APhA 2025: Pharmacy Automation and Medication Management Insights

In an interview with Pharmacy Times®, Michelle Chui, PharmD, PhD, professor at the University of Wisconsin-Madison, discussed the complex role of automation in pharmacy medication management, highlighting her presentation at the American Pharmacists Association (APhA) Annual Meeting & Exposition.

Chui emphasized that automation goes beyond simple pill counting to include clinical decision support and inventory management. She highlighted the importance of implementing automation thoughtfully to support pharmacists' workflow and improve patient safety, rather than creating additional challenges. Chui explained that effective automation could help pharmacists save time and focus more on patient counseling and clinical services. The conversation explored various types of automation, from dispensing robots to radio-frequency identification (RFID) inventory tracking, and the need to carefully measure and evaluate technological interventions in pharmacy practice.

Pharmacy Times

How can automation improve medication management in a pharmacy, and what are the impacts on patient safety?

Michelle Chui

Medication management is such a big topic right now, it's very complex, and what we have to do is definitely a diversion from what it takes to just fill prescriptions, which primarily automation has been used to do. When you think about automation supporting medication management, I think there's so many different components to it. There's the actual automation about how can we support this work, but then the other question is, how do we implement it in a way that is thoughtful and contributes to the workflow for community pharmacists and hospital pharmacists as it is? I think that there's always this assumption that the work that we do as pharmacists is actually very linear and very simple. A lot of times when you think about automation, you can think about automation as pill counters as an automation, and that's a very simple automation. Then there's other more expansive, more elaborate, more complex automation, including electronic medical records, clinical decision support, that's a little bit more complex. When it comes to those types of automation, we really have to step back and think about, what are pharmacists doing, how are they doing it, and what do they need in order to be more successful? Sometimes automation can help pharmacists, and sometimes automation can actually make the work more brittle, which leads to pharmacists working around the system, and that's no better, right? So, I think that my point in here is that medication therapy management, medication management, is a good thing, but we really need to step back first and really understand how pharmacists can use automation before we implement it.

Pharmacy Times

What is an example of how automation is used in pharmacy practice-based research and what were the benefits?

Chui

There are so many different types of automation that can be used in pharmacy. Of course, there's automation to improve speed of dispensing, like robots, like counting machines, things like that. There's also automation and clinical support, health information technology to support the cognitive work that pharmacists do. Things like clinical decision support alerts can both help and hinder pharmacists doing the work they do. Then there's also areas in which newly prevalent in the workspace and pharmacy in the last decade are issues related to drug shortages, reducing wastage, trying to ensure that we are focused on expiration dates. This issue of inventory management is also an area that can really support pharmacy and the work that they're doing.

Pharmacy Times

How will automation change the pharmacist's role in patient counseling and clinical services?

Chui

Pharmacists are always talking about the fact that they don't have enough time to counsel patients. They don't have enough time to review the profile. They don't have enough time to really do the comprehensive assessment and evaluation that they want to do to really take care of their patients. Automation could be the answer. I say could, because not all automation, as I said, not all that glitters is gold. So, I think that there are opportunities to think very carefully about how automation can speed things up. For instance, there's a study done looking at using RFID codes to look at drug shortages ensure that the inventory is appropriate. In this study, it found that what took maybe 6 steps before with the advent of RFID reduced it to 2 steps. It reduced the amount of work that humans had to do in order to address this process. In some case, if automation can do that, then that's great. But again, you have to take a step back. You have to think really carefully about how to implement it in a thoughtful way. You have to ensure that the automation, or the health information technology, is usable and workable and successful and provide satisfaction to pharmacists in order to do that. Then maybe it can actually improve pharmacist work life.

Pharmacy Times

How would you measure the effectiveness of a new automated dispensing system in a pharmacy?

Chui

There's lots of different ways to do that. Obviously, from a pharmacist researcher perspective, I would love to partner with clinicians who are thinking about implementing these types of services, so that researchers can actually partner with clinicians right at the very beginning before they implement so that we can actually collect data before something is implemented. Either an automation or an alert system or something related to the electronic health record. We'd like to collect data ahead of time so that then we can evaluate the implementation of it, and then we can evaluate the effectiveness at the back end. So often, clinicians have these brilliant ideas about ways to improve their work life or ways to improve patient safety, they implement it and then they want to evaluate it at the end, but they didn't do enough work on the front end to try to ensure that there's actually change. From my perspective as a researcher, I would love to get in on the ground floor when these ideas are coming forward. So, then you can look at a longitudinal assessment, you can look at a pre post evaluation, and that includes all types of metrics. So, you can look at clinical metrics like reduction in blood pressure for your patients, or reduction in diabetes metrics for patients. You can look at efficiency metrics of how much time did pharmacists and technicians spend doing something. You can look at satisfaction scores of both not only the pharmacists and technicians, but also patients potentially, and looking at those kinds of things as well. But again, the focus is you have to be able to look at it from the very beginning and then be able to tell like we actually made a difference in this intervention. And so, thinking about supporting the clinical work from the very beginning is really critical, and where I would like to go forward.

Pharmacy Times

Is there anything you would like to add?

Chui

I just want to say that APhA has been a great venue for researchers and clinicians, both to come together to try to bridge and work together to improve practice. I hope that APhA continues to champion those opportunities.