Prescription Vending Machine

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This might have a good role in certain situations... but at a WAGS in SF it was piloted but it did *NOT* fly...

This is HORRIBLE in terms of patient care.... sounds like these would be new RXs from the clinics.... so when does anyone TELL The patient about the meds? Cuz you KNOW it's not happening w/ the doctors themselves.

And an additional $1 fee to use the machine? wth? so they don't have to 'waste' a pharmacist's time to counsel and talk about possible interactions or adverse effects?
 
This is a great example of why I get pissed off when ignorant people ask me about why I'm in pharmacy school. "Aren't you gonna be replaced by a coin-operated machine in the future anyway?"
 
I don't think these machines would be legal here in Georgia. According to the GA law, attempting to prevent the pharmacist-patient contact when dispensing is illegal. Also, a patient can never pick up or drop off an RX without a RPh present at that location. I think Georgia is just super strict about this stuff because we're also the only state in the country that doesn't allow mail order pharmacy (excluding closed system HMO's like Kaiser).

I believe the laws were added after the fact, when mail order started popping up and I don't think they're going away any time soon here.
 
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The solution to patient care would be to just put a computer on it that has GOOGLE. Anyway, we know everything before we get to the pharmacy since we google it the night before. Maybe WebMD would also work.
 
p-rog said:
I don't think these machines would be legal here in Georgia. According to the GA law, attempting to prevent the pharmacist-patient contact when dispensing is illegal. Also, a patient can never pick up or drop off an RX without a RPh present at that location. I think Georgia is just super strict about this stuff because we're also the only state in the country that doesn't allow mail order pharmacy (excluding closed system HMO's like Kaiser).

I believe the laws were added after the fact, when mail order started popping up and I don't think they're going away any time soon here.
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One the related videos shows that there is a phone next to the machine. It's a direct line to a pharm tech/pharmacist.
 
We have InstyMeds in our ER - it's essentially a vending machine. It does fill a need for after-hours care my town where no pharmacies are open past 10 pm. It has a phone on it to call a pharmacist directly.
 
Even though the state has allowed remote dispensing for year, Wisconsin just passed rules about remote dispensing.
 
spacecowgirl said:
We have InstyMeds in our ER - it's essentially a vending machine. It does fill a need for after-hours care my town where no pharmacies are open past 10 pm. It has a phone on it to call a pharmacist directly.
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I interviewed with them when they were a fledgling company! The position was to be the tech on the other end of the phone. I remember them saying that the machine only held simple meds commonly prescribed in the ER - antibiotics and pain meds, mostly.

This is my second post related to pharmacy tech interviews in 10 minutes. I'm on a roll.
 
Once again, the thing with automation/robots is not that they make mistakes but its the humans behind them that makes mistakes. Doctors will always mistakes and this is why we are here.

In retail setting, it wont fly because of too many variables involve. Dealing with insurance rejection alone will be a major headache! I have one tech dealing with insurance problems full time and spend a good amount of my time also calling MD to get drugs changed.
 
The machines will have video monitors and speakers for patient counseling from a pharmacist at a remote site for patient counseling. Of course, when 99% of patients are prompted for counseling, they will elect to forgo counseling. RMOP in a box it is.
 
Trent Steele said:
The machines will have video monitors and speakers for patient counseling from a pharmacist at a remote site for patient counseling. Of course, when 99% of patients are prompted for counseling, they will elect to forgo counseling. RMOP in a box it is.
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The demand for pharmacists will definitely go down then.
Hopefully pharmacotherapy with competent pharmacotherapists takes over then...
 
pharmalt82 said:
The demand for pharmacists will definitely go down then.
Hopefully pharmacotherapy with competent pharmacotherapists takes over then...
Click to expand...
So are all or most pharmacists going to become pharmacotherapists in the near future? I've always been interested in going into pharmacy, but it's hard to tell what the future of the profession will be like years to come.
 
Your predictions are about as accurate as his:

[YOUTUBE]http://www.youtube.com/watch?v=XnwyQFe3wRA&feature=related[/YOUTUBE]
 
I had to use InstyMeds last night, I have to admit, it was pretty slick.
 
RxMTM said:
The solution to patient care would be to just put a computer on it that has GOOGLE. Anyway, we know everything before we get to the pharmacy since we google it the night before. Maybe WebMD would also work.
Click to expand...

