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Don't look now, but technology is morphing the roles and responsibilities of pharmacists.
The days of deciphering physicians' penmanship, dealing with pill-counting trays and waiting endlessly to confirm prescriptions for traveling patients are dwindling as pharmacy begins to embrace robotics, e-scripts and Web-enabled patient databases.
The changes are primarily driven by two factors: lawsuits and labor. With well-known pharmacies settling out of court and a shortage of skilled workers, the industry is taking a closer look at advances in pharmacy automation.
Robots Reduce Risk
The National Pharmacists Association recommends that, for safety's sake, a pharmacist fill no more than 15 prescriptions an hour.
Pill-dispensing machines are filling the void in many busy pharmacies. But could these robots replace living, breathing apothecaries?
"Technically, there is no reason why a pharmacist could not be replaced by a pill-dispensing machine," says Mark Ludwig, healthcare project manager for Sprint Service Innovation and Evaluation Lab. "The greater issues are legal, ethical and cultural."
Pharmacies are adopting robotics in droves, while leaving druggists on staff to handle legal, ethical and cultural issues, i.e. counseling patients.
Alegent Health's Bergan Mercy Medical Center in Omaha is among the latest pharmacies to adopt robotics. The Homerus Robot, developed by Pyxis Corp., a San Diego-based medication, supply and information management systems provider, will eventually dispense all inpatient medications -- nearly 4,000 each day -- at Alegent Health's four metropolitan-area hospital campuses.
"This robotic system is truly unique in the area and very exciting," says Angela Ward, Alegent's operations director for pharmacy. "We see this as an opportunity to enhance patient safety and let our pharmacists spend more time consulting with physicians and nurses about patient care."
Anatomy of a Robot
The robot is 12 feet tall and has 11 mechanical rings, each containing 72 spirals. Each spiral contains 20 grooves that hold individual medications. When fully loaded, the robot can hold 15,840 doses of medication. Currently, the pharmacy has about 320 different drugs on the robot or about 13,000 doses, Ward says.
Experts say medication errors occur most frequently at three different points in the prescription process: when physicians make the initial order, when the pharmacy fills the prescription and when the medication is administered.
"Studies have shown that 11 percent of medication errors occur when the pharmacy dispenses a medication," says Ward. "That won't happen with this system. The bar code scanning prevents the human error that can occur when the medications are manually picked out of bins."
E-Scripts Speed Filling
Paperless prescriptions are also making their mark on the industry. Giant Food and Pharmacy, among others, has adopted technology that allows doctors to "call in" prescriptions in less than 30 seconds using an Internet connection, handheld PC or cell phone.
US Health and Human Services Secretary Tommy Thompson has supported paperless systems as an effective way to reduce deaths from medical mistakes, cut stress for overworked pharmacists and save money on healthcare costs.
Russell Fair, RPh, vice president of pharmacy operations for Giant Food, agrees. "More than 30 percent of a pharmacist's workday is spent on the phone receiving and clarifying prescriptions," says Fair. "By 2005, retail pharmacists are expected to fill 4 billion prescriptions."
Fair chose a service from OnCallData Inc. for the chain's 154 stores and says pharmacists now spend more time counseling patients instead of answering questions over the phone and processing prescriptions.
Applauding Patient Databases
Finally, patient databases allow druggists to capture, store, analyze and archive information in compliance with HIPAA security requirements. Pharmacists are applauding information technology networks that make it easier to deal with traveling patients.
"These networks can not only capture information at the point of care, but also permit geographically dispersed medical staff, pharmacists and others controlled anytime, anywhere access to the appropriate patient information," says Ben Parker, manager, Sprint Service Innovation and Evaluation Lab. "This permits pharmacists to focus on dispensing medication, conferring with caregivers and patients, as well as managing their own businesses in a more effective, cost-efficient manner."
Experts say IT will continue to change pharmacy. Other areas of focus include supply-chain programs, such as drug-return management systems.
