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If your hospital is not using a closed-loop medication management system, it soon will be. That's the prediction from the Fourth Annual Summit on Patient Safety & Information Technology held in San Francisco last month. Bar-coding, radio frequency identification (RFID), computerized physician order entry (CPOE), and other elements of a closed-loop medication system are moving at different speeds in similar directions.

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Only a handful of the 715 pharmacists on a conference call with CMS officials got to ask questions, but they recited a litany of problems with the implementation of the Part D drug benefit 10 days earlier. Among the snafus most frequently cited were dual eligibles being charged large deductibles and co-pays; hours spent on drug plan help lines; and drug plans denying 30-day transition scripts for drugs requiring prior authorization. When one R.Ph. asked who would reimburse pharmacies for all their lost time spent on Part D, an official said that since pharmacies contract directly with the drug plans, it's not CMS' place to get involved in such issues.