The outpatient pharmacies of tertiary hospitals are undergoing significant technological innovations

Source: wechat Official Account of China Medical Security

Original Title: Medical Insurance Adds Another Powerful Tool to Prevent "Backflow"! The traceability system has been launched to achieve efficient data collection

In June 2024, the outpatient pharmacy of the Fourth Affiliated Hospital, Zhejiang University School of Medicine (hereinafter referred to as "Zhejiang University Fourth Hospital") witnessed a technological innovation: a medicine conveyor belt integrated with an advanced "intelligent camera" was officially put into use. Whenever the net basket filled with medicine passed by, it would be "photographed as a memento". This camera is not an ordinary monitoring device, but an important component of the hospital's newly launched dynamic batch collection system for drug traceability codes (hereinafter referred to as the collection system). This collection system can batch collect the traceability code information on the drug packaging during the dynamic transmission of drugs from the outpatient drug warehouse to the drug dispensing window, and automatically and precisely bind this information with the drug prescription and patient information, achieving the immediate integrated processing from the collection, binding to the upload of drug traceability codes, which greatly improves the efficiency and accuracy of drug traceability code collection in hospitals.

In 2024, Zhejiang University Fourth Affiliated Hospital actively responded to the deployment of the medical insurance department, explored the collection and application of drug traceability codes, and established a special task force for the collection of drug traceability codes. In less than a month, the Fourth Affiliated Hospital of Zhejiang University has solved a series of problems such as personnel, systems and equipment, achieved efficient collection of drug traceability codes, automatic binding of medical insurance settlement data and upload, and established a full-process closed-loop management system for drug traceability codes. As of the end of January 2025, the comprehensive collection rate of drug traceability codes at the Fourth Affiliated Hospital of Zhejiang University has reached over 99%.

      Innovate the collection method of traceability codes to achieve efficient collection.

     In the process of promoting the collection of drug traceability codes, the Fourth Affiliated Hospital of Zhejiang University, adhering to the principle of minimizing the impact on the original business, sorted out the drug circulation lines within the hospital, analyzed the collection requirements, actively explored and innovated, and formed a set of efficient and convenient collection methods. The drug distribution link achieved a closed loop of collection, and at the same time, the collection in the warehousing link was carried out simultaneously. The collected data is applied to the verification upon entry into the warehouse, inventory management, and the handling of disassembled drugs, effectively enhancing the level of drug traceability code management.

      The traditional manual drug distribution and collection is usually completed at the drug distribution window. The specific approach is as follows: first, confirm the prescription information, then collect the drug traceability code for each box, and finally bind the prescription information and the traceability code information. The entire collection process is time-consuming and laborious. Zhejiang University Fourth Affiliated Hospital has fully integrated its existing equipment and business processes, concentrated technical forces to tackle key problems, explored different collection modes and devices, and compared multiple dimensions such as collection time consumption, cost, and patient experience (see Table 1) to select solutions. Ultimately, it was decided to adopt a batch collection method. With one scan, the traceability codes of multiple drugs were collected simultaneously. The collection process was completed in the drug dispensing background, minimizing the impact on the drug distribution window.

When collecting in batches, hospitals have introduced electronic medicine baskets that can store prescription information. Combined with the use of the electronic medicine basket, the collection system can automatically obtain prescription information and complete the synchronous operations of collection, binding and upload. The hospital has also integrated collection equipment through the transformation of the drug conveyor belt. During the process of transporting drugs from the dispensing backend to the dispensing window, the collection system can dynamically complete batch collection. It will also compare the collected traceability code information with the prescription information to automatically retrieve the collection completeness rate. If there is any uncollected or missed collection, the collection system will automatically remind the pharmacist to make up for the collection when confirming the prescription at the collection stage, ensuring that all that should be collected are collected. Continuously improve the collection efficiency. As of January 2025, batch collection and dynamic collection at the Fourth Affiliated Hospital of Zhejiang University accounted for 36% of the total outpatient drug collection volume.

