AUTOMATED MEDICATION ORDERING USING MEDICINES DISPENSING DATA AND A SOFTWARE ROBOT
European Statement
Selection, Procurement and Distribution
Author(s)
Linda Jeffery
Hospital Pharmacy Central Denmark Region
linjef@rm.dk
Why was it done?
Ordering medications manually takes time and is prone to human error. Since the electronic patient journal, MidtEPJ, holds detailed records of patients’ medication administration, the idea was to use that data to automate the ordering process. The vision was a system where medication use would automatically trigger a restocking order. As there is no direct interface between MidtEPJ and the pharmacy’s ordering system, Apovision, the project aimed to see if it was possible to transfer data between the two systems. As three (of the five) regions in Denmark use the same EPJ system, and all rely on Apovision, a successful pilot in Central Denmark Region could potentially be scaled nationwide.
What was done?
This project investigated whether it would be possible to automate medication ordering for a hospital ward’s standard stock by using dispensing data from MidtEPJ. A software robot (RPA) was developed to pull data from MidtEPJ and create a draft requisition in Apovision. The goal was to simulate an automated process that could ease manual workload, improve accuracy, and support better stock management.
How was it done?
The regional IT team worked closely with the pharmacy to design a workaround. Dispensing data were extracted from MidtEPJ, processed by the RPA, and used to generate a draft order in Apovision. A neurological ward was chosen for testing due to its single medication room and relatively consistent data. Fifteen medications were selected based on their high flow, dosage complexity, and formulation. The system triggered a draft order once a set usage threshold was reached. The process remained semi-automated to meet GDP standards and allow pharmacy technician oversight.
What has been achieved?
The robot successfully generated daily reports and draft orders based on documented usage. However, some discrepancies were found due to documentation habits, timing of data extraction, and product variations. The project showed, for the first time, that automated ordering is technically possible and that a link between MidtEPJ and Apovision can be created.
What next?
The concept is scalable, but further work is needed to improve data accuracy and system integration. With the right technical support, the model could be expanded to cover full inventories and be rolled out across other regions.
WHEN CRISIS BECOMES COLLABORATION: A NATIONAL RESPONSE TO COMPOUNDED MEDICINES SHORTAGES
European Statement
Introductory Statements and Governance
Author(s)
F.H. Nielsen
A.G Pedersen
L. Jensen
M. Kristoffersen
P. Stoffersen
T. P Dahl
Why was it done?
The shutdown significantly increased the risk of shortages for 271 compounded medicines, many vital for specialised treatments. To secure patient safety and equal access, a coordinated national approach was required to mobilise production capacity and set priorities. Due to the short shelf life of compounded medicines, it was crucial to establish a rapid national response to prevent critical shortages.
What was done?
Following the sudden shutdown of a compounding pharmacy, a national response was initiated. A joint online platform was established between the National Group for Compounded Medicines and the National Task Force for Medicine Shortages, both composed of representatives from hospital pharmacies. This platform consolidated data and decisions, ensuring planning through a national perspective. Based on the merged data, production was coordinated between remaining compounding pharmacies, both public and private, to ensure supply.
How was it done?
An online platform was established to track stock levels across hospital pharmacies, and clinical criticality was assessed on a 1–3 scale visualised with a colour code showing national coverage in days or weeks. Oral solutions with short shelf life were identified as top priority due to imminent stock depletion. Each product was reviewed for possible substitution, therapeutic alternatives, or justification for compounding. Short-term measures included extemporaneous preparation, while long-term strategies involved outsourcing, substitution, and redistribution of stock. Regular national meetings ensured the remaining two compounding pharmacies developed joint production plans, distributing workload and adjusting capacity.
What has been achieved?
This initiative demonstrates how hospital pharmacies, through national collaboration, can ensure resilience in crises. Within two months, nearly all medicines were reintroduced, substituted, or outsourced, and supply maintained without major safety incidents. The national approach included both public and private pharmacies, and their collaboration was strengthened.
What next?
The model provides a transferable framework for future shortages, proving that collaboration, shared data, and prioritisation tools can ensure patient safety and equity of access. The same model has since been applied to other critical shortages, confirming its broader value.
