ATM Kiosks fuel industry expectations

For some, automated prescription delivery kiosks mark an improvement in customer service. For others, they pose a danger to patient safety and pharmacist job security. But everyone agrees we will see more and more of them in coming years.

"We've had more than 500 people sign up for the service at one location in a single month," said Pinney, adding it is particularly popular with patients who refill drugs every month. "People simply do not want to stand in line if they can help it. It's the way things are in society today, and it's not going to change."

"So far, no state board that has considered the issue has blocked their use," said Robert Hanson, VP of pharmacy services for Asteres. In most states where boards of pharmacy have given permission for the automated dispensing kiosks, the machines are allowed to deliver refills only. Some states allow the machines to be open 24 hours a day, seven days a week. Some allow their use only during business hours. All states require that a pharmacist be available to answer questions. In the case of after-hours kiosks, an 800-number must be provided.

"That is hardly a sufficient safety guarantee," said Fred Mayer, president of Pharmacists Planning Service Inc., a nonprofit organization in San Rafael, Calif. "You know how hard it is to get through on an 800-number?" Mayer's organization has fought the machines tooth and nail since they hit the market a couple of years ago, even filing an unsuccessful lawsuit last year to block their use in California. "We have 107,000 deaths a year from adverse drug reactions and interactions," he said. "These machines can only make those numbers worse. Pharmacists shouldn't be trained for eight years to stick something in a kiosk."

The machines also pose an employment threat, said Timothy Haley, account representative for Managed Pharmacy Care & Administrative Services, an independent pharmacy services organization in Lake Arrowhead, Calif., that also opposes the kiosks. The popularity of the kiosks is based solely on profit motive, he said, and that's worrisome.

"I think that anytime automated health care takes a patient further away from a provider, it creates danger," Haley said. "The kiosks rely on two technologies that are simply not well integrated-information and dispensing technologies. The potential for problems is enormous. In most situations, kiosks are not helpful to the pharmacy community. They take a toll on the job market for pharmacists and technicians."