     Meanwhile, the hospital has upgraded and renovated the existing automatic dispensing equipment to achieve automatic collection of traceability codes. Using the drug traceability code as the unique identification code inside the drug dispensing equipment, the dispensing machine can identify and save the drugs when they are being dispensed. When the dispensing machine receives prescription instructions and dispenses medicine, it identifies the saved traceability code information, automatically associates the prescription information, and synchronously binds and uploads it, thereby achieving the effect of contactless collection. As of January 2025, the contactless collection by the dispensing machine at the Fourth Affiliated Hospital of Zhejiang University accounted for 63% of the outpatient collection volume.

For the drugs used in small quantities within the hospital, the hospital has also actively explored the collection model of small quantities of drugs. Through measures such as marking the small quantities of drugs, combining the calculation of drug quantities, and eliminating duplicate codes, comprehensive data governance has been carried out to achieve the in-hospital consumption and closed-loop management of the traceability information of small quantities of drugs.

In addition, during the collection process of drug warehousing, the Fourth Affiliated Hospital of Zhejiang University successfully broke down the data barrier by transforming the interface between the drug warehouse management system and the drug supplier system. When a batch of drugs is confirmed for warehousing, the staff in the drug warehouse retrieve the warehousing data of the drug supplier based on the "invoice number accompanying the goods", automatically obtaining the traceability code information of the entire batch of drugs entering the warehouse, achieving "code accompanying the goods", integrating data resources, and effectively avoiding repetitive collection at the warehousing end. For the sporadic drugs that have been stored in the warehouse, the hospital has also adopted the method of scanning the traceability codes of the entire box of drugs. By connecting to Alibaba's "Code for Peace of Mind" platform for analysis, it has achieved efficient collection and automatically obtained the traceability code information of the smallest package of the entire box of drugs. The collection upon entry into the warehouse provides a data basis for the further application of drug traceability codes within the hospital.

Improve the refined management level of drugs and ensure the safety of drug use.

After successfully establishing an efficient and convenient collection system for drug traceability codes, the Fourth Affiliated Hospital of Zhejiang University fully utilized the uniqueness of drug traceability codes and applied them to all aspects of drug management within the hospital, thereby enhancing the level of refined drug management.

Firstly, in the drug warehousing process, a strict traceability code verification procedure should be established to ensure the reliable quality of the drugs entering the warehouse. When drugs are stored in the warehouse, the hospital will verify the collected traceability codes in real time through the Zhejiang Province Smart Medical Insurance Information Platform by calling the drug traceability code query interface with the data in the national drug traceability code database. If there is any abnormality, it will issue a timely warning to prevent drugs from "flowing back" into the hospital. At the same time, it can accurately identify clues of "returning drugs", prevent the "secondary sale" of medical insurance drugs, and ensure the safety of medical insurance funds.

Secondly, during the drug dispensing process, a traceability code verification mechanism is implemented to ensure the accuracy of drug dispensing. Because the packaging of some medicines is extremely similar, errors are inevitable during the manual verification process. By verifying the unique traceability code information, the safety hazard of sending the wrong medicine can be effectively avoided. During the process of dispensing drugs, the collection system automatically compares the drug traceability code with the prescription information. If there is an error in the quantity or specification of the drugs, the collection system will issue an "audible and visual reminder". The person in charge of the outpatient pharmacy said that this application has to some extent alleviated the heavy verification pressure on pharmacists at the front-line Windows, avoided errors in drug dispensing from the source, and allowed them to have more time to guide patients on medication. In addition, during the drug dispensing process at the window, the collection system can also verify the validity period of the drugs by analyzing the traceability code information. When expired or soil-to-expire drugs are detected, the collection system will also issue a reminder, further ensuring the safety of drug use.

Finally, in terms of drug traceability management, a complete traceability process should be established to avoid errors and omissions. When hospitals receive and use externally supplied drugs, they collect, verify and keep the drug traceability codes. At the same time, they check key information such as the specifications, batch numbers and expiration dates of the externally supplied drugs to ensure their safety and traceability. As for the drug return process, the hospital scans the drug traceability code and checks the traceability code information saved in the original drug distribution record to ensure that the returned drug is exactly the same as the dispatched drug, avoiding confusion or errors in the drug circulation process.