Usefulness of Combination of Decision Support Protocol for Out-of-Hospital Prescription Queries by Community Pharmacists with Electronic Data Capture and Robotic Process Automation Systems

Protocol-based pharmacotherapy management (PBPM), which involves predefined protocols to change physician prescriptions, has been reported to improve the work efficiency of physicians and pharmacists in handling outpatient prescription inquiries from community pharmacists. However, recent drug shortages have led to an increase in outpatient inquiries and inquiries requiring complex responses for which PBPM does not apply, thus increasing the workload of hospital pharmacists. Herein, we evaluated improvements in work efficiency using a community pharmacist–managed PBPM with digital transformation, which includes an electronic data capture (EDC) system and a robotic process automation (RPA) tool. Before the community pharmacist–managed PBPM with digital transformation implementation, community pharmacists inquired via telephone whether a prescription change was acceptable. Hospital pharmacists responded using hospital pharmacist–managed PBPM and recorded the data in the electronic medical record. After implementation, community pharmacists modified the prescriptions using the community pharmacist–managed PBPM and entered the changes into the EDC system, which automatically generated the text to be recorded by the RPA tool in each patient’s medical record. Median response time of community pharmacists for each outpatient prescription inquiry was 1.9 (1.6 – 2.8) min before and 2.0 (1.8 – 2.5) min after implementation (P = 0.132), while that of hospital pharmacists was 5.4 (4.6 – 7.1) min before and 0.2 (0.1 – 0.3) min after implementation (P < 0.001). The results indicate that PBPM coupled with the EDC system and RPA tool significantly improves the efficiency of hospital pharmacists in processing outpatient prescription inquiries without increasing the time burden on community pharmacists.