APM: Automatic Pharmacy Machine is here.

[kwakster928]

http://money.cnn.com/2005/06/21/news/midcaps/scriptcenter/

Self-serve drug machine makes it debut

ScriptCenter, the Asteres dispenser of prescription drugs, could be coming to a pharmacy near you.
June 21, 2005: 3:14 PM EDT
By Aaron Smith, CNN/Money staff writer




NEW YORK (CNN/Money) - In December 2002, Linda Pinney, founder and chief business officer of Asteres Inc., had an epiphany while waiting in line at a pharmacy in Del Mar, Calif.

"I was standing in line thinking there's got to be another way," said Pinney, who was filling a prescription for a drug to treat her Attention Deficit Hyperactivity Disorder. "Make an ADHD person wait in line to pick up a prescription and they're going to come up with a solution."

Thus was born the ScriptCenter, an ATM-style device that dispenses drugs instead of cash.

Three years after Pinney's restless waiting got her thinking, the first ScriptCenter was installed in that very same Del Mar pharmacy, a member of the Longs Drug Stores chain.

"We're always looking for ways to serve our customers, and it seems as though customers are very time constrained," said Longs Drug Stores (up $0.02 to $43.60, Research) spokeswoman Phyllis Proffer. "This is a great example of how we can use technology to save the customers' time."

For the last six months, the first ScriptCenter has served as a test device, delivering prescription refills for hundreds of patients. The California Board of Pharmacy granted a tentative approval for the machine, reserving the right to withdraw it any time. But so far there haven't been any problems, according to the board.

"There seems to be some controversy about the machines," said Patricia Harris, executive officer for the California Board of Pharmacy. "There is concern from the pharmacy profession that you're losing that contact with the patients when they're receiving pharmaceuticals from the machine."

But Harris says the machines are intended to speed up a process, not replace pharmacists. "You still have to go through your checks and balances to make sure it's a legitimate prescription up front," she said. "We see no issues from it, from a staff perspective."

"There is a very strict authentication process to use the machine," said Pinney, who considers it more secure than receiving prescription drugs in the mail.

To guard against fraud, patients use identification cards or passwords to access the drugs and the machines take security photographs of the transactions, like with ATMs.

States start approving
Asteres, a privately-held Del Mar-based company, plans to install two more machines at San Diego pharmacies this month and another machine in San Francisco. In addition to Longs Drug Stores, Safeway Inc. (up $0.91 to $24.45, Research) has agreed to host the ScriptCenters at California locations.

Meanwhile, the Virginia Board of Pharmacy has also granted tentative approval to the ScriptCenter, and one of the machines is in the process of being set up at an Giant Food store in Reston, Va. owned by Ahold USA.

"It's going to be one store and approved for refills only," said Ralph Orr, deputy executive director for the Virginia Board of Pharmacy, "to allow the chance for the technology to be looked at."

The Hawaii Board of Pharmacy on Friday became the first state board to approve the ScriptCenters for accepting new prescriptions, in addition to refills, said Pinney. Also, Asteres has begun the regulatory process in about a half dozen other states.

Some of the ScriptCenters are located inside 24-hour stores. In California and Virginia, the machines can be used even when the pharmacies are closed, Pinney said. Hawaii waived that right by allowing ScriptCenters to accept new prescriptions.

Pinney isn't worried about thieves walking off with drug-laden ScriptCenters.

"The ScriptCenter weighs 1,300 pounds when loaded," said Pinney. "It is drilled down through the cement. I don't think it's going anywhere."


feel free to discuess. I will input my view later.

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[GravyRPH]

I guess I better find the nearest unemployment office. I've always thought teaching would be an interesting career.

*smirk*

 

[drhemi70]

I went to the web site and the pharmacy still fills the script. They then place it in the machine. When the customer shows up they swipe their id and get their drugs after paying the machine.
DR

 

[GravyRPH]

I went to the web site and the pharmacy still fills the script. They then place it in the machine. When the customer shows up they swipe their id and get their drugs after paying the machine.
DR

I wonder how many Antibiotic/Vicodin combo orders will have only the Vicodin gone from the machine?

 

[SomeGuy]

Well, 2 things:

1.
This machine should be called the automatic dispensing machine. To call it a pharmacy when its nothing but an automated pharm tech that is incapable of offering the slightest amount of medical information is offensive.

2.

In California and Virginia, the machines can be used even when the pharmacies are closed, Pinney said.

This really surprises me. I thought the law was that a pharmacist MUST be on duty in order for prescriptions to be dispensed. We don't allow techs to dispense while a pharmacist isn't on duty, so why the heck would we allow a machine to?

