Over the years, information and automation systems implemented within the outpatient pharmacy have significantly improved the efficiency and accuracy of prescription intake, dispensing, verification and point of sale processes. Yet the prescription “will call” or “pick up” function, the last stop for an outpatient prescription prior to sale to the patient, often remains a manual process. This reliance upon manual retrieval of filled prescription sorted and stored by Rx # or patient name has several significant potential issues:
- Increased Medication Errors: Picking errors (wrong patient) and bundling errors (wrong or missing drugs), often from multiple storage locations, result in selling errors or mis-sells, which not only represent the second highest occurring error within pharmacy operations but also represent a major opportunity for HIPAA violations and fines as a result.
- Increased Drug Diversion: Unsecured will call/pick up storage areas for filled controlled substance prescriptions and other prescription drugs with a high resale value represent a prime opportunity for internal diversion and theft within the outpatient pharmacy.
- Increased Patient Wait Times: The inefficiency created by manual sort systems to rummage through filled prescription bags in order to find a specific patient’s prescriptions is often a significant component of patient will call wait times, as well as a source of frustration for pharmacy staff members and decreased patient satisfaction.
There have been a few semi-automated solutions such as hanging bags with RFID (Radio Frequency Identification) chips and LED lights, which can reduce the potential for will call medication errors and reduce patient wait times. However, these systems often require additional pharmacy staff time to manually overbag filled prescriptions and then manually sort and place them in the appropriate storage sequence. In addition, these systems do not provide a secured storage location, especially for controlled substances. Finally, these solutions do not address the documentation gap of who placed the prescription in and retrieved it from the will call system. This is typically a key gap in drug control accountability documentation within most outpatient pharmacies.
The IntelliCabs™ Solution provided by GSL Solutions addresses these current shortcomings of manual and semi-automated will call/pick up processes. Much like GPS (Global Positioning Systems), GSL associates an RFID tag to a prescription and then tracks that tag with radio antennas. Prescriptions are assigned and processed in one of three different size workflow baskets (SmartBasket™) with a unique imbedded real-time RFID tag. The system keeps track of the location of the workflow basket and the associated prescription(s) and is linked to the patient name or patient identifier.
Upon filling and verification of the prescription(s) by the pharmacist, the SmartBasket™ with the completed prescription(s) is randomly assigned by the Intellicab software to any vacant cubby within a secured storage drawer which collectively comprise a modular intelligent storage cabinet called IntelliCabs™. (As such, multiple prescriptions for a single patient can be broken up and placed in separate cubbies if necessary since marrying bundles is no longer an issue.) IntelliCab drawers are enhanced with RFID badge readers that allow for access to each activated drawer and ensure accountability by identifying which person accesses its content. Pharmacy staff members are assigned an RFID identification badge, which allows them access to the Intellicab drawer(s) and system based on their pre-assigned user-role.
Upon being served at the will call station, the patient’s prescriptions are identified in the usual manner. Then, through integration with the pharmacy’s prescription processing and/or point of sale system, the Intellicab locations are automatically activated. The pharmacy staff member badges into each activated Intellicab drawer and retrieves the completed prescriptions from the designated cubby location(s). To aid in retrieval, lights and sounds help guide the user to the right Intellicab drawer and cubby location. The pharmacy’s normal operating procedures using the prescription processing and/or point of sale system accomplish a double check of final prescription dispensing and sale validation.
This type of active RFID will-call system has several advantages compared to manual or semi-automated systems.
- Accuracy: Intellicabs reduce picking errors and bundling errors compared to manual alpha or numeric filing will call system processes, as well as incomplete pick-ups resulting from an inability to quickly find filled prescriptions. In addition, HIPAA compliance risks and fines are significantly reduced due to a reduction in patient mis-sells.
- Efficiency: Additional pharmacy staff time to prepare and package completed prescriptions for manual or semi-automated will call systems is not required. Time consuming manual alpha and/or numeric sorting, placement and finding processes are eliminated. Also, the system is designed to allow multiple users to retrieve prescriptions simultaneously. Finally, identification of and return to stock prescription processes are significantly enhanced due to date and time stamps when placed in will call storage.
- Security: Intellicabs provide a secure storage area for both controlled substances and other high value prescriptions to minimize internal diversion of filled prescriptions. In addition, the system provides complete pharmacy staff member accountability, including activity and physical location, from prescription intake to final patient sale for each step of the workflow.
- Satisfaction: Staff member interactions and patient experience and satisfaction are improved as a result of reduced frustrations of finding a patient’s prescriptions and reduced wait times.
Intellicabs have been used extensively by the Department of Defense (over 15 million prescriptions processed) and more recently Kaiser Permanente and Safeway pharmacies. They have been able to improve efficiency, compliance, and reduce wait times.
We look forward to the release in Q1 2017 of GSL’s Intellivault product, which using similar technology and processes, will assist outpatient pharmacies with the tedious manual physical control and inventory documentation of controlled substances stored and utilized for prescription filling in the outpatient pharmacy.
Visante consultants believe this product offering presents outpatient pharmacies with a unique opportunity to improve patient safety, security of the medication, pharmacy efficiency, and patient and staff experience.