The new pharmacy is the hub of the University of California, San Francisco (UCSF; USA) integrated medication management system, combining a state-of the-art technology with personalized care. The facility is housed in a tightly secured, sterile environment, with an automated system that prepares oral and injectable medicines, including toxic chemotherapy drugs. In addition to providing a safer environment for pharmacy employees, the automation also frees UCSF pharmacists and nurses to focus more of their expertise on direct patient care.

Once computers at the new pharmacy electronically receive medication orders from UCSF physicians and pharmacists, the robotics pick, package, and dispense individual doses of pills. Machines assemble doses onto a thin plastic ring that contains all the medications for a patient for a 12-hour period, which is bar-coded. Nurses will be able to use barcode readers to scan the medication at patients' bedsides, verifying it is the correct dosage for the patient. In addition, the new pharmacy system offers a training ground for pharmacy students in the medication distribution systems of the future.

The automated system also compounds sterile preparations of chemotherapy and nonchemotherapy doses and fills intravenous (IV) syringes or bags with the medications. An automated inventory management system keeps track of all the products, and one refrigerated and two nonrefrigerated automated pharmacy warehouses provide storage and retrieval of medications and supplies. Not a single error has occurred in the 350,000 doses of medication prepared during the system's phase in period.

"The automated pharmacy streamlines medication delivery from prescription to patient," said Lynn Paulsen, PharmD, director of pharmaceutical services at UCSF Medical Center. "It was important to develop a system that is integrated from end to end. Each step in safe, effective medication therapy - from determining the most appropriate drug for an individual patient to administering it - is contingent on the other."

"UCSF led the way in training clinical pharmacists, who focus on the patient rather than the drug product," added Mary Anne Koda-Kimble, PharmD, dean of the UCSF School of Pharmacy. "Automated medication dispensing frees pharmacists from the mechanical aspects of the practice. This technology, with others, will allow pharmacists to use their pharmaceutical care expertise to assure that patients are treated with medicines tailored to their individual needs."

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