Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE The Utilization o Auto!ation in Pha"!a#$ P"a#ti#e An A%%e%%!

ent o it% &ene it Mi#hele Mou"a No"thea%te"n Uni'e"%it$

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE A)%t"a#t In thi% anal$%i%* the )ene it o the utilization o +ha"!a#$ "o)ot% in +"a#ti#e i% a%%e%%ed th"ough %#hola"l$ e'iden#e, The hi%to"$* e%ta)li%h!ent* and #la%%i i#ation o +ha"!a#$ "o)ot%

a"e int"odu#ed* and thei" i!+le!entation in +ha"!a#$ +"a#ti#e toda$ i% de+i#ted, A loo- i% ta-en at thei" !ean% o a##o!+li%hing ti!eline%% and e i#ien#$ in a #o!!unit$ %etting* a% .ell a% thei" #a+a#it$ to !ini!ize !edi#ation e""o"% in the ho%+ital %etting, The un#tioning o an auto!ated di%+en%ing unit i% de%#"i)ed* and the #a%#ade o +o%iti'e e e#t% that %aid di%+en%ing unit ha% u+on the .o"- lo. o the +ha"!a#$ i% na""ated, To #on#lude the anal$%i%* the utu"e o auto!ation i% %+e#ulated u+on* and in%ight in a'o" o the a"gu!ent o" in#"ea%ed u%age o auto!ated di%+en%ing unit% in +ha"!a#$ +"a#ti#e i% +"e%ented,

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE

The ield o +ha"!a#$ i% one that .a""ant% the d"i'e o" +e" e#tion, E'en the !o%t !inute !edi#ation e""o"% !u%t )e a'oided at all #o%t%* in o"de" to !a0i!ize +atient %a et$ and au%+i#iou% +atient #a"e out#o!e%, The +ha"!a#$ !u%t un#tion at a "a+id +a#e* %o that all +atient% a"e %e"'ed .ith the ut!o%t #a"e and a"e +"o'ided .ith thei" ne#e%%a"$ !edi#ation%, The need o" thi% #o!+"o!i%e o "a+idit$ and a##u"a#$ #an %o!eti!e% )e di i#ult to a#hie'e in the de!anding en'i"on!ent o a #ontinuall$ un#tioning +ha"!a#$ unit, 1hen a te#hni#ian2% e$e% a"e a'e"ted to the ."ong %t"ength o a d"ug on the %hel * o" he3%he inattenti'el$ +la#e% the ."ong la)el on an a!)e" 'ial* +"odu#tion ti!e i% not onl$ o"%a-en* )ut +atient %a et$ i% "i%-ed, It i% .ith the int"odu#tion o +ha"!a#$ auto!ation that +"o e%%ional% ha'e %u##eeded in le%%ening the%e unde%i"ed in%tan#e% o e""oneou%ne%%* and ha'e )een a)le to %ee an u+%u"ge in the e i#ien#$ o the +ha"!a#$ +"a#ti#e a% a .hole, Pha"!a#$ "o)ot% hel+ to o"! the #o!+le0 un#tioning unit o the +ha"!a#$, The$ allo. +ha"!a#$ %ta to #o!+lete ta%-% in a !o"e e i#ient and ti!el$ !anne" than .a% +o%%i)le )e o"e the in#o"+o"ation o thi% auto!ation, In one da$ o +"e%#"i+tion +"o#e%%ing at the +ha"!a#$* an auto!ation unit #an e!it hund"ed% o illed +"e%#"i+tion% that .ould othe".i%e ha'e to )e hand #ounted )$ a te#hni#ian, 1hile the "o)ot% a"e 'alued o" thei" a%%i%tan#e* it "e!ain% +o%%i)le that the$ #an at ti!e% )e the #ul+"it in in%tan#e% o e""o", It i% u+ to +ha"!a#$ tea! !e!)e"% to lea"n to .o"- .ith thi% te#hnologi#al ad'an#e!ent in %u#h a .a$ that a##entuate% it% )ene it%* .hile !ini!izing it% %ho"t#o!ing%, Ro)oti# ad'an#e!ent ha% had a %u)%tantial +"e%en#e in indu%t"$ %in#e the eighteenth #entu"$, An ea"l$ de inition o "o)oti#% i% "ooted in the +"in#i+le o indu%t"ial auto!ation* .hi#h "e'ol'e% a"ound the )a%i# %tanda"d that i% "edu#ing 4#o!+le0it$ and #"eati'it$ in the la)ou" +"o#e%% )$ %u)%tituting !a#hine% o" hu!an la)ou"5 6&a""ett* M, et, al,* (711* +, /8, A% "o)oti#