Because we all know everything on the internet is true.
 
btpayne13 said:
So are all or most pharmacists going to become pharmacotherapists in the near future? I've always been interested in going into pharmacy, but it's hard to tell what the future of the profession will be like years to come.
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The idea of pharmacotherapy , clinical pharmacy, etc...is extremely overrated in pharmacy profession. It's true that physicians depend on pharmacist on certain area of pharmacotherapy; however, these consults are extremely minimal. Therefore, i wouldn't think all pharmacists will be pharmacotherapists in future once the dispensing model is vanished. Because there won't be enough openings/demand to fit that many of unemployed pharmacists (say that dispensing model is gone). Generally speaking, a hospital with 400-500 beds can have around 4-5 clinical pharmacists/pharmacotherapists...So yeah, it is unrealistic for pharmacists to all become pharmacotherapists....
 
rxforlife2004 said:
The idea of pharmacotherapy , clinical pharmacy, etc...is extremely overrated in pharmacy profession. It's true that physicians depend on pharmacist on certain area of pharmacotherapy; however, these consults are extremely minimal. Therefore, i wouldn't think all pharmacists will be pharmacotherapists in future once the dispensing model is vanished. Because there won't be enough openings/demand to fit that many of unemployed pharmacists (say that dispensing model is gone). Generally speaking, a hospital with 400-500 beds can have around 4-5 clinical pharmacists/pharmacotherapists...So yeah, it is unrealistic for pharmacists to all become pharmacotherapists....
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We have a 230 bed hospital and about 15 pharmacists that do clinical work. Then there are additional staff pharmacists.

You have a great point...look at this: http://www.acpe-accredit.org/pdf/ACPE%20Update%20APhA%20Annual%20Meeting%20March%202010%20PPT2003%20FINAL.pdf

Page 18-23

Don't know how relevant that is...maybe the APhA os selling us dreams?
 
rxlea said:
We have a 230 bed hospital and about 15 pharmacists that do clinical work. Then there are additional staff pharmacists.

You have a great point...look at this: http://www.acpe-accredit.org/pdf/ACPE%20Update%20APhA%20Annual%20Meeting%20March%202010%20PPT2003%20FINAL.pdf

Page 18-23

Don't know how relevant that is...maybe the APhA os selling us dreams?
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I am not sure about what you meant by "clinical work" here...but by that, I meant the pharmacists who are responsible for dosing AG/Vanco/PK monitoring, TPN, ABx reviewing, chart reviewing, IV to PO, Auto sub/switch, making rounds , going for code blue, etc...not the one sitting in front of computer screens and doing order entries. If you really have 15 clinical pharmacists like that and with 230 beds, i am sure you guys are way overstaffed.

My first job as a pharmacist in a hospital with 500 beds..we only had 2 pharmacists AM for clinical shift, then another 2 pharmacists PM overlapping 2 hours. That was it. And another per diem/part time during the weekend.

AphA is a joke...don't believe in their data...very biased. They're also the ones that drilling in students' head about how wonderful residency is until they are done and soon realize there is no job or end up doing the same thing as the guy who didn't do residency.
 
rxforlife2004 said:
I am not sure about what you meant by "clinical work" here...but by that, I meant the pharmacists who are responsible for dosing AG/Vanco/PK monitoring, TPN, ABx reviewing, chart reviewing, IV to PO, Auto sub/switch, making rounds , going for code blue, etc...not the one sitting in front of computer screens and doing order entries. If you really have 15 clinical pharmacists like that and with 230 beds, i am sure you guys are way overstaffed.

My first job as a pharmacist in a hospital with 500 beds..we only had 2 pharmacists AM for clinical shift, then another 2 pharmacists PM overlapping 2 hours. That was it. And another per diem/part time during the weekend.

AphA is a joke...don't believe in their data...very biased. They're also the ones that drilling in students' head about how wonderful residency is until they are done and soon realize there is no job or end up doing the same thing as the guy who didn't do residency.
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Yes, to all of these things. Granted, there are a few part-timers. We have a mobile pharmacist for each area of the hospital.

We don't really have "order entry" (at least i don't think the way you mean it). We have CPOE so the pharmacists just verify it.

The pharmacists in hem/onc, ICU, and transplant go on rounds. A couple do grand rounds.

EDIT: and many of these pharmacists rotate through various areas with the exception of hem/onc. I am thinking my hospital is the exception...

OH...and one pharmacist is the research pharmacist.
 