OPTIMIZING HOSPITAL PHARMACY STOCKS WITH CC-MPC (CHANCE-CONSTRAINED MODEL PREDICTIVE CONTROL) APPROACH
European Statement
Selection, Procurement and Distribution
Author(s)
S.Hajjaj,I.Bennani, S.Alaoui, A.cherif Chefchaouni ,S.El Deeb,S. Boufaress, Y.Hafidi, S.ElMerrakchi,F. Bandadi, B.Moukafih,A.El Kartouti
Why was it done?
Hospital pharmacies frequently face drug shortages due to unpredictable demand, long lead times, and budget constraints. Traditional reorder point policies are insufficient for handling stochastic consumption, and shortages can impact patient care. Applying predictive and probabilistic control methods allows for optimized decision-making, reduces unnecessary orders, and ensures higher service levels.
What was done?
A predictive inventory management framework based on CC-MPC is being developed and assessed through simulation to optimize hospital pharmacy stock levels under uncertainty .
How was it done?
The approach combines:
1. Data collection: Weekly consumption data of strategic drugs over a defined period, including average delivery times and historical stockout events.
2. Probabilistic modeling: A normal distribution is used to characterize demand uncertainty, with mean (μ) and standard deviation (σ) based on historical consumption data.
3. CC-MPC model parameterization: includes Safety stock thresholds, probabilistic stockout risk levels, constraints (storage,order, operational and economical) adapted to the hospital’s context.
4. Prospective simulation: generates optimized ordering plans over 6–12 month horizons, using rolling-horizon updates.
5. Practical integration: daily recalculation of optimal orders based on updated consumption data.
What has been achieved?
Based on previous simulation studies, the CC-MPC approach has the potential to reduce the number of orders by 40% and average stock levels by approximately 10%, while preventing stockouts over extended periods. Estimated annual budget savings ranged from 1 000 € to over 27 000 €, highlighting the possible benefits of implementing this predictive framework in hospital pharmacies.
What next?
Once the method tested and data collected,the next step is to transform the method into a software application, which can be integrated into pharmacy operations. This program is designed for practical hospital use. It aims to optimize stock management under real-world conditions.
UDI-BASED END-TO-END TRACEABILITY: A SMART APPROACH TO MEDICAL DEVICE MANAGEMENT
European Statement
Patient Safety and Quality Assurance
Author(s)
Andrea Piovanelli, Ivan Schimmenti, Enrico Almici, Paola Crosasso, Fabio Genestrone, Elena Toniato
Why was it done?
Medical devices’ traceability is a critical issue in hospital settings due to the high cost of devices and the need to associate item-patient-procedure. Standardized identification systems become fundamental to manage clinical risk, while addressing inefficiencies in inventory management, and minimizing waste from poorly monitored expiration dates. RFID-based solutions have been tested to implement identification and traceability with the promise of automating procedures and facilitating personnel activities, nonetheless their complexity and cost have limited their adoption so far. EU Regulation 2017/745 (MDR) introduced the requirement of native UDI (Unique Device Identifier) codes present on each medical device. As such, it is now possible to implement simple and cost-effective solutions for identification and traceability that do not require specific hardware or tedious relabeling procedures compared to RFID, and exploit 2D data carriers natively present on MDs.
What was done?
To implement a digital, end-to-end traceability system for medical devices using native UDI (Unique Device Identifier) codes, in compliance with EU Regulation 2017/745 (MDR). The objective is to improve patient safety, optimize inventory management, reduce operational costs, and ensure regulatory compliance without the need for relabelling and dedicated personnel.
How was it done?
The proposed solution leverages optical identification technologies and hands-free systems to automate device tracking from hospital entry to patient association. Smart cabinets manage inventory and access control, while smart baskets automatically link devices to patients. An AI-powered platform analyses data across all phases to support stock optimization, automatic reordering, structured reporting, and performance evaluation.
What has been achieved?
The system enables real-time inventory visibility, eliminates manual errors, improves device utilization. Avoiding costly, time-consuming and risky relabeling of MDs with RFID tags lowers implementation costs, minimizing environmental impact. Clinically, it enhances patient safety enabling rapid response to recalls and adverse events. Operationally, it streamlines logistics, reduces staff workload, and improves planning through AI-driven insights.
What next?