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE

inno'ation ha% +"og"e%%ed into the health#a"e ield* it% o#u% on auto!ation and the la)o" +"o#e%% ha% %igni i#antl$ de#"ea%ed* and 4+%$#hologi#al and #ogniti'e +e"%+e#ti'e% that e0+lo"e "o)ot %o#ia)ilit$ and hu!an:"o)ot inte"a#tion* "e le#ting the in#"ea%ed +"e'alen#e o +"o e%%ional and +e"%onal %e"'i#e "o)ot% in the .o"-+la#e*5 6&a""ett* M, et, al,* (711* +, /8 a"e )e#o!ing in#"ea%ingl$ +"edo!inant, The auto!ated di%+en%ing unit% that .ill )e di%#u%%ed in thi% anal$%i% #an )e +"i!a"il$ #ha"a#te"ized a% +"o e%%ional %e"'i#e "o)ot%* in that the$ a"e lo#ated .ithin a +"o e%%ional %e"'i#e %etting and aid +ha"!a#i%t% in the di%+en%ing o !edi#ation%, The utilization o "o)ot% in +ha"!a#$ +"a#ti#e ha% allo.ed o" ad'an#e!ent and "i%ing e i#a#$ in the +"o e%%ion, A% the%e "o)oti# te#hnologie% #ontinue to de'elo+* the +"o e%%ion .ill e0+e"ien#e alte"ation%* .hi#h .ill #ontinue to de ine and %ha+e the !ethod% o +"a#ti#e, Thi% i% illu%t"ated 4;in< the #a%e o health#a"e o"ganization%* ;.he"e< "e%ea"#he"% ha'e ound that te#hnologie% #an o##a%ion %hi t% in ta%-%* "ole%* and "elation%* +"odu#ing ne. +atte"n% o inte"a#tion a!ong o##u+ational g"ou+%5 6&a""ett* M, et, al,* (711* +, 98, Th"ough the i!+le!entation o the%e aid% in the di%+en%ing o !edi#ation* the i!+li#ation% o "o)oti# inno'ation% o" the natu"e and )ounda"ie% o the +"o e%%ion #an )e "e'ie.ed* a% .ell a% te%ted, Ti!e !anage!ent i% e%%ential in attaining o+ti!u! e i#ien#$ in the #o!!unit$ +ha"!a#$ +"a#ti#e, The"e a"e nu!e"ou% ta%-% that !u%t )e #o!+leted )oth ha%til$ and %i!ultaneou%l$ th"oughout a da$ o o+e"ation, P"e%#"i+tion% !u%t )e +"o#e%%ed and +atient% !u%t )e #ontinuall$ a%%i%ted )$ a +ha"!a#$ tea! !e!)e", In o"de" o" !edi#ation% to +"o+e"l$ )e di%+en%ed to +atient%* the !edi#ation !u%t i"%t )e o)tained "o! the %hel and %#anned o" a##u"a#$= it i% then to )e #ounted )$ a te#hni#ian and +a%%ed on to the +ha"!a#i%t o" the inal #he#-, Thi% not onl$ "e>ui"e% ti!e* )ut o#u%, It i% +e"tinent to the %a et$ o the +atient* a% .ell a% the %ta)le .o"- lo. o the +ha"!a#$* that the te#hni#ian e0hi)it% ine a##u"a#$ in hi%3he"

