Claude Parnell wants to know why it is that people can track a $5 pair of socks at every stopping point between Amazon.com and their house, but most hospitals can't track medications between the pharmacy department and the bedside -even those that cost $10,000 or more per dose.

For Parnell, operations director for system therapeutics at Geisinger Health System, Danville, Pa., it's on the verge of being a rhetorical question. Geisinger is now deploying a combination of robots, pneumatic tubes, and software to track medications from the moment the order is entered to the time it's administered to the patient. (See below.) The final piece of the puzzle is an interface with its electronic health record system so that nurses-or any other hospital staff, for that matter-can find out the status of any medication from any workstation.

"Whether it's this technology or another, the time has come for tracking to be applied on a widespread basis," Parnell says. "I see a manifold benefit to the patients we service, and it helps me get such a better handle on my operation because I know how long it takes orders to get through the pharmacy system."

Medication carts have evolved dramatically in the past several years, and the most advanced ones now function as full medication administration workstations, with on-board bar code readers, tracking software that's integrated with the hospital's pharmacy information system and/or electronic health record, and full computing capabilities so that nurses can chart at the bedside. Their security measures can include passwords for each user, swipe cards, and even biometric identification. Workstations on wheels, or "WOWs," which once were largely confined to toting portable computers, are fast becoming medication dispensing carts on wheels. Can a new acronym be far behind?

Several factors may decide. For the latest carts to work as intended, users must pay even more attention than usual to logistics and ergonomics, says Erin Sparnon, senior project officer at the ECRI Institute, Plymouth Meeting, Pa., which assesses medical technology.

The sophistication of carts varies widely, she says, as does the software that operates them. Some have lots of different options for controlled access; others have just two modes: locked and unlocked. She recommends designing the medication workflow first, before looking at either carts or software.

Elizabeth Gardner’s feature story in the May issue of Health Data Management covers the evolution of carts from workstations on wheels to medication delivery on wheels.

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