by then we will probably have no jobs left except for people who design AI to design more robots.. then it will be time to migrate to virtual consciousness. ..

Robots are a pharmacist's friend
 
FutureDO2016 said:
Robots can't diagnose, treat, or perform surgeries although they can be useful tools in surgery. Ultimately, physicians and surgeons are irreplaceable but robotic dispensing systems can replace the pharmacist as in UCSF. Thus, the role of the pharmacist is evolving to do more patient counseling but even that should be done by a well trained doctor who has more knowledge in pathology, pharmacology and microbiology.
Click to expand...

More knowledge in pharmacology, are you f...ing kidding me?
 
Dispensing robots are old news. They have been implemented in many large hospitals and trust me they have NOT replaced pharmacists or technicians even.

Plus, they can break down way too often and although rare can make mistakes.
 
confettiflyer said:
What I DO foresee is a Watson-like system that acts as surveillance when attached to large hospital systems that can root out patterns that are not conducive to care. You can tease out which prescribers aren't really following guidelines, which prescribers are not "within the norm" and perhaps even have it make recommendations for care in a more individualized way. Of course, for liability purposes, these robots/computers can't act independently...unless laws are changed, they will simply be tools, nothing more.
Click to expand...

I shadowed a med safety coordinator at a large tertiary institution and literally the only difference betwren her (+ software) and watson doing this is her picking which trends are statistically significant and packaging them into interventions (ie emails and powerpoints) and distributing it in a human and relatable way for practice. Watson could basically accomplish half of her job.. and then she would be just doing emails and chairing committees. In this case, AI / automation would really serve, again , to eliminate the mundane type tasks rather than the human element and final decision making.

I am excited about this type of clinical decision making aide. Human practitioners will be needed for a lot longer though. Even if they are basically given the answers to clinical questions by robots/software, which btw we basically are (ie decison support trees / software) at this point... the human "doctor" will need to pass final judgment. .. always. ......... until transhumanism becomes a reality that is.. but that is still longer than our careers will run
 
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so basically in 50-100 years, pharmacy technicians will be gone? And pharmacists will just stand there to answer questions?
 
type b pharmD said:
I shadowed a med safety coordinator at a large tertiary institution and literally the only difference betwren her (+ software) and watson doing this is her picking which trends are statistically significant and packaging them into interventions (ie emails and powerpoints) and distributing it in a human and relatable way for practice. Watson could basically accomplish half of her job.. and then she would be just doing emails and chairing committees. In this case, AI / automation would really serve, again , to eliminate the mundane type tasks rather than the human element and final decision making.

I am excited about this type of clinical decision making aide. Human practitioners will be needed for a lot longer though. Even if they are basically given the answers to clinical questions by robots/software, which btw we basically are (ie decison support trees / software) at this point... the human "doctor" will need to pass final judgment. .. always. ......... until transhumanism becomes a reality that is.. but that is still longer than our careers will run
Click to expand...

See I think it's great... especially when you see large consolidation with different healthcare entities and you have this TROVE of data that needs to be sifted through and it's impossible for a single person or even a committee (or not cost effective) to go through.

I even envision a national healthcare surveillance network that's checking national trends in real-time and can pick up things like outbreaks or other odd patterns...couple this with ICD-10 and you have the potential for a lot of things.
 
FutureDO2016 said:
so basically in 50-100 years, pharmacy technicians will be gone? And pharmacists will just stand there to answer questions?
Click to expand...

Yup...hell I do that now when you boil down the basics of my job (i guess you can count managing therapy under protocol = answering questions, if you stretch). The last time I actually verified a product leaving a central dispensing pharmacy was...i dunno, weeks ago?
 
If that's the case, wouldn't patients want to ask their doctor any questions or more information about their disease basically rendering the pharmacist an unnecessary gateway to drugs.
 
FutureDO2016 said:
If that's the case, wouldn't patients want to ask their doctor any questions or more information about their disease basically rendering the pharmacist an unnecessary gateway to drugs.
Click to expand...

physicians have time to do this? news to me.

from a corporate perspective, anytime i can reduce the need to pay for a hospitalist and shuffle work off to NP's, PA's, pharmacists, dieticians, other midlevels, etc...i'm gonna do it. physicians cost too much to be talked to at length by patients.

example... it's more cost effective to have a pharmacist manage anticoagulation than devoting a FT physician to do it.
 
