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The human side of $130,000 dispensing robots

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The human side of $130,000 dispensing robots

Patients could be forgiven for thinking of the quirky Willy Wonka factory when they visit the Wattle Park Pharmacy in Melbourne.

Prescriptions are delivered to the pharmacist seemingly out of nowhere via a spiral slide.

Of course, what looks like magic is simply the new frontier in pharmacy — robotic dispensing.

The robot Ben Bradmore and his partner Andrew Robinson installed in September is a little more intriguing than usual, because it was customised for their pharmacy.

The pharmacy is on two levels: the retail shop is below, while upstairs is devoted to packing medications for aged-care facilities.

The robot is upstairs —hence the need for the slide.

Mr Bradmore says the robot saves time on menial tasks — ticking off and putting away stock, and inventory management.

It saves up to fours hours a day, time better spent with customers and growing the business.

“It was not our intention to decrease staff levels, but to make staff more productive,” Mr Bradmore says. “We are doing more Medschecks and we are able to record clinical interventions better than we have in the past.

“Pharmacists have more contact with customers and S3 sales have increased.”

The team also spends more time on healthcare services, and are offering flu vaccinations and weight management support for the first time.

Moving the dispensary upstairs into the robotic system freed up space to install a consulting room and add in new product lines such as new beauty products, newspapers, drinks, a Tatts agency and Myki (public transport) products.

Front-of-shop sales have increased by 4-5% and OTC is up more than 10%.

The robot has also improved cashflow through efficient inventory management.

Stock-holding in the dispensary went down straight away, Mr Bradmore says.

“We were able to move unnecessary stock on hand into dollars in the bank.”

Around 300 pharmacies have installed robotic dispensing and the number is growing steadily, says Robert Allen, the chief executive officer for Dose Innovations.

While they are not new — simpler machines emerged more than 15 years ago — they are becoming more sophisticated and popular.

“This year at APP, there were at least four automated systems. Last year there were two,” he says.

Given the rapid increase in the number of companies offering robotic dispensing, Mr Allen recommends pharmacies do their homework.

They should ask what quality assurance certification and buyer protection the supplier offers.

“Some pharmacies have had to pull out robots because they don’t work.”

Mr Allen says robots will never replace pharmacists.

“Some pharmacists are fearful it will put them out of work, but it empowers them.

“We’re moving away from the 1950s two-counter model, so pharmacists can talk directly to customers.

“What robots can’t do now — or ever will — are human, cognitive functions such as counselling and advice.”

However, the latest innovation, due in July, will provide an additional aid to pharmacists when counselling patients.

It’s a smart-screen system that allows the customer to view OTC medications while the pharmacist explains their use and determines which are suitable, Mr Allen says.

In general, robotic dispensing is suitable for pharmacies dispensing 150 or more scripts a day, Mr Allen says.

The cost typically starts at around $130,000

Another supplier, Andrew Finster of Meditec, says many pharmacies are looking to robots to grow their business, while others see it as something exciting, like a new car.

It’s possible to overinvest in technology, he says.

“Most people do not have enough [cold chain medications] to warrant adding a complex fridge.”

The cost of an integrated system starts around $200,000 with ongoing costs roughly 5-6% of the purchase price, says Mr Finster, who is the Australian business partner of Omnicell, a US robotic dispensing brand.

As a guide, pharmacies need to dispense 300 scripts a day — or be heading in this direction — for an integrated system to be economically viable, he says.

“Unless a pharmacy was expecting growth, they would be challenged for it to make commercial sense.”

“At the lower end of the scale we are still supplying stand-alone channel or chaotic systems (see box).”

Case study: How I found time to help a patient

A real-life experience as told by pharmacy student Nasiha Ahmed

Opinion was divided when the concept of automated dispensing was brought up in Nasiha Ahmed’s
pharmacy class.

“A lot of people were concerned it would take over our jobs,” recalls the final-year University of Technology Sydney pharmacy student.

“Others believed it would give back time to allow better patient care.”

Ms Ahmed got a chance to find out for herself when the pharmacy where she works as a student pharmacist installed robotic dispensing.

Suddenly, she had more time to spend with patients.

“I didn’t have to spend time on tedious tasks like marking off stock and putting it away on shelves.

“I got to spend my time in a more useful way that I have been training for.”

Ms Ahmed was thrilled when that enabled her to pick up a previously unidentified medication side-effect when a patient came seeking OTC pain-killers for a migraine.

“I went through all her medications and found she’d recently been prescribed a new treatment. She was on her third repeat.”

The onset of the migraines coincided with the customer starting this treatment.

Ms Ahmed then contacted the patient’s GP to alert them to the medication side-effect and that the woman needed to be reviewed.

A post about her experience on her Linked-In page spread rapidly among her teachers and fellow students.

“It’s really important to handle change and be open to it because it can definitely benefit patients,” Ms Ahmed says.

“Automated dispensing allows me and pharmacists to engage with patients and give them the time they deserve, and fulfil our duty of care to the best of our ability.

“It is a very rewarding process.”


What to think about when considering a robot

  • Is it viable? The number of daily scripts required to make a robot economically feasible varies according to which developer you speak to. But you need to do your own homework to ensure it will deliver an acceptable return on investment.
  • What features do you need? They’re all seductive, but extras such as cold-chain storage may not be cost-effective.
  • Can the robot keep up with growth of your pharmacy? One of the reasons pharmacies install robotic dispensing is to grow the business. The robot needs to be able to be adapted for a higher stock inventory, if required.
  • What quality assurance does it have? A warranty is obviously a must, but you want to make sure parts and servicing are available through an Australian company.
  • What is the life-span of the robot? The main body of the robot should last many years, with technology in the picking arm for example, able to be replaced and updated as necessary.


Robotic dispensing features

The terminology and functions vary across brands and models, but here is a basic run-down of common features:

Channel system | Similar to an ATM or vending machine, it was the first technology to land in Australia. Offers the fastest dispensing, but storage capacity is limited to around 20% of dispensary stock.

Chaotic system | Imagine a large walk-in closet with lots of storage and a specific shelf for every item. That’s a chaotic system (the original brand is a Rowa). The picking arm selects the item being dispensed from the appropriate shelf. It also sorts and stores medications. Slightly slower dispensing than a channel system (by 8-12 seconds), but has a much larger storage capacity.

Integrated systems | A combination of the channel and chaotic systems.

Tick-off | One system allows complete management of deliveries, from ticking off against the wholesaler invoice to sorting and putting the stock away on shelves.

Inventory control | The robot can provide reliable data about stock on hand, enabling the pharmacy to order only what it needs. Some robots can be set up to prepare orders to submit, based on how many days’ supply the dispensary needs to carry of a particular item.

Uninterrupted power supply (UPS) | Similar to a battery, this allows the robot to keep functioning in the event of a power outage. In the event of a failure, the medications can be accessed manually from the robot. The pharmacist can use the operator console to note which medications have been taken out so the robot can adjust the inventory when it’s back online.




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