Pharmacy Informatics Exchange: Hospitals try ATM for drugs

Hospitals try ATM for drugs

3/16/2009 11:46 AM from http://www.nationalpost.com/story-printer.html?id=1393577

Hospitals try ATM for drugs

Machine connects to call centre to dispense pills

Tom Blackwell, National Post

Peter J. Thompson/National Post

Hundreds of Toronto patients have been picking up their prescription drugs in recent months much as they might withdraw cash or buy a can of soda -- from special vending machines that some observers believe could transform the pharmacy business.

Customers using the PharmaTrust kiosks insert their prescription into a slot and, a few minutes later, the device spits out their medication.

Skeptics question whether the machines will ever duplicate the benefits of meeting in person with a druggist. Proponents, though, say the Canadian-made invention, which allows users to communicate with a real pharmacist by video link, offers real convenience when there is no pharmacy open, or close by.

"I think it could be the next BlackBerry," says Dr. Sharon Domb, medical director of family medicine at Toronto's Sunnybrook Health Sciences Centre, which has been testing the technology since last June. "The feedback has been positive: 'It's great, it's fast, I don't have to go anywhere else.' "

Another hospital -- Cam-bridge Memorial in southwest Ontario -- plans to install the machines in its emergency department next month, while more are to be rolled out in a large, east-end Toronto doctor's office at about the same time.

Some pharmacists will undoubtedly feel threatened by the technology, says Jeff Poston, executive director of the Canadian Pharmacists' Association.

But he predicts the machines will have only a niche role, likely in remote communities that have limited pharmacy services, since the devices offer patients a "lesser" form of communication with the druggist.

"I tend to think the face-to-face encounter with the pharmacist would win hands down," he said.

Yet the notion of purchasing prescription medicine somewhat as one would buy a bag of chips does not seem as jarring to many patients as it sounds.

Shelly Dev, a long-time patient of Dr. Domb's at Sunnybrook, even suggests the machine's built-in telephone allows for a more private conversation with the pharmacist, while the whole transaction is far quicker than visiting a drugstore.

She used one of the dispensers for the first time on Friday to fill a prescription for antibiotics, and was done in less than five minutes.

"It's very easy to use," said Dr. Dev, who is an intensive-care physician at Sunnybrook. "Usually, for most folks, you go see your physician ... you leave, you go to another place to drop off your prescription, you have to go back to pick it up. It's monotonous."

When customers insert their prescription, the ATMlike machine -- made by PCA Services Inc. -- snaps high-resolution photographs of both sides and transmits them to a pharmacist waiting in the firm's Oakville, Ont., call centre.

He or she reads the information, directs the machine to start dispensing and waits while robotic technology finds the prescribed medicine from among 340 different drugs stored inside. Once the pharmacist has verified the kiosk has picked the right product, the machine pops out the order.

During the transaction, the customer speaks to the pharmacist via a telephone and video screen built into the kiosk.

Just over 800 patients used the machines at Sunnybrook to obtain 1,200 prescriptions between June and September. A survey of 108 of them indicated that more than 95% received their drug in less than five minutes and would use PharmaTrust again, said Peter Suma, president of PCA. None of the prescriptions was incorrectly filled, he said.

Not everyone, however, was able to take advantage of the pharmaceutical ATMs. About a third of patients who tried discovered that their medicine was not available, said Dr. Domb, though PCA offers to deliver those orders to the patient's home the next day.

Despite such limitations, Mr. Suma predicts his kiosks will be embraced by consumers accustomed to instant, technologically aided service, especially when the devices are "deployed ubiquitously."

"Although this seems controversial now, I bet the telephone seemed controversial to the guys who were delivering messages back then," he said.

And steps are being taken in one province, at least, to allow much wider distribution of the machines, which in Ontario can be set up now only in hospitals and clinics.

The Ontario College of Pharmacists recommended last week the province change the law to allow all "remote" dispensing-- whether it involves a machine or a technician based in an isolated locale -- as long as a licensed pharmacist oversees the transaction.

"It could be a very good thing, provided the safeguards for the public and accountability are in place," said Deanna Williams, the college's registrar.

The financially strapped Cambridge hospital will earn some revenue from the machines, but contracted with PCA chiefly to offer convenience to emergency patients who show up 24 hours a day, said Julia Dumanian, the hospital's CEO.

Relatively few pharmacies in the community are open late, let alone all night, she said.

Meanwhile, PCA is on the verge of striking deals with major clients in the United States and the United Kingdom. In those cases, the company plans to partner with another organization, which would run the call centre, much as RIM works with cellphone networks to provide Blackberry service, said Mr. Suma.