 

[SomeGuy]

x2

 

[BMBiology]

The Hawaii Board of Pharmacy on Friday became the first state board to approve the ScriptCenters for accepting new prescriptions, in addition to refills, said Pinney.

I am fine with the refills because this will only save time for the pharmacists but I wonder how is the scriptcenters going to accept new prescriptions?

I know in California, patient counseling is required for new Rx.

 

[ultracet]

I am fine with the refills because this will only save time for the pharmacists but I wonder how is the scriptcenters going to accept new prescriptions?

I know in California, patient counseling is required for new Rx.

yeah in VA too...


hmmm....

i guess its good that in VA they're only doing 1 store to see how they like it....

if it is approved for refills i wonder how long it will take before they will use it for everything


i mean honestly all it would take would be a sticker bar code that came from the drug companies.... (md puts them on the pad) and then the patient could have a health info card that they swipe with their info on it (there are local hospitals in VA that already have these).

no its not safe but....

if pharmacists can't or won't do it they will find someone or something that can

 

[drhemi70]

BMB,
This machine has nothing to do with filling. The parmacist gets the scipt from the doc as normal. The pharmacist then fills the script as normal. The parmacist then loads the filled script into the machine. That is the last the pharmacist touches it. The patient then shows up swipes an ID card the machine brings up all available filled scripts it contains for the patient, the patient pays for the scripts they want and the machine spits those filled scripts out.
DR

 

[BMBiology]

i mean honestly all it would take would be a sticker bar code that came from the drug companies.... (md puts them on the pad) and then the patient could have a health info card that they swipe with their info on it (there are local hospitals in VA that already have these).

That is really a simple way of thinking about it but we know it is much complex than that. If you think the pharmacy is a place where you just pick up your medications then yes that would work. But if this were true then it would not take longer than 5 minutes to pick up your medications. I am kinda ashamed to explain this to you since you are a pharmacy student:

(1) automated machines cannot check drug interaction
(2) automated machines cannot check safe dosage
(3) automated machines cannot check allergic reactions
(4) automated machines cannot counsel specific needs to each patient
(5) automated machines cannot answer questions not only medical questions but also insurance questions.

These are just a few examples. Automated machines can never replace the pharmacists! Period. It can only assist the pharmacists and allow us more time for patient care. It still surprises me that many patients still pick up their refills at the pharmacy when mail order and electronic refills are available. No machine can replace the confidence the comes with pharmacist/patient interactions especially when it comes to something important like medications. The question here is whether the public prefer to get your medications from the mailman/machine or pharmacist? The vast majority still choose the pharmacist and that will not change in the near future.

Even with today's technology, very few physicians are using electronic prescription (electronically send Rx to the pharmacy). I don't really think physicians are going to take the time to search the medication, the strength, type up the dosage, then wait to print the sticker bar code and paste it on a signed prescription as you claimed. Not only is this time consuming but it will cost the health care system more money! It is simply cheaper for the physcian to write the Rx and let the pharmacists do the dispensing.

 

[BMBiology]

BMB,
This machine has nothing to do with filling. The parmacist gets the scipt from the doc as normal. The pharmacist then fills the script as normal. The parmacist then loads the filled script into the machine. That is the last the pharmacist touches it. The patient then shows up swipes an ID card the machine brings up all available filled scripts it contains for the patient, the patient pays for the scripts they want and the machine spits those filled scripts out.
DR

Yes I understand that but how about patient counseling for new Rx? It is required by law, at least in California.

This does not make sense to me even without the patient counseling. You mean to tell me patients would come to the pharmacy, wait in line to drop it off, pay for the drugs. The phamacists then fill the new Rx and load the meds in the automated machine (which i am sure will only be done twice a day). Later that day the patient would have to come back and maybe wait in line again to get his medicine from the machine? Why would anybody do all of that when he/she can wait about 20 mins to pick up his new Rx?! I can understand the use of automated machines for refills because it does offer some convenience but this doesn't make sense! Have you ever tried to ask a patient to come back a few hours later to pick up his new Rx? 😕 😡 Meds that they have never taken and believe they need immediately.

If patients ask their physcians to fax or electronically send their Rx to the pharmacy and pick up the new meds at a later time, then they would save some time. This is available today but yet it is still rarely used. This could be because if they are willing to wait 40 minutes to see their physician, they are willing to wait an extra 20 minutes to pick up their new meds.

 

[crying moo]

Yes I understand that but how about patient counseling for new Rx? It is required by law, at least in California.

