Automated pharmacy dispensing comes to a Pennsylvania hospital

January 1, 2009

Good Samaritan Hospital in Lebanon, Pa., has installed the AcuDose-RX system. Pharmacy automation will help prevent errors, streamline delivery of care, and support economies of scale.

Key Points

Every day, more pharmacies are turning to automated solutions as they strive to decrease errors and increase the amount of time pharmacists can spend with customers.

One of the latest institutions to make the move to high tech is the Good Samaritan Hospital in Lebanon, Pa., which recently installed a fully automated, bar-code, point-of-care solution for dispensing medication in the pharmacy.

A hospital spokeswoman said the change was made after the Food and Drug Administration identified specific errors caused by handling mistakes such as illegible handwriting or misinterpretation of instructions. The hospital hopes the new system will help prevent those problems.

To fully automate the medication management process, the hospital invested in a number of technological enhancements to the pharmacy, medical information system, and patient care floors.

"By investing in state-of-the-art pharmacy technology, we improve our ability to provide care throughout the entire health system," said Senior Vice President and Chief Operating Officer William Hendrick. "The new system allows us to become more efficient by purchasing medications in bulk and automating the process of filling patient orders. Even more important, the FDA has affirmed that these systems are so accurate that they reduce the likelihood of medication errors, which helps us to further promote patient safety."

The process began with the installation of a fully electronic, paperless medical record system. The system is designed to link together the patient registration, medical record, and billing systems.

Nurses at the hospital are using laptop computers to access the electronic medical record system, which allows them to retrieve and update information in the patient's medical records. Once the bar-code system is fully in place, nurses will carry handheld scanners that can capture the same information in much less time.

The next step was the installation of the AcuDose-RX system. The system automates the secure storage and rapid dispensing of narcotics and other frequently prescribed medications in patient-care units. Currently, 722 hospitals nationwide, 56 of them in Pennsylvania, are using the AcuDose-RX system.

The system is composed of a cabinet with multiple secure drawers of numbered compartments.

Nurses use a touch-screen computer and keyboard to log in and enter patient information. If it's time for the patient to receive medication, a drawer will open and the screen will indicate the compartment that contains the proper dose. The system also enhances secure inventory management. Each time a medication is dispensed by the system, it automatically updates the count. It requires a hand-keyed inventory of any narcotics.

The hospital's staff calls the ROBOT-Rx the "heart" of the bar-code system. The robot is found in only one-third of medium and large hospitals nationwide.

The pharmacy computer sends the robot prescriptions that have been verified by pharmacists; these prescriptions were received electronically or hand-keyed from traditional handwritten slips. The robot uses a bar-code reader to scan the bar-coded peg to identify the medication and dosage it holds. Once the robot determines that the medication matches the prescription, it selects the packet and carries it to a chute, dropping it into an envelope pre-printed with the patient's name, room number, and unique bar code.

The envelope is then taken by a pharmacy technician and prepared for delivery to the patient's room. For the first 30 days, 100 percent of the prescriptions filled by the system are reviewed. After the 30-day period, and if 99.9 percent accuracy is achieved and sustained, it is randomly checked.