Despite current use or planned implementation of AMDS in many Canadian hospitals, the evidence supporting the clinical harms and benefits, and cost-effectiveness is lacking. The systematic review suggested priority within the context of limited evidence and financial resources for unit dose drug distribution and computerized prescription systems along with consideration of AMDS. Limited observational data suggested that implementation of AMDS requires careful attention to processes to achieve the full potential of this technology. No studies were identified that addressed clinical or cost-effectiveness of AMDS.Significant initial and ongoing investment, in addition to planning and revision of medication processes for all users are required for the implementation of AMDS.