The automation system is a combination system between computerization using barcodes as well as dispensing systems by machines. The automation system has been widely used in several hospitals in Indonesia, both for Outpatient Pharmacy and Inpatient Pharmacy services. But in reality, Hospital Pharmacy in Indonesia also experiences many obstacles and challenges, starting from the decision to choose an automation system to how to maintain the automation system in service to the maximum. Here are some parameters for getting started and getting to know the automation system in a hospital pharmacy:

• Get to know the Internal Pharmacy Service first 

Internal hospitals must understand several things internally, including the number of prescriptions per day, how much time it takes to complete 1 prescription, how much manpower or human resources are needed to complete the number of prescriptions, how are the patterns or habits of doctors in prescribing a drug, quality of pharmacy services for hospital visitors, types of drugs that are often prescribed, and other necessities. The hospital can also see the flow of patients coming to go home, whether the hospital has started an electronic prescription? And how is the payment process for outpatients.

            Phase 1 aims to assess the potential and self-capacity of the hospital pharmacy to find out whether manual or human services have reached saturation point. or it can be said that the pharmacy team always feels a lack of human resources or wants to add any number of people, the service will remain the same and even though they have done many ways, the service still has not reached the target time.

• Conducting a feasibility study to the planning system

Choosing the right type of machine as needed is the next step for the hospital to understand how much value to invest and what benefits are obtained. The types of machines available in Indonesia are Box Dispensing Machines for outpatient pharmacies, And Dose Dispensing Machines for inpatient pharmacies. Several types of machines can already help the work process from the start of taking to the automatic identification or labeling process.

             For outpatient pharmacy, there is indeed a machine that dispensing drugs in the form of a box, so the pharmacy needs to do more careful planning, for example in carrying out repackaging according to the pattern or habit of prescribing doctors for certain drugs. But for routine monthly drugs, or drugs for BPJS claims, generally the factory preparations can meet this need, 1 box for 1 month. In the calculation of the feasibility study the parameters that can be calculated as a benefit include the time saved when using the machine, the human labor saved, the number of dispensing errors that decrease due to the machine, the amount of stock or inventory savings, even how many potential recipes the machine can accept in time certain if the engine capacity can still be increased (the current number of recipes can still be fulfilled by a larger engine capacity). Some other values ​​are also that the computerized system makes everything easier in the process of re-filling stock, makes it easier in stock taking, and most importantly, there is an increase in psychology for the pharmaceutical team. When they have a system that makes their work easier, they are happier and more enthusiastic. at work. As a consideration of the costs that come out, you must calculate the investment in machines and the required attributes. If the hospital does not yet have other support systems such as servers, or electronic prescriptions, then this must also be started for the hospital so that the combination services from upstream to downstream can be maximized. Routine monthly equipment, service and accessories costs can also be included in the feasibility study calculation. Hospitals can start investments of varying values, starting from 2 billion to 8 or 9 billion having a dispensing robot system. When compared with the existing benefits and potential, this value is very fulfilling to run. Hospitals can work with distributors to get mutually beneficial solutions.

             For inpatient pharmacy, the available system meets national and international accreditation standards, namely administration in the form of a unit dose. The investment for inpatient machines is almost 2x the amount of outpatient machines because inpatient drugs are of more various types than outpatient drugs, so machines must also be more flexible in preparing drugs to become Dose Units. The benefits obtained are also greater, including the amount of human labor saved, compared to human labor. The speed of the UDD engine is also much faster than human power. Decrease in medication errors can also be minimized to the process of administering drugs to patients. At this stage the hospital may also consider starting a system of close loop medication management. The system aims to document all drugs starting from the reception, until the computerized administration of drugs to patients via barcode. From the profit, the UD machine will be worth investing in.

• Plan preparation and change management 

After the most crisis stage, namely the submission of funds, a plan must be prepared so that the implementation of the robotic system is successful, the stages that must be passed and the risks that may arise including how to overcome them. Using this robotic system, not only will the pharmacy team change, but the teams from other services will change, especially for the robotic in inpatient pharmacy. Prescription services from the upstream medical service team are recommended by electronic prescriptions, nursing services, downstream administration of inpatient care is also carried out electronically and all teams that can support computerized systems and systems for documenting and tracing systems.

            This process aims to provide an overview so that the hospital team can formulate the right strategy and steps so that all hospitals feel the echoes of this automation system.

• Continuos improvement and innovation

After making the right strategy and steps, it is time for the internal pharmacy team and even the hospital team to keep growing and innovating always with their new friends, the robotic system. One of the parts has been fulfilled and is resolved by robotic, other parts can still be developed. Innovations that can support them or improve the quality of their services can be felt by hospital visitors so that the image of the hospital can continue to improve.