The adoption of an end-to-end UDI-based traceability system represents a significant advancement in medical device management. It delivers tangible benefits in terms of economic efficiency, clinical safety, organizational performance, and environmental sustainability. This innovative approach aligns with the digital transformation of healthcare and offers a scalable model for hospitals seeking to modernize their logistics and compliance processes
IMPLEMENTATION OF AN ATYPICAL MEDICATION ROOM TO OPTIMIZE MEDICATION MANAGEMENT AND REDUCE WASTE AT HERLEV GENTOFTE HOSPITAL, DENMARK
Pdf
European Statement
Clinical Pharmacy Services
Author(s)
Henrik Kjer, Christina Laustsen, Rasmus Riis, Caroline Rasmussen, Jeanette Bajrami, Christian Rubek, and Steffen Jørgensen
Why was it done?
An atypical medication room (AMR) was established at Herlev Gentofte Hospital, Denmark to centralize the storage and handling of medications not part of the standard assortment (i.e. atypical medication). The project aimed to improve the efficiency of medication management, reduce medication waste, and streamline workflows associated with the use of atypical medicines. To enhance the accuracy and efficiency of inventory control, the ScanPill technology was developed as a tool for digital tracking and updating of medication stock.
What was done?
Atypical medications are often stored across various departments with low turnover, leading to potential waste and time-consuming retrieval processes. Centralizing these medications in an AMR and using ScanPill aimed to reduce waste due to expiry, improve stock management, and simplify medication retrieval for healthcare professionals.
How was it done?
Atypical medications from multiple departments were collected and stored in the AMR. The ScanPill system was developed to facilitate the scanning of QR codes and barcodes on medication packaging, allowing for precise tracking of stock levels and easy updates to the atypical medication list. Staff were trained to use the AMR and ScanPill to ensure smooth transitions in retrieving, returning, and documenting atypical medicines. Regular inventory checks and updates were conducted to maintain an accurate database of available medications.
What has been achieved?
The AMR, supported by ScanPill, led to improved handling and management of atypical medications. The centralized storage reduced the need for duplicate stock across departments and enabled quicker access to necessary medications, reducing retrieval time and potential waste. The ScanPill technology improved inventory accuracy and streamlined the process of checking medication in and out, ensuring up-to-date records. Staff feedback has been positive, noting enhanced workflow efficiency and reduced medication waste.
What next?
Future steps include evaluating the economic impact of the AMR and its effectiveness in reducing medication waste. Efforts will be made to refine the use of ScanPill, enhance staff training, and explore potential applications of the AMR model across other departments. Continuous monitoring will ensure optimal performance and identify further areas for process improvement.
A HOSPITAL MEDICATION EXCHANGE SYSTEM – AN INVESTIGATION OF WASTE AND ECONOMIC IMPACT
Pdf
European Statement
Selection, Procurement and Distribution
Author(s)
(NFR) Nathalie Fogh Rasmussen
(MS) Maja Schlünsen
(JHPR) Joo Hanne Poulsen Revell
(LJK) Lene Juel Kjeldsen
Why was it done?
Exchanging medication stocks between hospital wards is a common method for reducing pharmaceutical waste at hospitals. However, the impact of such systems is unclear. Therefore, we aimed to calculate the annual economic cost savings after the establishment of a medication exchange system at the University Hospital of Southern Denmark in Aabenraa.
What was done?
A medication exchange system at a Danish hospital was evaluated according to avoidance of medication waste and potential economic impact.
How was it done?
For two weeks in February 2024, pharmaconomists registered all medications that were exchanged between six hospital wards representing 147 of 302 hospital beds. The quantity of the excess medications when returned was registered and the amount of pharmaceutical waste was calculated. This was compared to the amount of waste incurred by ordering a whole package for the ward. Moreover, the economic cost was calculated based on the value per package and compared to the economic costs of purchasing whole packages.
What has been achieved?
In total, 244 exchanges were registered. The pharmaceutical waste was estimated to 13-26%. The Department of Pulmonary Diseases, followed by the Department of Gastrointestinal Diseases, caused the greatest waste. The exchanged medicine had an economic cost of 3,566 DKK (478 euro). In comparison, the cost of purchasing whole packages was estimated to 21,042 DKK (2,822 euro). Thus, the total cost saving was ((21,042-3,566 DKK)x(52/2 weeks)=454,376 DKK (60,935 euro), corresponding to ((454,376/147) x 302)= 933,480 DKK (125,146 euro) for the entire hospital. The results led to establishment of a physical medication room to store the excess medication available for other clinical wards. All medications are registered electronically to support optimal use of excess medication throughout the hospital.
What next?
The economic evaluation may be replicated for comparable medication exchange systems at other hospitals, and thus, generate evidence for the economic and environmental impact of the system.