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE "et"ie'al* #ounting* and +a#-aging o the !edi#ation%, It i% th"ough the u%e o auto!ation unit% in the #o!!unit$ +ha"!a#$ that +ha"!a#$ tea! !e!)e"% a"e a)le to attain a a%te" +a#ed and !o"e e""o":"idden .o"- lo., Pha"!a#$ "o)ot%* %u#h a% the @#"i+tP"o @P:(77 a%%i%t in thi% in#"ea%e in e i#ien#$* allo.ing o" +ha"!a#$ tea! !e!)e"% to +la#e !o"e e!+ha%i% u+on +atient inte"a#tion and a%%i%tan#e* "athe" than the !onotonou% a#ti'it$ o +"e%#"i+tion illing, Re%ea"#he"% "o! the Ai'i%ion o Pha"!a#$ P"a#ti#e and Ad!ini%t"ati'e @#ien#e%* College o Pha"!a#$* Uni'e"%it$ o Cin#innati +e" o"!ed a %tud$* .hi#h anal$zed the e e#t%

that in%tallation o the @#"i+tP"o @P:(77 had u+on an inde+endent +ha"!a#$ 6Lin* A, C,* Huang* Y, C,* Pun#he%* B,* Chen* Y,* (77C* +, 1D/(8, The %tud$ utilized a +"ein%tallation and +o%tin%tallation e'aluation o thi% auto!ated +"e%#"i+tion: illing %$%te!, Th"ough the u%e o 'ideota+ing and .o"- %a!+ling te#hni>ue%* "e%ea"#he"% #olle#ted the +"ein%tallation and +o%tin%tallation data o the @#"i+tP"o @P:(77, The data a%%e%%ed and #o!+a"ed in#luded the u%e o the +ha"!a#$ %ta and the ti!e %+ent in di"e#t and indi"e#t +"e%#"i+tion: illing a#ti'itie% )e o"e and a te" the u%e o @#"i+tP"o "o)oti#% .a% initiated, The "e%ult% o the %tud$ indi#ate that thi% auto!ated +"e%#"i+tion: illing %$%te! +"o'ided %igni i#ant a%%i%tan#e in "elation to +"e%#"i+tion +"o#e%%ing, &e o"e in%tallation o auto!ation* the di"e#t and indi"e#t +"e%#"i+tion: illing ti!e% u%ed .e"e E,7C and (,11 !inute%* "e%+e#ti'el$* to #o!+lete the %te+% "e>ui"ed to ill one +"e%#"i+tion, In an e'aluation o the a'e"age ti!e %+ent +e" +"e%#"i+tion* it .a% #on#luded that the in%tallation o auto!ation #ould %a'e nea"l$ 7,(( !inute +e" +"e%#"i+tion, The ti!e "e>ui"ed to +h$%i#all$ ill the +"e%#"i+tion %igni i#antl$ de#"ea%ed "o! (,E/ to (,7C !inute% .ith an a'e"age o 7,?E !inute %a'ed, It .a% al%o noted that the"e .a% a %tati%ti#all$ #on%ide"a)le di e"en#e in "ega"d to the +e"#entage o ti!e that +ha"!a#$ tea! !e!)e"% .e"e a)le to %+end on di e"ent a#ti'itie% in #onFun#tion .ith the

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE in%tallation o auto!ation 6Lin* A, C,* Huang* Y, C,* Pun#he%* B,* Chen* Y,* (77C* +, 1D/(8,

