Automated drug dispensers become more popular in Fargo-Moorhead

FARGO – A screaming child with a late-night earache will make any parent’s skin crawl.

Not only may the pain trigger a trip to the emergency room, but the chances of getting needed medications before morning are often nil.

The InstyMeds machine at Innovis Health in Fargo dispenses prescription medicine much like a vending machine. (David Samson/The Forum)

Hospitals can’t stop ear infections, but several are addressing the prescription problem by installing ATM-style machines that dispense drugs.

These InstyMeds systems hold dozens of commonly prescribed medications, giving patients access to drugs after retail pharmacies close or saving them another trip when they’re not feeling well.

“For us, it was really about offering our patients the convenience factor,” says Todd Forktel, an administrator at Innovis Health. The Fargo hospital installed its system in April.

InstyMeds works much like an ATM machine, automatic car wash or any other type of automated kiosk.

A physician sends the prescription to InstyMeds via a computer. The patient receives a code that he or she punches into the machine to retrieve the medication, which is labeled and comes with instructions.

The system bills the patient’s insurance. Co-pays are accepted via credit card, debit card or cash. If problems or questions arise, patients can use an attached phone to reach an InstyMeds pharmacist.

“They’re so easy to use,” says Natalie Rund, emergency department nurse manager at Lake Region Healthcare in Fergus Falls, Minn. “I tell patients, if they can use an ATM machine, they can use this.”

Each hospital determines which drugs the machine will dispense. Limited supplies of antibiotics, anti-nausea drugs and pain relievers are among the most common.

InstyMeds doesn’t allow refills and most hospitals avoid filling it with medications designed for chronic conditions like high blood pressure.

“We’re not trying to compete with the pharmacists,” says Chris Harff, CEO at MeritCare Thief River Falls, Minn. “We just want to help patients who like the convenience.”

The technology fills a gap in communities that don’t have pharmacists ready to fill prescriptions 24 hours a day, seven days a week. For example, there’s no retail pharmacy open in the Fargo-Moorhead area after 10 p.m., Forktel says.

MeritCare in Fargo has a pharmacy open all the time for its emergency room patients, but not for the general public, says spokeswoman Carrie Haug.

MeritCare Thief River Falls installed its InstyMeds machine several years ago, Harff says.

“Patients love it,” she says. “If you’re sick enough to go to the emergency room, you don’t want to hang out at the pharmacy. They’re done when they leave here.”

Not everybody is fond of the technology. The North Dakota Board of Pharmacy discourages the use of dispensing machines like InstyMeds, says Howard Anderson, its executive director.

“Research has shown that the best scenario is for a patient to get information and counseling from a pharmacist,” he says. “We recommend physicians give the patient a starter supply of drugs and a prescription so a pharmacist reviews it as soon as possible.”

North Dakota has a telepharmacy program that allows patients to consult with a pharmacist even if one isn’t in the community, Anderson says.

“We’re not telling physicians they can’t dispense medications, but we’d prefer they look at this (telepharmacy) model,” he says.

Emergency rooms and urgent cares with automated dispensers still allow patients to get their prescriptions filled at a pharmacy. But patients who are comfortable getting cash from ATMs and checking in on airline flights via computer terminals have few qualms about doing the same for their prescriptions.

“In the evenings, everyone’s wondering how they’ll get medications,” says Dr. John Baugh, who works in the emergency room at Innovis Health.

Physicians, too, wonder if they’re giving patients enough drugs to last until they can get to a pharmacy, he says.

The popularity of InstyMeds has increased since Innovis installed its system in April. The first month, it dispensed 249 prescriptions. During three weeks in July, it dispensed 418 before running out of medications.

Baugh say, “Most patients seem to want to use it so they can get their medications and go home.”

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Telepharmacy project at the GLFHC West site

The Greater Lawrence Family Health Center recently announced the grand opening of the Telepharmacy project at the GLFHC West site, 700 Essex St. in Lawrence. The program is the first-of-its-kind project in Massachusetts which allows increased access to prescription drugs via remote medication dispensers.

"The Health Center has worked closely with the Board of Pharmacy, the Massachusetts Department of Public Health, and the Massachusetts College of Pharmacy and Health Sciences to help launch the program," according to Robert Ingala, GLFHC Chief Executive Officer. "MCPHS will work with the Center in order to help evaluate patient compliance and measure project successes." One way the Telepharmacy will improve patient compliance is its ability to print labels and directions in a patient's native language.

The Automated Drug Dispensing System (ADDS) allows pharmacists to reach more patients in more locations. The self-contained, computer-controlled automated prescription dispensing system which allows for the remote monitoring and dispensing of pre-packaged, unit-of-use pharmaceuticals is HIPPA-compliant. Along with the technology, patients are required to receive prescription counseling from the GLFHC pharmacist via a two-way audio and video system in a private counseling area.

From the clinical aspect, the ADDS system allows for quicker interaction with the patient, the pharmacist and the physician in the event of problems like drug interaction or insurance issues.

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