TRANSFORMING PHARMACY WORKFLOWS: APPOINTMENT-BASED CARE FOR ONCOLOGY AND HAEMATOLOGY PATIENTS
Pdf
European Statement
Patient Safety and Quality Assurance
Author(s)
ESTEBAN ALONSO, M TERESA; RODRIGUEZ FERNANDEZ, ZULEMA; ALAMO GONZALEZ, OLGA; GUTIERREZ FERNANDEZ, ISABEL; SANCHEZ LUQUE, LAURA; MARTINEZ TOMAS, PAULA; BENITO JUEZ, PILAR; ESPINOSA GOMEZ, M PAZ; GUEMES GARCIA, MAGDALENA.
Why was it done?
This initiative was arose from the need to improve the quality of pharmaceutical care (PC) and stock management to ensure adequate coverage for patients. Without appointments, it was challenging to align consultations with individual patient needs and to prepare medications for the time until the next visit, as patients arrived irregularly. Additionally, multiple patients on the same treatment would often visit on the same day, increasing the risk of stock shortages. This unpredictability led to inefficiencies in both patient care and stock management. The goal was to ensure a smoother patient flow, enhance PC quality, and improve stock control through scheduled visits.
What was done?
An initiative was developed to introduce a scheduled appointment system for Oncology and Hematology patients who need to collect medication from the hospital pharmacy. Previously, patients arrived without appointments, causing unpredictable patient flow and difficulties managing stock. The new system schedules patients around one hour after their medical consultations, with special arrangements for those on long-term stable treatments.
How was it done?
The main challenge was integrating the new appointment system into existing workflows in Oncology and Hematology. Close coordination between pharmacy staff, clinicians, and administrative personnel was essential. Patients were scheduled to pick up their medication around an hour after their consultations. Long-term patients, who need consultations every six months or more, were scheduled during less busy times, such as early mornings. This improved workload management in the pharmacy, ensuring more efficient and higher quality patient care. Effective communication with patients was key to overcoming early hesitation.
What has been achieved?
The system has resulted in a more predictable patient flow, leading to better PC quality through improved preparation and more efficient medication use, reducing shortages and surpluses. Patients now receive more personalized care, as workload is more balanced.
What next?
This initiative serves as an example of good practice, transferable to other hospital pharmacies and healthcare settings facing similar challenges. The next step is to verify patient satisfaction through surveys
GOOD PRACTICES TO MINIMIZE PHARMACEUTICAL WASTE IN HOSPITALS
Pdf
European Statement
Selection, Procurement and Distribution
Author(s)
SS Suvi Sivula, JN Jonna Niemi, KM Konsta Malmi, EA Elina Ahomäki
Why was it done?
In 2021, over 110,000 kilograms of pharmaceutical waste was produced at HUS Helsinki University Hospital, Finland (HUS). That was almost 2.5 million euros when the value of the medicines and the pharmaceutical waste management costs were considered. In 2022, HUS Pharmacy launched a project to reduce pharmaceutical waste, both for economic and environmental reasons.
What was done?
The goal was to reduce the annual pharmaceutical waste in euros and in kilograms at HUS, primarily at the Pharmacy. We also aimed to help departments to reduce their pharmaceutical waste.
How was it done?
The project group was formed of about 15 pharmacists and pharmacy technicians from different units of HUS Pharmacy, located in different areas in Southern Finland. The project team met monthly to review the costs and causes of pharmaceutical waste at the Pharmacy. The team discussed challenges, shared good practices and came up with ideas. In addition, departments were supported in reducing pharmaceutical waste with lectures, materials, videos etc.
During the project we found three main reasons for producing pharmaceutical waste: expired products, residues of cytotoxic drugs and compounding errors. To avoid these, we created a better overview on the whole stock of the Pharmacy, internal communication was increased, and products were moved more actively between units. Unit-specific procedures were also developed, collaboration with departments was increased, and published studies were used especially to reduce cytotoxic waste.
What has been achieved?
During the project, the annual value of wasted pharmaceuticals at the Pharmacy decreased from 928,000 euros (year 2021) to 507,000 euros (year 2023). In addition, the annual amount of pharmaceutical waste at HUS reduced from 112 000 kilograms to 101 000 kilograms. Also, the total cost of pharmaceutical waste at HUS, including the value of wasted pharmaceuticals, decreased.
What next?
The project team’s work has become a permanent part of our work instead of a project.