This does not make sense to me even without the patient counseling. You mean to tell me patients would come to the pharmacy, wait in line to drop it off, pay for the drugs. The phamacists then fill the new Rx and load the meds in the automated machine (which i am sure will only be done twice a day). Later that day the patient would have to come back and maybe wait in line again to get his medicine from the machine? Why would anybody do all of that when he/she can wait about 20 mins to pick up his new Rx?! I can understand the use of automated machines for refills because it does offer some convenience but this doesn't make sense! Have you ever tried to ask a patient to come back a few hours later to pick up his new Rx? 😕 😡 Meds that they have never taken and believe they need immediately.

Well that's essentially what goes on at the drive thru window. People drop off their RX and come back later (30 min-days later) using the window. Counseling can happen at the drop off point, so when the patient comes back to pick up meds they just stop by the machine.

It makes sense, kinda. I don't see how much different it is from the cashier-tech. I'd like to not have to deal with people brining all their junk from front-end and ringing it all up with their Allergra refill. And if there's a line at the machine let them get angry at the machine for being too slow!

I just want to know what happens when there's an insurance issue and person goes to pick up their med and it says $35 and they want to complain that their copay is ALWAYS $5!

 

[baggywrinkle]

I went to the web site and the pharmacy still fills the script. They then place it in the machine. When the customer shows up they swipe their id and get their drugs after paying the machine.
DR

OMG, I LOVE it. Retail without the bitching.

What do they do about counseling requirements? What do they do if there is a rebill? As much as we might like to charge 232 bucks for thirty caps I don't think Ms Bitchnmoan is gonna let it fly. They can even attach a dummy pharmacist to the machine for them to beat on.

 

[BMBiology]

Well that's essentially what goes on at the drive thru window. People drop off their RX and come back later (30 min-days later) using the window.

The drive through offers conveniences that the automated machines do not offer:
(1) You do not have to get out of your car to pick up your meds. The automated machine does not offer this convenience.
(2) You can go to starbucks, pick up the laundry and your meds will be ready for pickup within 30 mins. The pharmacy, however, will not load the automated machine every 30 mins but probably twice a day. It is not possible because it takes time to load the machine and it would prevent the usage of the machine when it is being loaded. This means you have to schedule your pickup time around the loading time.

In addition, there is pharmacist/patient interaction with the drive through. This meets the requirement for patient counseling on new Rx. This is why the automated machine doesnt make sense for new Rx. It does not save time, nor does it offer conveniences that are already available with current pharmacy services. There may be people who may use this service for new Rx (considering it is legal for new Rx) but there is no rational for its usage.

 

[ultracet]

That is really a simple way of thinking about it but we know it is much complex than that. If you think the pharmacy is a place where you just pick up your medications then yes that would work. But if this were true then it would not take longer than 5 minutes to pick up your medications. I am kinda ashamed to explain this to you since you are a pharmacy student:

(1) automated machines cannot check drug interaction
(2) automated machines cannot check safe dosage
(3) automated machines cannot check allergic reactions
(4) automated machines cannot counsel specific needs to each patient
(5) automated machines cannot answer questions not only medical questions but also insurance questions.

These are just a few examples. Automated machines can never replace the pharmacists! Period. It can only assist the pharmacists and allow us more time for patient care. It still surprises me that many patients still pick up their refills at the pharmacy when mail order and electronic refills are available. No machine can replace the confidence the comes with pharmacist/patient interactions especially when it comes to something important like medications. The question here is whether the public prefer to get your medications from the mailman/machine or pharmacist? The vast majority still choose the pharmacist and that will not change in the near future.

Even with today's technology, very few physicians are using electronic prescription (electronically send Rx to the pharmacy). I don't really think physicians are going to take the time to search the medication, the strength, type up the dosage, then wait to print the sticker bar code and paste it on a signed prescription as you claimed. Not only is this time consuming but it will cost the health care system more money! It is simply cheaper for the physcian to write the Rx and let the pharmacists do the dispensing.

i understand all of that however currently the id cards have their allergies and prior histories on them.

i honestly know what all pharmacy entails however i do think complete automation is possible. i didn't say it was a good thing for anyone or safe but i do think it is possible

 

[baggywrinkle]

i honestly know what all pharmacy entails however i do think complete automation is possible. i didn't say it was a good thing for anyone or safe but i do think it is possible

At the moment I am all excited about Madigan Army Medical Center ( we'll see how it goes in six months). Keep in mind that a military pharmacy technician has superior training compared with civilian programs. I have seen the pharmacology manual used by Health Services Training Command. It is abbreviated and concentrated, yet it would challenge many practicing pharmacists. As a result, technicians enjoy expanded practice roles including patient counseling, which is done within a pharmacists earshot so important information may be interjected when necessary.

