Hospital pharmacists do more than input medication orders and verify them. Their role has expanded to include patient interface, and they are frequently called upon to provide physicians with the latest information about the thousands of medication options available for treatment.

Changes in the payer mix, new regulations and professional standards, plus advances in technology, have created a new world for hospital pharmacists.

Even the methods used to dispense medications in the hospital setting have changed. A handful of hospitals in Georgia have begun using a technology-based robotic dispensing system that selects medications for individual patients, one day's dose at a time.

"This system helps make things safer," said Clyde Buchanan, MS, RPh, FASHP, senior director of pharmacy services at Emory Healthcare System. "It's barcode based so that it's much more accurate." Orders still are checked on a sample basis and confirmed manually by a hospital pharmacist.

"At least one to two hospitals are doing trial systems with the physician entering the orders," Buchanan said. "This eliminates the need to keep up with paper and reduces the chance of misreading handwriting. However, the pharmacist still checks and verifies information."

Most hospitals keep about 3,000 medicines on hand and pharmacists must know which one is most appropriate for each patient. For example, there are a number of different types of insulin available. The clinical pharmacist would meet with the patient to assess factors that could make one type more effective.

"Pharmacists are becoming more involved with patient care than they used to be, especially in hospitals," Buchanan said. "Clinical pharmacists now participate as part of the medical care team, often recommending the best or most suitable medication for a patient."