Robot may be right medicine for pharmacy

Loma Linda University Medical Center installs high-tech system to dispense drugs. R2D2 it's not. But ROBOT-Rx, a tireless, speedy and precise robotic arm that scoots back and forth

Thursday, February 17th 2000, 12:00 am

By: News On 6

Loma Linda University Medical Center installs high-tech system to dispense drugs.

R2D2 it's not.

But ROBOT-Rx, a tireless, speedy and precise robotic arm that scoots back and forth on rails, is very much like a gadget out of "Star Wars".

The high-tech mechanical servant all but eliminates medication dispensing errors, according to the manufacturer. After a month of testing, it has been in use three days in Loma Linda University Medical Center's second-floor pharmacy.

This technology comes as pharmacists nationwide worry that increasing workloads and stress are increasing the likelihood of medication errors that could harm patients, said Paul M. Norris, the director of pharmacy services.

"It allows us to reduce dispensing errors and to free up pharmacists to be up on the floors making rounds with physicians."

Loma Linda is the first Southern California hospital equipped with a ROBOT-Rx, said Michael S. Espy, a sales executive for McKessonHBOC Automated Healthcare, the Pittsburgh-based manufacturer.

Riverside Community Hospital is installing a similar system, Espy said.

"I like watching it work," Norris said, chuckling. "It doesn't take breaks or holidays off."

According to Norris, the device is a centralized, robotic drug distribution system that stores, dispenses and restocks bar-coded medications for hospital patients.

The robotic arm operates on vertical and horizontal rails. It's programmed to retrieve medications and deposit them into plastic trays called cassettes.

Running 24 hours a day, it rolls back and forth on tracks as it twists left and right, plucking clear-plastic bags of medication off of pegs and plopping them in cassettes destined for patients around the hospital.

The system comes in seven sizes, ranging from $300,000 to $700,000. It employs bar codes (akin to those used to inventory goods on supermarket shelves) to verify, retrieve and track medications from drug wholesaler to patient.

All drugs come in bar-coded packages, which contain specific information, such as whether the medication is generic or brand-name, its expiration date and lot number. Bar coding allows uniform labeling, which greatly increases accuracy and safety, Norris said.

Bar-coded medications and patient identification bar codes also can be scanned at the patient's bedside to reduce errors, he said.

The tireless automaton can move six feet per second and is capable of picking one medication in less than three seconds, 10 medications for a single patient in less than 30 seconds, and filling orders for 120 patients per hour.

The 200-plus ROBOT-Rx hospital pharmacy systems installed nationwide have dispensed more than 45 million doses without a single error, according to the manufacturer.

The National Pharmacists Association recommends that pharmacists fill a maximum of 15 prescriptions per hour for the sake of patient safety. Studies conducted at Auburn University School of Pharmacy in Alabama and elsewhere have found that the rate of pharmacists' errors increases after they fill more than 24 prescriptions per hour.

Last year, David Lawrence, chief executive of Oakland's Kaiser Health Plan, the nation's largest HMO, reported that about 180,000 patients die each year from errors or complications arising from the use of prescription drugs.

Speaking to biotech industry executives, Lawrence compared the death rate from drug errors in hospitals to two 747 jetliners crashing every three days, killing all aboard.

"When you go into a hospital, you should be safer than when you step onto an airplane," Lawrence said. He noted that statistics show the average patient is not.

The ROBOT-Rx doesn't operate without any human control, Norris said. Before the device gets its orders, a computer system screens prescriptions from doctors to check for allergies, drug interactions and that the dose is appropriate, he says.

Norris predicts that within 10 years robots may be able to understand drug interactions, diseases and dosage forms well enough to minimize even that human intervention.

"Then we'll have `RoboPharm,' " he said.