Collaboration between all healthcare workers is in a key role for reducing pharmaceutical waste. Waste cannot be completely avoided, but it can be reduced significantly, as our project has revealed.
Procedures must be developed further, for example early notifications from departments to the Pharmacy about changes in medical practices are critical for managing our stock.
Centralised DataMatrix reading for drug authenticity verification
European Statement
Selection, Procurement and Distribution
Author(s)
Leonor Romero, Paloma Lozano, Veronica Canales, Vanesa Dechado, Marta Puebla, Ricardo Villarubia, Isamar Gomez, Estefanía Ramírez, Juan Rodríguez, Belén Soto
Why was it done?
According to Directive 2011/62/EU, one of the measures is the inclusion in the secondary packaging of the drug of a Unique Identifier that allows the recognition of a unitary case at any point in the supply chain until it is dispensed to the patient. Another is the development of a European repository that allows the traceability of medicinal products for human use within the European market. In Spain, in accordance with Article 84.1 of Royal Decree 717/2019 of 5 December 2009, the SNSFarma Node was established as an instrument for technological integration and information exchange with the national repository known as the SEVeM.
What was done?
The logistics company of our hospital aggregates several codes corresponding to the Datamatrix of the individual containers in an electronic file, in order to send the reading automatically to Spanish Medicines Verification System (SEVeM).
How was it done?
The shipment of the drugs and the electronic file will be linked by the Seria Shipping Container Code (SSCC), which will univocally guarantee traceability between the two. The Pharmacy Service staff receive the delivery notes by reading the barcode without the need to scan the Datamatrix of each container.
Since the implementation of this project between July 2023 to September 2023, a total of 61 delivery notes have been registered under the code aggregation system with 27 suppliers involved. The number of packages read was 2151.
What has been achieved?
This project ensures the automatic sending of readings to SEVeM and to facilitate the reception of delivery notes at the Pharmacy Services by barcode reading.
This has allowed pharmacy staff to save time in receiving delivery notes, to improve traceability of batches and expiry dates of medicines, to improve stock control thanks to the confirmation of quantities received and to verify the medicines in accordance with European regulations to fight medicine falsifications and ensure that medicines are safe and that the trade in medicines is rigorously controlled.
What next?
A limitation is the existence of suppliers that are not involved in this project since their delivery is not done through the logistics company. In these cases, the datamatrix reading must be performed on each container individually.
Setting up automated dispensing cabinets in a cardiac surgery intensive care unit: what impact for the nursing team and the pharmacy?
Pdf
European Statement
Selection, Procurement and Distribution
Author(s)
MARIANNE DE LACROIX DE LA VALETTE
Why was it done?
Managing medications in hospitals is both a health and an economic issue.
Hospital pharmacists are working to improve supply, traceability, safety and stock management in order to meet these challenges.
Healthcare staff must be able to administer the medications prescribed to patients in complete safety, with the products available at the time of order. The management of medications within the department represents a significant amount of time that needs to be reduced.
What was done?
The objective of this study was to analyse the impact of deploying automated dispensing cabinets (ADC) in a cardiac surgery intensive care unit within a university hospital in France.
How was it done?
In 2022, an on-site study was conducted in the cardiac intensive care unit (18 beds) at Rennes University Hospital. The aim was to quantify the time allocated to manage medications before and after the installation of the automated dispensing cabinet.
Several types of measurable metrics were identified and compared. These include picking time for nurses of medications for administration to the patient; time allocated for ordering and storing medications; time to respond to emergency orders; management of narcotics; and time in the management of expired medications.
What has been achieved?
A comparison of the pre and post installation of the automated dispensing cabinet showed nursing time savings in the picking of controlled drugs of 53%. Overall restocking time was decreased by 9%. The number of urgent order requests to pharmacy was decreased by 51%.
The time allocated towards removing expired medications was reduced by 3.8 days / year (nurse FTE). Lastly, the implementation of automated dispensing cabinets reduced the value of the department’s stock by 26%.
What next?
The time spent by nurses in managing medications was significantly reduced after the installation of automated dispensing cabinets. However, some of this time is transferred to the central pharmacy towards restocking the medications into the automated dispensing cabinets.
The automated dispensing cabinets makes it possible to monitor the stock of medicines in a department on a daily basis. This enables for data driven decision making on selection of decentralized stock and respective quantities to maintain.
The deployment of automated dispensing cabinets improves overall efficiencies and allows more time for nurses to provide direct patient care.