Ms. Heinze is a freelance writer based in Vancouver, British Columbia.
Matt's Medicine Store in Independence, Missouri, was facing a problem not uncommon to many community pharmacies today: The volume of prescriptions was increasing, and the staff was finding it difficult to keep up with the workload.
Matt Mallinson, RPh
"We close at 6:00, and we were not getting out of here until 8:30," explained Matt Mallinson, RPh, owner. "Employees were disgruntled, obviously, and we were all missing family events that we should have been going to. It was a work environment that just wasn't very comfortable; we had to do something to be able to do more prescriptions and get them out of here."
Mallinson knew the answer: By automating a large portion of his store's prescription fulfillment, turnaround time would decrease, and not only would he and his employees get out the door when they should, but his business in general would become more streamlined. He spent 3 years researching various automation options, finally settling on a ScriptPro SP 200—a robot with the capacity of dispensing 200 different drugs.
"The biggest time waster is the manual preparation of prescriptions: the counting of pills into the bottle, the peeling off of the label, attaching it, getting the bottles off the shelf and putting them back, making sure that you have the right bottle and dumping the excess pills back into the bottle," explained Mike Coughlin, president and chief executive officer (CEO) of ScriptPro in Mission, Kansas. "When you look at all of the steps that a pharmacy goes through in starting with a piece of paper and ending up with a prescription—labeled, with the drugs in it—there is a larger number of steps to go through."
Mike Coughlin, President and CEO of ScriptPro
Not only does a robot perform these tasks automatically, it may be replenished at the pharmacist's convenience. Most importantly, it reduces the potential for human error.
"There is huge error reduction," Coughlin emphasized. "You are handling the drugs once, because you are taking a bulk stock bottle and you are pouring it into the machine. If you follow the procedure of bar-code scanning and matching the bottles, then all of those drugs that are loaded at the beginning of the day or the night before are going to be accurate."
For Mallinson, the decision to automate was a natural progression. "Most of us know that our volume is going to be increasing, and our profit margins are continuing to decline," he said. "We have 3 choices in our profession right now: We may wait for retirement, sell out, or automate and continue in business." Although the purchase of the machine required a considerable investment up front, it has saved the pharmacy money in the long run. It costs roughly $1.25 to fill a prescription with automation, versus about $4.25 with an employee.
Jim Wilson, RPh, MBA
Inventory management—one of the biggest challenges that any business faces—is made easier because these systems track stock in real time. "With automation, there is no getting around that; they actually replenish inventory when they stock the machine, the machine counts it all and they know how much they are dispensing and exactly what they need, and they can calculate reorder rates so they don't run out," said Jim Wilson, RPh, MBA, president of Wilson Health Information, LLC, in New Hope, Pennsylvania.
Mallinson's inventory costs have also gone down, despite the argument that the initial loading of a robot requires a significant inventory investment up front. "When I ran my top 400 products to figure out which top 200 I wanted to put into the machine, I saw that I was buying 3 to 4 bottles of a certain drug a month anyway," he explained. "If I buy them 2 at a time and fill the machine up, what's the difference in buying them 2 at a time every 2 weeks, or 1 every week?"
Because of the time that he saves on processing prescriptions, Mallinson is free to seek better deals on inventory as well. "My inventory costs went down because, if you're staying at work every night until 9, you don't have the time to look at the cost of goods. Now, with the robot, I have a little extra time to look at my cost of goods," he said, adding that he is saving half the cost of the machine per month by shopping around for generics. "That is not the advantage of the machine, but the advantage of me having more time and becoming a better businessperson." This also enables Mallinson and his pharmacists to spend more time with patients, and, consequently, he has noted an increase in OTC sales.
Matt Mallinson, RPh, uses ScriptPro 200 technology to verify a prescription at his pharmacy in Independence, Missouri.
At first, Mallinson admits that he was worried that patients would be reticent to accept their prescriptions from a machine; however, that concern dissipated as he examined how many other automated sources they do business with. "You start realizing that we have become an automated society, and the consumers accept it," he said. "They are accepting their prescriptions through the mail, so there is not an issue with it—especially when you explain to them that it's error-free and that is does not grab the wrong bottle."
Mallinson notes that the installation and training period was relatively seamless. The incorporation of the machine did not require the pharmacy to undergo a major overhaul, and employees were comfortable with the robot in a matter of several days. ScriptPro technicians were on site to answer any questions during the first week of operation, and Mallinson, once having made the decision to automate, involved his team in the project from the get-go. He advises his peers to do the same and to take their time in researching the machine that is best suited for their operation.
Wilson, too, emphasizes the importance of conducting a thorough assessment of the marketplace. "They need to do their due diligence by comparing different systems and meet with the manufacturers to get the full picture— not only how much the robot costs, but what the overall cost will be in the scheme of things," he said. "Things change, and their volume might change 2 years from now. They need to make sure it is the right machine for the volume of business that they expect to do." Some machines are easier to clean and maintain than others (and therefore less susceptible to creating issues surrounding cross contamination); some manufacturers offer better technical support. All of these factors should be taken into consideration long before a purchase is made.
While not every pharmacy may be ready to make the investment that is required to implement automation, Coughlin encourages pharmacies to design their work flow so that it can eventually accommodate robotic systems. "In almost every industry, automation is viewed as a fundamental element of a productive system," he said. "You want to make things happen as automatically as possible, and once you've assessed what the automatic functions are, you lay out your work flow and your facility design around that."
In the long run, this approach saves pharmacies both time and money. "Some pharmacies try to hang on without going to that level, and they end up adding people and implementing less powerful systems. Ultimately, they end up with a robotic solution, and they probably should have been looking at that from the start. You need to at least be planning it into the design process."
In Seniors: Consider CMV Serostatus
When Recommending Flu Vaccine
Older people who have cytomegalovirus seem to have less robust responses to the trivalent influenza vaccine than those who do not have CMV.
News from the year's biggest meetings
Clinical features with downloadable PDFs