WITH AN INCREASING NUMBER OF PRESCRIPTIONS THAT MUST BE FILLED ON a daily basis, pharmacists are faced with many concerns, such as inventory management, maintaining an efficient workflow, and preventing medications errors. All of these are critical to providing high quality pharmaceutical care to patients.

These were some of the issues faced by Glenn Rebber, RPh, at Family Practice Pharmacy, an outpatient clinic and pharmacy in Waco, Texas. Rebber realized that he needed help with the workflow process because the volume of prescriptions he and his fellow pharmacists were dispensing was increasing drastically. At first, his main interest in installing an automated dispensing system was to improve the work environment by relieving stress and improving workflow. Rebber looked at a number of systems before he found one that he believed would not only improve the workflow and inventory management, but also prevent dispensing errors. "Reduction of medication errors became a critical consideration," notes Rebber.

Family Practice Pharmacy chose the ScriptPro SP 200 robotic prescription dispensing system. This system has allowed the pharmacy staff to maintain an efficient workflow and provide high quality health care. Today, the pharmacists at Family Practice Pharmacy dispense over 500 prescriptions per day during an eight-hour shift with two pharmacists and four technicians. The ScriptPro SP 200 provides time-savings because the staff does not have to retrieve medications or label medication vials, since these functions-counting, filling, and labelingare performed by the machine. In addition, the system assures accuracy because of system checks and balances that use bar code verification.

Indigent Patient Programs
Filling prescriptions for indigent patient programs is a large part of the pharmacy's practice. Rebber estimates that Family Practice dispenses over $4 million per year on medications for indigent patient programs, such as Pfizer's Connection to Care and Sharing the Care. The pharmacy receives medications at a discounted price and these medications are to be dispensed specifically to patients enrolled in these programs. The pharmacy is required to keep a separate inventory for each medication that is covered under these plans. Managing these parallel inventories can be a time intensive process.

ScriptPro has proved to have significant advantages for this specific need. Rebber notes, "We can now keep a separate stock of the medications for the indigent patient programs without disrupting workflow and inventory. ScriptPro allows you to assign an owner to each cell. For example, when a patient enrolled in the Connection to Care gets a prescription filled for Glucotrol XL, ScriptPro is able to recognize which cell holds the Connection to Care stock. The medication is dispensed from a cell that is assigned for the Connection to Care Glucotrol XL rather than from the regular stock of Glucotrol XL."

Inventory Management
Since installing the new automated dispensing system the pharmacy has decreased inventory by 20%, while filling more prescriptions compared to the previous year. One of the features that enhances inventory management is the ability of the machine to detect when a cell has a low quantity of medication. Each cell can be adjusted depending on the volume used for each drug. A minimum and maximum limit can be set for each cell. If the supply of a medication drops to the minimum, the machine alerts the staff, so that medication can be reordered. In addition, the status of all 200 cells can be easily accessed on the system monitor in the control center, with green, yellow, and red indicating full, low and empty levels of cells.
Another benefit of ScriptPro SP 200 is the ability of the machine to prevent dispensing of expired medications. "When the medications are added to the machine, the technician or the pharmacist must input the lot number and expiration date on the manufacturer's label," added Rebber. The system will not dispense medications that have expired.

Rebber looked at a number of systems before he found one that he believed would not only improve the workflow and inventory management, but also prevent dispensing errors.

Patient Safety
Most important to Family Practice Pharmacy, ScriptPro SP 200 has the benefit of helping to prevent medication errors. By assigning a cell to each medication, the system ensures that the correct medication is going to be dispensed. Each cell has a permanent bar code label. When a cell is filled, bar code scanning of the stock bottle and the cell ensures the correct NDC match. If a cell were placed in the wrong location, the robot would send a warning message, and would not dispense the order. When filling an order, the robotic arm scans the cell's bar code before opening it, assuring the medication is dispensed from the correct cell. The prescription label also indicates which cell the medication was dispensed from. Bar code scanning assures that the medication was dispensed from the correct cell. Furthermore, the prescription label, which is printed by the system and applied when the medication is delivered to the conveyer, also contains a line drawing and description of information such as the color, markings and shape of each drug. During the filled prescription scan an on-screen image of the drug provides an additional check before the technician caps the vial. Every medication label, even those that are not loaded into the ScriptPro SP 200 cells, has a bar code that must be scanned to assure that the pharmacy personnel obtained the correct medication. Pharmacy personnel also scan their PIN bar code so that the system has an electronic record of time, date, and personnel.

Support
Support is a crucial factor in any purchasing decision. Rebber notes, "During the past two years, the system has only been down one day. ScriptPro was here immediately to get us up and running again." The ScriptPro call center is available for problem resolution 24 hours a day, 7 days a week. The system is delivered and installed, with training and go-live support.

Though Rebber notes that vials must be handloaded into the robotics cabinet, the time spent on this is more than made up for by the time saved in retrieving and labeling. The system can dispense more than 100 prescriptions an hour. Family Practice Pharmacy now operates quicker and more efficiently, with greater staff satisfaction and patient safety.