1hile it i% ne#e%%a"$ o" a +ha"!a#$ %ta to )e#o!e a##li!ated to the u%e o a +ha"!a#$ "o)ot in o"de" to o+ti!ize the e i#ien#$ it "e>ui"e%* it #an $ield g"eat "e%ult% in te"!% o an i!+"o'ed .o"- lo. .hen i!+le!ented into +"a#ti#e, 1hile !edi#ation e""o"% #an )e det"i!ental in all +ha"!a#$ %etting%* the$ a"e !o"e li-el$ to )e "e#ognized in #o!!unit$ +ha"!a#$ +"a#ti#e due to the %e'e"al %te+% and +ha"!a#$ %ta !e!)e"% a +"e%#"i+tion !u%t go th"ough )e o"e it i% di%+en%ed= ho.e'e"* in the a%t +a#ed and o ten u"gent at!o%+he"e o an in+atient +ha"!a#$* !i%ta-e% #an )e !o"e li-el$ to o##u" and go unnoti#ed, To !aintain the integ"it$ o the t"u%ted +"o e%%ion o +ha"!a#$* it i% 'ital that !edi#ation e""o"% a"e !ini!ized to the g"eate%t deg"ee +o%%i)le, The u%e o auto!ated di%+en%ing unit% in the ho%+ital %etting #an hel+ to +"o!ote and a#hie'e a##u"a#$ in +"o'iding +atient% .ith the #o""e#t !edi#ation, A %tud$* .hi#h a%%e%%ed the i!+a#t o auto!ated di%+en%ing !a#hine% on %a et$* e i#ien#$* and %ta %ati% a#tion* .a% #ondu#ted in a UG ho%+ital %etting )$ "e%ea"#he"% o the (77D Ro$al Pha"!a#euti#al @o#iet$ o B"eat &"itain 6F"an-lin* &, A, et, al,* (77D* +, 9C8, A "o)ot .a% in%talled at ea#h o the ho%+ital2% t.o %ite% at the initiation o the e'aluation: a @.i%%log Pa#- Pi#-e" at %ite 1 and a Ro.a @+eed#a%e at %ite (, Aata .a% then #olle#ted in "ega"d to di%+en%ing e""o"% identi ied at the inal:#he#- %tage* a% .ell a% in "ega"d to the ti!e ta-en to la)el* +i#-* and a%%e!)le di%+en%ed ite!%, The "o)ot allo.ed o" a %igni i#ant de#"ea%e in di%+en%ing e""o"% on ea#h %ite, The +e"#entage o e""o"% de#"ea%ed "o! (,C to 1,7 o di%+en%ed ite!% on %ite 1* and "o! 1,( to 7,E on %ite (, The"e .e"e "edu#tion% in the ti!e "e>ui"ed to +i#ite!% o" di%+en%ing* )ut "edu#tion% gene"all$ o##u""ed in e""o"% in'ol'ing ."ong #ontentHit i% e""o"% o thi% natu"e that #an +o%e the g"eate%t dange" to +atient%, It .a% ound that th"ough

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE in%tall!ent o an auto!ated di%+en%ing !a#hine* the"e .e"e !aFo" )ene it% in te"!% o "edu#ed di%+en%ing e""o"%* "edu#ed +i#-ing ti!e%* and in#"ea%ed o'e"all %ta %ati% a#tion inde+endent o the t$+e o "o)ot utilized 6F"an-lin* &, A, et, al,* (77D* +, 9C8, In e'aluating the e'iden#e +"o'ided* it a++ea"% that an in#"ea%e in +ha"!a#$ "o)ot u%e #an hel+ !edi#al +"o e%%ional% in thei" endea'o" to a'oid !edi#ation e""o"% in +"a#ti#e, In +ha"!a#$ "o)ot%2 a)ilit$ to in#"ea%e e i#ien#$* a% .ell a% a##u"a#$ in the +ha"!a#$ %etting* +"o e%%ional% a"e a)le to utilize thei" ti!e in .a$% that a"e !o"e e e#ti'e and +e"%onalized o" the +atient, An a'e"age auto!ated di%+en%ing unit o+e"ate% )$ "et"ie'ing +"e%#"i+tion in o"!ation "o! the +ha"!a#$2% ho%t #o!+ute"* %ele#ting an a++"o+"iatel$ %ized 'ial o" illing* %ele#ting the #o""e#t %olid o"al !edi#ation "o! a )an- o %to"age #a%%ette%* #ounting the do%age o"!%* illing the 'ial .ith the di%+en%ed ite!%* and la%tl$* +la#ing the 'ial on a #a"ou%el o" la)eling and deli'e"$ to the +atient, The +ha"!a#i%t i% then "e>ui"ed to #he#-

