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Robotic Rx

Bayfront Medical Center has a special new employee. Meet Phil, the prescription-filling automaton.

Published November 2, 2003

[Times photo: Dirk Shadd]
Phil, whose official name is McKesson Automation Robot-Rx, reads bar codes on 658 different packages of medications in its tiny dispensing room.

ST. PETERSBURG - Phil, the new guy, sits patiently in his room in the basement of Bayfront Medical Center, waiting for his boss to leave.

Phil needs his privacy. He can't do a thing until Jeff Lannigan steps outside and the right buttons on the panel are pushed.

When that finally happens, Phil springs to life and whirls around a metal pole in the center of the glass-walled room.

Then he plucks packets of prescription pills off a wall with his suction cups, sounding like Darth Vadar after a foot race.

Phil is the name Lannigan gave to a state-of-the-art drug-dispensing robot, the first of its kind in the Tampa Bay area. The official name is a McKesson Automation Robot-Rx.

Bayfront is holding a contest to name the robot. The winner will be chosen Nov. 11.

Besides Phil, other suggestions include Count Drugula, Bay Bot and Regis Pillbin. One person has suggested Mr. Right.

"We're excited he's here," Lannigan, Bayfront's pharmacy manager, said as he watched Phil work. "He's certainly needed."

Because the squeeze is on.

More than 3-billion prescriptions will be filled in the United States this year, according to the National Association of Chain Drug Stores. That includes prescriptions filled by chain and independent drug stores, supermarkets and mail services.

Doctors will write the equivalent of 10 prescriptions for every person in the country, and as the population ages and drugs are more aggressively marketed, the numbers are growing.

A shortage of pharmacists needed to keep up with the demand hit its peak two years ago, but it still exists in some areas. There are about 5,000 open pharmacy positions nationwide.

And because of the paperwork and overwork associated with the enormous volume of prescriptions, mistakes still are being made. Most estimates put the number of mistakes at about 4 percent.

Still, that represents more than 100-million mistakes a year - sometimes with tragic consequences.

The Food and Drug Administration estimates that as many as 7,000 people die each year in hospitals, and tens of thousands more in outpatient facilities, because of preventable medication errors.

Enter the robots.

They arrived on the scene about five years ago, mostly for use in large mail-order companies, but now are coming to hospitals.

Bayfront's robot, which took four men a week to install in August, reads bar codes on 658 different packets of medications hanging from metal rods inside its tiny dispensing room.

In an instant, it reads which company made the drug, what the drug is and what size the package is.

If the machine cannot read the code because the package is crimped or for any other reason, it removes the package and drops it in the "reject" bin.

To restock the drugs, a pharmacist loads packets on the inside of the door and shuts it. The machine then reads the codes, removes the packets and places them on their proper rod.

From the time a physician puts the order into a computer until it's filled and dispensed, the process is driven by the bar codes. In the final step of the process, which Bayfront hopes to initiate next year, nurses on the floor use devices that also read the codes and match them to patient codes.

"What used to take us 24 hours to do, the machine does in 31/2," Lannigan said.

It also frees pharmacists to, as Lannigan put it, "do more of the clinical work we were trained to do: look at drug therapy and try to get a better outcome.

"Maybe you don't need that med. Maybe there's another one that will work better. Then we take those suggestions to the physician.

"Maybe you can switch from an IV antibiotic that costs $20 to one you take by mouth that costs $3."

The robots are expensive. Phil is worth close to $1-million, although for the next seven years, Bayfront is leasing the machine for a yearly fee that is about a tenth of his total cost.

It might not be long before smaller, less expensive models show up at corner drugstores, leading some to wonder whether filling a prescription with a robot eventually will be like banking with direct deposit and ATMs.

Could this signal the end of the friendly neighborhood druggist?

Pharmacists contend it could have the opposite effect.

"Automation won't replace pharmacists," said Susan Winckler, a pharmacist and vice president for policy and communication for the 50,000-member American Pharmacists Association. "The role that the automation plays is the nonjudgmental task: the counting and the pouring."

And the system, Winckler said, is still not error-free.

"You have to put the right medications in the packet and do the right programming," she said. "The machine will dispense the product in bin five when asked to. But if that is supposed to be Lipitor in there, but is actually Allegra, the machine will not catch that. That's human error.

"So you still need that health care professional reviewing the records and saying, "Yes, that bottle of Lipitor is for Mrs. Jones.'

"But if a machine can count out 100 pills for my mother while the pharmacist is talking to her, that's a good use of automation and a good use of the pharmacist's time."

[Last modified November 27, 2003, 06:59:31]

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