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rxforlife2004 said:
The idea of pharmacotherapy , clinical pharmacy, etc...is extremely overrated in pharmacy profession. It's true that physicians depend on pharmacist on certain area of pharmacotherapy; however, these consults are extremely minimal. Therefore, i wouldn't think all pharmacists will be pharmacotherapists in future once the dispensing model is vanished. Because there won't be enough openings/demand to fit that many of unemployed pharmacists (say that dispensing model is gone). Generally speaking, a hospital with 400-500 beds can have around 4-5 clinical pharmacists/pharmacotherapists...So yeah, it is unrealistic for pharmacists to all become pharmacotherapists....
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agreed 100%

when you consider the push for CPOE. then pharmacists are not even entering the orders. how can you justify all those pharmacists on staff to prepare medication and dispense? you cannot at their current salary.

all these advances coupled with the excess of pharmacists, i see salaries going buh bye.

i have to agree with the consults being minimal. everyone tries to claim physicians do not know medication. they dont know EVERY med out there and neither do all pharmacists. however, they have better grasps on what they are doing considering a lot of these meds are being used for other reasons.

back to this post, i agree with you here.
 
zkaij said:
I'm just an ignorant pre-pharm, so there are many things I don't understand--please bear with me. So far in the thread, people have expressed either skepticism as to the possibility of this machine replacing dispensing pharmacists or speculation that it will reduce jobs and/or lower pay. Those are your thoughts, as the TC asked for. But me, I'm curious about your feelings about this. Are any of you worried at all? The retail/community ones in particular. CVS is a pharmacy chain, but most of all they're a business right? Maximizing their profits and all that jazz. If they could reduce the number of pharmacists required, then their profits would increase drastically wouldn't they? So don't any of you that are working for CVS fear this or worry for your careers? Just curious both my own sake going towards this career path and for curiosity's sake.
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I don't know how the law in future will change, but for now, in the meantime, you have to understand that you need a pharmacist to be present as long as the store is open.

Of course they would love to cut down the # of pharmacists if they could. However, this will lead to a catastrophic result: medication errors. Imagine you cut down a pharmacist along the line, and there is just one major med error that actually harming the patient...and the patient sues back the company, it would take millions to settle down. So would u rather cut 100K/year-salary pharmacist or take the risk of being sued for millions of $ due to being understaffed ?
 
PharmaTope said:
when you consider the push for CPOE. then pharmacists are not even entering the orders. how can you justify all those pharmacists on staff to prepare medication and dispense? you cannot at their current salary.

i have to agree with the consults being minimal. everyone tries to claim physicians do not know medication. they dont know EVERY med out there and neither do all pharmacists. however, they have better grasps on what they are doing considering a lot of these meds are being used for other reasons.
Click to expand...

We have CPOE here and I have to completely disagree with you, at least for our institution. We have more than enough to do double-checking the physician entries and we have many "pharmacy-to-dose" policies that give us lots of work. Our physicians very frequently consult us on therapy choices, we do lots of drug-drug interaction checking (physicans blow past those screens and only get the most serious interactions/warnings). We do lots of DUE and performance improvement, safety initiatives, etc. We have plenty to do.
 
spacecowgirl said:
We have CPOE here and I have to completely disagree with you, at least for our institution. We have more than enough to do double-checking the physician entries and we have many "pharmacy-to-dose" policies that give us lots of work. Our physicians very frequently consult us on therapy choices, we do lots of drug-drug interaction checking (physicans blow past those screens and only get the most serious interactions/warnings). We do lots of DUE and performance improvement, safety initiatives, etc. We have plenty to do.
Click to expand...

+1 Every single one of our pharmacists does "clinical work". There are tons of pharmacy to dose. They do kinetics, TPNs, monitor drug levels, adjust dosing, recommend alternative therapies, and so much more. The doctors frequently consult the pharmacists, as do the residents.
 
rxforlife2004 said:
I don't know how the law in future will change, but for now, in the meantime, you have to understand that you need a pharmacist to be present as long as the store is open.

Of course they would love to cut down the # of pharmacists if they could. However, this will lead to a catastrophic result: medication errors. Imagine you cut down a pharmacist along the line, and there is just one major med error that actually harming the patient...and the patient sues back the company, it would take millions to settle down. So would u rather cut 100K/year-salary pharmacist or take the risk of being sued for millions of $ due to being understaffed ?
Click to expand...

👍👍
 
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