the +"e%#"i+tion o" a##u"a#$ )e o"e the !edi#ation i% to )e di%+en%ed to the +atient, &$ %a'ing the +ha"!a#i%t and the te#hni#ian% the t"ou)le o #o!+leting thi% illing +"o#e%% )$ hand* the"e i% !o"e ti!e to a%%e%% a##u"a#$ el%e.he"e in the +ha"!a#$, Fo" e0a!+le* in a #o!!unit$ +ha"!a#$ %etting* e""o"% a"e o ten !ade .hen hu""$ing to in+ut a +"e%#"i+tion into the #o!+ute" %$%te!, Thi%* )eing the initial %te+ in the +"e%#"i+tion: illing +"o#e%%* #au%e% a nota)le %et)a#- in te"!% o ti!eline%% .hen it #o!e% to )eing o"#ed to !a-e thi% #o""e#tion in "e illing the "e'i%ed +"e%#"i+tion= ho.e'e"* i one doe% not ha'e to allo#ate the ti!e to +h$%i#all$ ill the +"e%#"i+tion* thi% +"o'ide% hi!3he" .ith the ti!e to en%u"e he3%he ha% de initi'el$ in+ut the #o""e#t in o"!ation into the %$%te!, &$ a'oiding e""o"% ea"l$ in the .o"- lo. that #o!+"i%e% the +"e%#"i+tion +"o#e%%ing unit* the +ha"!a#$ tea! i% a)le to un#tion in a !u#h !o"e +atient o#u%ed natu"e, Pha"!a#i%t% a"e a)le to #on#ent"ate on the #oun%eling o +atient%* "athe" than the "e'e"%al o

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE un a'o"a)le hu!an e""o", Te#hni#ian% a"e a)le to +"o'ide +atient% .ith thei" !edi#ation% in a ha%t$ a%hion* "athe" than deal .ith the "e+e"#u%%ion% o +atient di%%ati% a#tion, 1hile one #an a"gue that "o)ot% #an %e"'e a% a %ou"#e o unnoti#ed e""o"* and that

+ha"!a#$ tea! !e!)e"% !a$ +la#e e0#e%% t"u%t into thei" +"e#i%ion* thei" e e#ti'ene%% i% t"ul$ a "e%ult o ho. the$ a"e i!+le!ented in +"a#ti#e, 1hil%t %tudie% ha'e %ho.n that "o)ot %$%te!% #on%i%tentl$ +"odu#e ze"o di%+en%ing e""o"% 6&ea"d* R, I,* @!ith* P,* (71/* +, 18* one #an %till di%+ute that it i% +o%%i)le o" a %t"a$ +ill to all into an in#o""e#t %e#tion .ithin the !a#hine* #au%ing it to #onta!inant an othe".i%e #o""e#t +"e%#"i+tion, 1hile an$ o"! o ad'an#e!ent #an )e e0hi)it a##idental !o!ent% o e""o"* it i% the Fo) o +ha"!a#i%t% and thei" tea! to )e o)%e"'ant o %u#h +otentialitie%, In thi% .a$* the u%e o auto!ation allo.% +"o e%%ional% to !aintain the %tanda"d o high o#u% and attention that o"!% the +"e#i%ion o the +"a#ti#e, P"o e%%ional% !u%t "e!ain 'igilant .hen u%ing thi% ad'an#ed te#hnolog$* o" 4;auto!ation< i% a %+e#i i# t$+e o te#hnolog$ that di"e#tl$ a e#t% the o"ganization2% de%ign* intelligen#e* de#i%ion:!a-ing* and +e" o"!an#e, Managed #a"e ad!ini%t"ato"% need to +"e+a"e thei" de+a"t!ental unit% o" the d"a!ati# e e#t% o te#hnolog$ to en%u"e the a##e+tan#e o auto!ation )$ +"o e%%ional #a"e gi'e"% and %ta !e!)e"%5 6@zein)a#h* @, L,* Ta$lo"* T, H,* Billen.ate"* E, L,* 1JJ?* +, 1(E8, A% +ha"!a#$ %ta )e#o!e #o! o"ta)le .ith the u%e o %u#h auto!ation and gain an a.a"ene%% o it% li!itation%* 4auto!ated di%+en%ing te#hnologie% .ill ;)e a)le to< hel+ !anaged #a"e o"ganization% o#u% on o+e"ational e i#ien#$* allo.ing health#a"e +"o e%%ional% to o#u% on +atient:#a"e o+ti!ization5 6@zein)a#h* @, L,* Ta$lo"* T, H,* Billen.ate"* E, L,* 1JJ?* +, 1(E8, The utu"e o +ha"!a#$ +"a#ti#e hold% g"eat +otential o" in#"ea%ed auto!ation and le%% hu!an inte"'ention in "e+etiti'e* $et ne#e%%a"$ ta%-% that a"e an indi%+en%a)le +a"t o the +ha"!a#$ .o"- lo. and !edi#ation +"o#e%%ing, 1hile auto!ation allo.% o" a !o"e "a+id