FutureDO2016 said:
If that's the case, wouldn't patients want to ask their doctor any questions or more information about their disease basically rendering the pharmacist an unnecessary gateway to drugs.
Click to expand...

Disease? Hopefully. .. most patients don't ask enough questions.

Drugs? Most physicians don't know much about drugs beyond the boilerplate.. you guys take about 6 credit hours on it?
But a lot of physicians know some about drugs. They just aren't aware of how to distribute. But in the end its a question of time and allocation of resources. Provider time can't be rationally (ie cost effectively) spent chatting about anything really, especially as PPACA implements pay for performance ie cost/reimbursement cutting. The market already incentivizes providers to see as many patients as they can as efficiently as they can. In the future it won't be an incentive. It will be required to break even.

With automated dispensing systems the neighborhood pharmacist will be doing exclusively med management and counseling. Physicians won't be doing that because it would be a waste of their time, education, and their practice's money. Which is why you see most health organizations / large practices currently employing clinical pharmacists to fill this role. You better believe that Walgreens, cvs, kroger, etc are positioning themselves for this slice of the pie already.

Not sure if you've heard of something called "power" which is a newer Walgreen program where dispensing is done almost entirely by an offsite robotic warehouse which ships prescriptions to the store each day. In these stores the pharmacist still present and working full time, but on counseling and drug theraoy management. While we can't bill cms for this yet, many large private insurers are more than willing to cover our salaries and more , for doing counseling. Why? Because it improves outcomes and mortality beyond what physicians are capable of.

Automation couldn't come at a better time.
 
Speaking of automation.. we once saw a video about a robot that will travel to and from central pharmacy ( where it will fill itself with drugs with the help of an operator) and out onto patient floors/rooms and dispense patient-specific unit doses at the correct time.. help nurses with reminders, and then travel back.. it can ride elevators, memorize the hospital floor plan, take alternate routes, and avoid running into people/carts/beds.

Has anyone on here been lucky enough to work with one? I think they are only at a few academic centers so far.. but they sound awesome. I just Imagine it would feel silly to be riding an elevator and the door opens and a robot gets on with you and leaves on its own floor etc..
 
type b pharmD said:
Speaking of automation.. we once saw a video about a robot that will travel to and from central pharmacy ( where it will fill itself with drugs with the help of an operator) and out onto patient floors/rooms and dispense patient-specific unit doses at the correct time.. help nurses with reminders, and then travel back.. it can ride elevators, memorize the hospital floor plan, take alternate routes, and avoid running into people/carts/beds.

Has anyone on here been lucky enough to work with one? I think they are only at a few academic centers so far.. but they sound awesome. I just Imagine it would feel silly to be riding an elevator and the door opens and a robot gets on with you and leaves on its own floor etc..
Click to expand...
I don't remember if this was from here or one of my classmates that worked at a large medical center but apparently their policy was no other people can ride in the elevator with the robot
 
joetrisman said:
I don't remember if this was from here or one of my classmates that worked at a large medical center but apparently their policy was no other people can ride in the elevator with the robot
Click to expand...

Lol! For some reason I feel like I would always be waiting for it to run into walls or get stuck in a door etc
 
Man this guy is totally right. Physicians know so much more than pharmacists, why do pharmacists even exist? Hell, now that I think about it... Physicians are so much better than NPs, PAs, and RNs at what they do as well... Hell, the same goes medical assistants, lab techs, janitors, cafeteria workers, maintenance, IT, etc. Why do we need any of those people? Let's just have a hospital that employs ONLY physicians. Scrape obamacare, this is what we need to do to reform healthcare!
 
type b pharmD said:
Lol! For some reason I feel like I would always be waiting for it to run into walls or get stuck in a door etc
Click to expand...
I'm pretty sure I remember reading on here that somebody worked at a hospital with a robot that would get lost/stuck. Maybe it was Mikey? Can't recall.
 
Yes! It would ander into the cafeteria I think. Haha, I remember this robot discussion from a few years ago.
 
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