From a clinical perspective, based on studies of lower internal validity, the use of bar-coding for medication dispensing systems, bar-coding for medication administration systems, and the simultaneous use of technologies reduced the risk of dispensing or medication errors in hospitals. Studies of previous models of profiled, ward-based automatic dispensing devices also reported benefits. One study showed an increase in error rate in a cardiac intensive care unit. We cannot reliably estimate the magnitude of benefit from pharmacy-based automatic dispensing devices because the studies were conducted using equipment that is no longer available for purchase or the studies used devices available in Europe. We cannot reliably estimate how automation affects the rate of potential adverse drug events, adverse drug events, morbidity, and mortality because these outcomes were not measured in most studies.
The implementation of a ward-based automatic dispensing device in a hospital can reduce costs while reducing error rates. This conclusion is only valid for medical-surgical patient care units.
The implementation of ward-based automatic dispensing devices in the intensive care unit results in a net increase in costs. This is due to the large capital expenditures that are incurred for a small number of patients. There is also uncertainty about the clinical impact of this type of automation in intensive care. The results are more robust for unprofiled rather than profiled systems. We cannot reliably estimate the economic impact of other technologies because of gaps in knowledge.