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE

+"o#e%%ing o +"e%#"i+tion%* one !u%t .onde" ho. a de#"ea%ed need o" hu!an inte"'ention .ill a e#t +ha"!a#$ +"a#ti#e a% a .hole, It i% u+ to +ha"!a#$ +"o e%%ional% to #ontinue to anal$ze and e'aluate ho. thi% auto!ation a e#t% +atient %a et$ and !aintain% a%%i%tan#e to +ha"!a#i%t% and thei" #o.o"-e"% ali-e, P"o e%%ional% !u%t ta-e ad'antage o the%e auto!ation unit% in the !o%t a++"o+"iate !anne"* in o"de" to o+ti!ize thei" e e#t% and o++o"tunitie%, Rathe" than u%ing the! a% )a#-)one o" the #o!+letion o ta%-%* the$ %hould )e utilized a% an a%%et in +"a#ti#e, Pha"!a#$ tea! !e!)e"% %hould e!+lo$ thi% e0+edited .o"- lo. a% a !ean% to +a"ti#i+ate in +atient out"ea#h and )e#o!e !oti'ated to +"o!ote !edi#ation adhe"en#e in +atient% on a #a%e )$ #a%e )a%i%, 1hile the te#hnolog$ it%el i% ad'an#ed and ha% the #a+a)ilit$ to !a-e an a i"!ati'e i!+a#t on the ield o health#a"e* it% %u##e%% i% de+endent u+on the "ea#tion it e'o-e% "o! +"o e%%ional% and ho. the$ e0+loit it% att"i)ute%, It% a%%i%tan#e in te"!% o e i#ien#$ and %a et$ .ill onl$ #ontinue to +"og"e%% a% the%e auto!ation unit% e'ol'e .ith %u%tained "e%ea"#h and de'elo+!ent, I +"o e%%ional% in the ield o +ha"!a#$ a"e a)le to a##li!atize to the u%e o a di%+en%ing "o)ot a% a !e!)e" o the +ha"!a#$ tea!* then thei" e e#t% on the ield o health#a"e #an )e !o!entou%,

Re le#ti'e Note: I thin- that thi% +ie#e .ould it into !$ +"o e%%ional +o"t olio )e#au%e it allo.ed !e to in'e%tigate the >ue%tion that I ha'e )een e0+lo"ing th"oughout the %e!e%te"* .hi#h ha% di"e#t i!+li#ation% on !$ +"e%ent and utu"e "ole in +ha"!a#$,

Running Head: THE UTILIZATION OF AUTOMATION IN PHARMACY PRACTICE Re e"en#e% 1, &a""ett* M, et al, 6(711* A+"il 118, Reconfiguring Boundary Relations: Robotic Innovations in Pharmacy Work. Ret"ie'ed "o! htt+:33hdl,handle,net31C(1,13ECDJ7, (, Lin* A, C,* Huang* Y, C,* Pun#he%* B,* Chen* Y, 6(77C* @e+t 18, Effect of a robotic

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prescription-filling system on pharmacy staff activities and prescription-filling time. Ret"ie'ed "o! htt+:33...,n#)i,nl!,nih,go'3+u)!ed31CC(9/E?, /, F"an-lin* &, A, et, al, 6(77D* Fe)8, n evaluation of t!o automated dispensing machines in "# hospital pharmacy. Ret"ie'ed "o! htt+:33onlineli)"a"$,.ile$,#o!3doi317,1(113iF++,1E,1,777J3a)%t"a#t, 9, &ea"d* R, I,* @!ith* P, 6(71/* Iul$ (8, Integ"ated ele#t"oni# +"e%#"i)ing and "o)oti# di%+en%ing: a #a%e %tud$, Ret"ie'ed "o! htt+:33...,n#)i,nl!,nih,go'3+!#3a"ti#le%3PMC/C(9JJ73, ?, @zein)a#h* @, L,* Ta$lo"* T, H,* Billen.ate"* E, L, 61JJ?8, utomated $ispensing %echnologies: Effect on &anaged 'are. Ret"ie'ed "o! htt+:33...,a!#+,o"g31o"-A"ea3Ao.nloadA%%et,a%+0KidL?E?E,