By Matt Phillion
Automation in healthcare grows more present all the time. In the pharmacy, robotics and other automation systems now help us maintain inventories, dispense medications, and reduce time, cost, and errors. Because medicine cannot operate through these solutions alone, maintaining the human connection remains a priority. But how do we balance human and machine for the best patient outcomes?
“We’re inundated with buzzwords: ‘AI.’ ‘Robotics.’ ‘Technology is the future and is going to solve all the world’s problems,’ ” says Doina Dumitru, senior director of medical affairs at BD Medication Management Solutions. “But buzzwords are buzzwords for a reason. There’s a lot of promise, a lot of potential, but it’s a long road to travel.”
We’ve already seen glimmers of what a tech-enabled future can look like, says Dumitru, but we have some time before we reach what she calls the “George Jetson visions” of our dreams.
Dumitru, a pharmacist by training, has seen the meeting of technology and medication management both in frontline clinical practice and as a healthcare administrator. Today, BD’s Medication Management Solutions division is working to reinvent medication management by closing the gaps in the medication use process through integrated technologies.
“Technology has transformed most areas of healthcare practice and the delivery of care, but medication management remains very challenging to fully automate,” says Dumitru.
Partially, this is because the nature of the care itself makes medication management more complicated. Patients are sicker, and because of this, they are receiving advanced and expanded types of therapy.
“We’ve seen oral medications developed for diseases that could only be treated by complex IV therapies before, but the reality is that these new therapies need medication management resources to manage them,” says Dumitru.
Technology and automation are critical in managing treatments, but at the end of the day “healthcare is a human-driven occupation,” Dumitru notes. As such, new technology should “be a tool meant to empower the provider to be able to provide care in the most efficient, effective way possible.”
The pandemic has emphasized that medical technology is not just about the patient, but also about the clinicians who use it. “It doesn’t matter how good your robot is [or] how efficiently it can function,” says Dumitru. “If the clinician can’t use it effectively, then it won’t meet the needs it was designed for.”
Where technology is now
Dumitru was on the front line when the switch to electronic medical records (EMR) began in earnest, working for a pioneer organization that was encouraging their adoption.
“We’ve done an excellent job of getting paper records to go away,” says Dumitru. “EMRs were transformative for medication management, but the next piece was introducing a next wave of medical technology in terms of inventory management, especially on the hospital side.”
Dumitru used to teach a visual metaphor to her pharmacy students, where the drug compendium that used to fit in her lab coat pocket has tripled in size since she graduated pharmacy school.
“When you have that many drugs to manage in a population of patients that has expanded, technology has enabled us to deliver those drugs to the patients who need them,” says Dumitru. “But on the flip side, one of the biggest opportunities is with all that automation, all that technology, it brings in more data. We’re now at the point where we have so much data it’s overwhelmed our ability to use, analyze, or package it.”
The old way of tracking data, through spreadsheets and the like, is no longer feasible with two or three times more inventory SKUs for drugs. But with automation, analytics can enable healthcare providers—scientists at heart with a passion for data—to harness the data and uncover opportunities for better care.
Machine learning presents a major opportunity for analyzing and correlating the massive amount of data now available to providers. “As it stands, right now machine learning–enabled analytics is critical,” says Dumitru. “No amount of old-fashioned number crunching can match the efficiency of these new technologies. But machine learning is not simple. Machines don’t learn on their own. We still need humans to teach the machines so they can do what they do best.”
The other piece of the puzzle is software that supports clinician workflows and analytics needs. The industry needs software solutions to evolve to the point where they can support machine learning and more advanced artificial intelligence.
“And if we back up even further, software is what powers hardware. Our hardware has to evolve accordingly,” says Dumitru. “It’s one big ecosystem. You can’t develop one without the other.”
Enabling providers to do what they do best
When looking at the medical technology hardware of the future, it’s important to keep in mind that humans are the heart of healthcare delivery, notes Dumitru. The solutions and hardware we develop should automate what makes sense to automate.
“A simple example: One of the tasks we have to do a lot in the pharmacy is check for expiration dates on labels,” she says. “Today’s ecosystem doesn’t allow for that. It’s not just the tech … the labeling on our drugs doesn’t have the information encoded in a machine-readable format. It’s printed, and even the best optical scanners can’t leverage that information in this situation.”
Eventually, Dumitru notes, regulations will require barcodes, which should help the industry step forward. Checking expiration dates seems like a simple task, but it’s a time-consuming process for today’s pharmacy with 2,000 SKUs on the shelves. Robotics could take that process off humans’ hands.
Not every process is fit to be automated in this way, though. “There are things we would never want a robot or even the most sophisticated AI algorithm to handle,” she says. “For example, when a nurse needs assistance and is about to push a new IV drug into a vein, they call the pharmacist to be available at the drop of a hat to consult with them and urgently advise them on safe administration of the drug. We have to have humans working in tandem.”
In these cases, the professionals need to look at the patient and make judgment calls in seconds about administering the drug, potential side effects, and more. “The point of technology is to free up the clinicians to do the kind of work that directly impacts patients at the time of care,” says Dumitru. “The pandemic gave us a front-row seat for this kind of care.”
Technology empowers clinicians, though as an industry, healthcare can be somewhat afraid of the change technology brings. Effective change management can alleviate those fears and get providers comfortable with future-state technology.
“It’s really about teaching and enabling,” says Dumitru. “Talk to any pharmacist or nurse who deals with these medication management tasks and they’ll happily give up their rote pill-counting tasks. Framing it that way, the focus remains on allowing them to provide direct patient care. The technology enables them to practice at the top of their license.” When talking about new technology, it’s easy to lose that part of the message and forget about its impact on improving workflows.
Ultimately, Dumitru says, patient care is not autonomous. “It requires people, and as we look at the future of healthcare, we should ensure we have a connected medication management system that keeps the focus on the human beings that provide the care,” she says. “Robots don’t go to medical school.”
And this, in turn, refocuses on the patients, who need that human connection between themselves and their providers.
“If we learned one thing during the pandemic, it’s that we missed humans the most. We were immersed in technology,” says Dumitru. “And that’s what we hear from patients in hospital experience surveys. When they praise anything that goes well, they usually describe how the humans took care of them at their most vulnerable moments. As technology expands, as robotics evolve, and as we find new ways to use these tools, the ultimate goal is to augment, support, and empower healthcare workers to deliver timely, effective care.”
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at firstname.lastname@example.org.