My point is Madigan has a drive through which is only used for refill prescriptions that is serviced by a technician and a script-pro robot. What is wrong with this? These folks fill 5,000 prescriptions a day. They are swimming just to keep their heads above water. Many of the busier retail pharmacies would benefit from a similar arrangement. Better trained technicians, and more automation will allow the pharmacist to run a safer operation. I'm all for it.

The standard of care in Washington State is all new prescriptions SHALL be counseled. This is mandatory over the patients objections. Anna, ask Richard Dohl if you doubt it. In order to comply with the law counseling becomes a full time activity - just as it is in the military setting. The current practice model which requires the pharmacist to count, check, and counsel is simply too much. The system is broken and needs to be changed.

 

[BMBiology]

The current practice model which requires the pharmacist to count, check, and counsel is simply too much. The system is broken and needs to be changed.

I completely agree. I have seen a pharmacy that fills 700 scripts a day with just 1 pharmacist. This is possible because the techs are very good. However, the pharmacist simply does not have the time to counsel. This is mainly done by an intern. I am worried that one day I will be that pharmacist. I cannot picture myself dispensing medications all day! This has to be changed.

I do not fear technology because I understand that it cannot take away the role of the pharmacist. Technology can only assist the pharmacists. I welcome it with open arms! Pharmacists have to separate themselves from just dispensing medications and play the role of a clinician, the role they have been trained to play.

 

[bananaface]

OMG, I LOVE it. Retail without the bitching.

What do they do about counseling requirements? What do they do if there is a rebill? As much as we might like to charge 232 bucks for thirty caps I don't think Ms Bitchnmoan is gonna let it fly. They can even attach a dummy pharmacist to the machine for them to beat on.

Perhaps the pharmacy could quickly recoup their investment by placing a bunch of exorbatently priced piniatas around the machine with little signs reading "you break it you buy it."

 

[bananaface]

I completely agree. I have seen a pharmacy that fills 700 scripts a day with just 1 pharmacist. This is possible because the techs are very good. However, the pharmacist simply does not have the time to counsel. This is mainly done by an intern. I am worried that one day I will be that pharmacist. I cannot picture myself dispensing medications all day! This has to be changed.

I do not fear technology because I understand that it cannot take away the role of the pharmacist. Technology can only assist the pharmacists. I welcome it with open arms! Pharmacists have to separate themselves from just dispensing medications and play the role of a clinician, the role they have been trained to play.

On a 12 hour shift that's one minute per rx. At 8 it's 40 seconds. Even if all the pharmacist did is check, that's still not a safe rate. And, heaven forbid that they should need to eat or use the restroom.

 

[drhemi70]

BMB,
Does the state of Cali require a counseling on refills? The way that I read these articles is that the REFILL script is sent in by a doc, the parmacist fills, and it is stuck in a machine.
DR

 

[baggywrinkle]

BMB,
Does the state of Cali require a counseling on refills? The way that I read these articles is that the REFILL script is sent in by a doc, the parmacist fills, and it is stuck in a machine.
DR

I cannot tell you about CA specifically, what I can tell you is the requirement for refills may be satisfied generally with an offer to counsel amounting to asking if there are any questions about the medication(s).

In an automated environment the machine may ask and require an input from the patient, summoning the pharmacist to actually counsel.

 

[ultracet]

the states that i have worked in do not require any sort of counseling for refills. that is exactly where these machines come into play.

the major downside i can see to these machines would be patients and problems with insurance... i think there will have to be a phone mounted next to them so when the rx is kicked back the patient can do their own calling and get it sorted out.

that would not be a downside for me but for the patient.

i realize that everyone seems to think that i am completely opposed to these machines. that is not the case. i simply proposed how they could be used for new prescriptions. i realize there is more to pharmacy than what i said but, come on, someone wondered how it could happen... i supplied an example.
I don't think these machines for new prescriptions is a good thing nor do i think it would be safe for the patients involved as i previously stated.

i will request that everyone please read my posts in context.

 

[nguyenkd]

On a 12 hour shift that's one minute per rx. At 8 it's 40 seconds. Even if all the pharmacist did is check, that's still not a safe rate. And, heaven forbid that they should need to eat or use the restroom.

our pharmacy closes from 1:30-2 for lunch when there is only one pharmacist on duty, and we have two signs stating so. today, ms. bitchy mcbitcherson threw the biggest fit ever. she said she should not have to wait while we go to happy hour. hah, i wish!

 

[bananaface]

Merging with the pre-existing thread. 🙂

 

[ODhopeful]

OH MY GOD!!!! I think pharmacy and optometry are going down the drain and we're all gonna be out of a job..... maybe it's time to do something else... damn it...