Automated dispensing addresses shortage, safety
February 1, 2002 3 minutes read
Automated dispensing addresses shortage, safety
Should machines replace double-checking of drugs?
A new automated prescription drug dispenser in Minneapolis aims to address two problems at once: medication errors and pharmacist shortages. A user simply inserts the prescription and a credit card into the machine and out pops the medicine. However, some pharmacists say that cutting out the double-checking of prescriptions by trained professionals could be a mistake.
Minnesota’s pharmacy regulators have approved the InstyMeds system for use anywhere in the state. The developer of the system, a former emergency room physician, hopes to place the dispensers in doctor’s offices and emergency rooms around the country.
After a physician writes the "e-prescriptions," patients or their family members get a prescription printout with a security code to type into InstyMeds. The computer verifies the prescription and checks insurance records. The machine then asks for a credit card to make the co-payment. After the payment is made, the medication is dispensed.
Automated dispensing: Friend or foe?
Automated dispensing is another facet of the trend toward computerizing prescriptions. Some automation can help meet some of the needs in the pharmacy, says Susan C. Winckler, RPh, Esq, group director of policy and advocacy for the American Pharmaceutical Association in Washington, DC. "The automated systems are better counters than people are."
However, automated systems that are not overseen by a pharmacist or are used outside of the pharmacy assume that the pharmacy’s main role is to count out the product and package the products, she says. "That is the wrong assumption. [When automated systems bypass the pharmacy], you miss the double-check of assessing whether there are interactions, whether the drug is appropriate for the patient. You miss the second health care professional providing that input.
"There is a role to be filled by automation," she continues, "but I don’t believe it is as broad as some of the proponents of automation would suggest."
Automated dispensing programs don’t have to bypass the pharmacy. For example, the government recently announced approval of projects at two groups of community health centers intended to make prescription drugs more readily available to safety-net patients and to make them less costly. The first project involves automated dispensing — pharmacists at a central health center site in Spokane, WA, will network with other health centers and use computer equipment to dispense prescription drugs through vending machines to patients at remote health clinics.
The Community Health Association of Spokane (CHAS) will rely on a four-step process to send drugs through vending machines to patients at remote clinics:
1. Health care providers at the clinics fax prescription orders to the central CHAS pharmacy.
2. A pharmacist at the central facility receives the prescription and fills it via computer link to a locked vending machine in a secure area of the network clinics, where it is dispensed in a bottle.
3. A pharmacy technician picks up the bottle, attaches a label and delivers it to the waiting patient.
4. The process may end at this point, or the patient may use videoconferencing equipment — another element of the demo — to receive counseling on proper drug usage from the pharmacist at the central CHAS facility.
CHAS will manage its four clinics in partnership with Native Health of Spokane, an urban Native American program, and Northeast Washington Health Programs, a community health center in Chewelah, WA. The network will provide medications to approximately 13,500 low-income or rural patients who otherwise would have difficulty obtaining their prescription drugs.
The demonstration project is part of a initiative announced June 18, 2001, to help organizations that participate in the 340B drug discount program find ways to reduce administrative costs and improve access to prescription drugs for patients.
In general, if the right tools and the opportunities for interaction with pharmacists are in place, then automated dispensing is just one more way that technology might be used, says David Witmer, PharmD, director of the professional practice and scientific affairs division and director of the section of clinical specialists at the American Society of Health-System Pharmacists in Bethesda, MD. "There is still a need for that professional interaction and overview of the medication use process."
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