Automated Dispensing System Bolsters Personal Service at Spalitto’s Pharmacy
U.S. Pharmacist, October 2004
Kansas City pharmacy, known for its patient care services, finds that automated dispensing has strengthened its image.
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| Pete Spalitto is shown at the ScriptPro SP 200 workstation in his pharmacy. “I find that spending time discussing the health concerns of my patients is important to my professional and business success,” he says. |
How do you remain a neighborhood institution for more than 75 years … even when your neighborhood has undergone demographic change? And how do you offer the same quality services in a neighborhood as an independent pharmacy when you are surrounded by several chain pharmacies? Commitment to customer service is one way. Staying abreast of the latest technology is another. For Spalitto’s Pharmacy, a Kansas City, Missouri, landmark since 1929, technology meant utilizing an automated dispensing unit to free up time for the pharmacy’s staff to relate to patients. Most of the patients who come into Spalitto’s Pharmacy are older people, many of them long-time residents of the neighborhood. Others are newcomers, mostly
Hispanic and Vietnamese, who are the newest immigrants to a section once known as the Little Italy of Kansas City. All rely on their pharmacist to help them take their medications correctly.
Spalitto’s fills about 400 prescriptions a day, according to Pete Spalitto, third-generation pharmacist and grandson of the founder of the pharmacy. Pete Spalitto is an ebullient pharmacist who believes that relating to his patients means more than speedy service.
Spalitto finds that spending time discussing his patients’ health concerns is important to his professional and business success. So it is no wonder that he is enthusiastic about his automated prescription system, now in operation for almost a year. The system automatically fills more than 50% of his prescriptions, giving him the time to provide complete care to his patients, which means giving them the information that will improve compliance with therapy. The system he installed, ScriptPro’s SP 200, has met all of his expectations when he decided to go with automation. Automated dispensing has reduced the potential for medication errors because it dispenses the correct drug and correct strength with counting accuracy of 99.7%. Since the staff spends less time running around chasing stock bottles to fill prescriptions, the organized workflow produces less stress in overall day-to-day operations. It also eliminated the need to hire an additional pharmacist.
Spalitto especially likes the inventory control features that are built into the system. He sets minimum and maximum limits for each drug in the SP 200. The robot produces a report at the end of the day that tells Spalitto the difference between product on hand and the maximum amount desired. If the supply of a product drops to the minimum, the staff is alerted and prompted to order more. Spalitto says this keeps him from having either too much or not enough of any drug.
As its name implies, the SP 200 contains 200 universal dispensing cells. Since the cells can be calibrated on-site in just a few minutes, the system easily handles different sized tablets and capsules. Barcodes are used throughout the process for accuracy and quality control. Pete
Spalitto and one other pharmacist manage the dispensing process from prescription entry to approval of the finished product. Spalitto’s employs three full-time and three part-time pharmacy technicians to process the prescriptions and handle front-end sales.
Spalitto’s philosophy is that his is a professional pharmacy, but because there are three well-known chains competing in his trading area, he decided that stocking certain nondrug items was indispensable for his pharmacy. The pharmacy also offers complete delivery service, a necessity because many of his elderly patients find it difficult to travel to the pharmacy. Phonedin prescriptions are a large part of his practice. His delivery van goes out at 9 AM and is kept busy all day long. Because Spalitto is committed to servicing his patients, he makes himself available for counseling and also encourages "small talk." That comes quite easily to him since his personality is infectious and his interest in his patients’ health is readily apparent to all who talk to him. He also decided to participate in Missouri’s disease state management program servicing Medicaid patients. The four disease state programs in Missouri are COPD, diabetes, hyperlipidemia, and hypertension. The program is designed to make sure that patients are compliant with their prescription care program. Pete works closely with COPD patients and their physicians to make sure that medications are being taken as prescribed. Spalitto’s participation involves following COPD patients through a careful medication and lifestyle program. Occasionally, this also requires him to visit a patient’s home to ensure that the medications are actually being taken. To participate, he took a 10-hour CE course on COPD management.
Pete Spalitto did not adopt automated dispensing lightly. He went to several pharmacy shows and talked to practitioners in the Kansas City area who had installed automated systems in their pharmacies. He was especially concerned about finding room for the system in his 2,400 sq.-ft. freestanding pharmacy. (Spalitto bought and remodeled a building diagonally across the street from the original pharmacy because it offered off-street parking.) A design team from ScriptPro explained that the unit could fit into a small back storage area. A wall was put up in the storage space to house the SP 200, which measures 10'9" x 2'4". Pete is beta-testing a new Collating Control Center for ScriptPro at his store. This device automatically sorts medication into conveyors, thus enabling collation of prescriptions for a patient who has been prescribed multiple medications.
This past summer, because of the success of the SP 200, Pete was able to take his family on a vacation to Las Vegas, the first vacation he has had in more than a decade. The ScriptPro unit enabled him to leave his one pharmacist behind to handle the daily workload without having to hire a replacement pharmacist. For Pete Spalitto, automation has translated into better patient service and a more efficient and error free pharmacy care system.
CaféRx Coalition Formed to Facilitate e-Prescribing
A new health care industry coalition called CaféRx has been formed by nine of the nation’s leading health care IT solution providers to speed up the process of e-prescribing. The coalition’s founding members include Allscripts Healthcare Solutions, Capgemini, Cisco Systems, HP, Microsoft, the National Council for Prescription Drug Programs (NCPDP), NDCHealth, RxHub, and SureScripts. The alliance’s formation was announced at the NCPDP Educational Forum in San Francisco.
E-prescribing has been widely viewed as critical to improving the quality of patient health care and reducing medication errors. "CaféRx will promote and support real-time connectivity between physicians, payers, pharmacy benefit managers, and retail pharmacies through vendor-neutral platforms and solutions," noted Donald Gravlin, vice president and chief technology officer for Capgemini Health’s payer practice. "We view e-prescribing as an essential step in the comprehensive automation of clinical processes."
To encourage the adoption of e-prescribing, CaféRx will offer extensive information on its Web site (www.caferx.org); launch a program to educate physicians and their office staffs about the value of e-prescribing; and support lobbying efforts that urge federal and state governments to provide incentives pursuasive enough to get providers to adopt e-prescribing and electronic medical records.
It is widely acknowledged that the adoption of eprescribing will benefit patients, physicians, and pharmacists. E-prescribing has been shown to significantly decrease medication errors, reduce the incidence of adverse drug reactions, and save physicians and pharmacists valuable time now spent on nonclinical administrative tasks. It also enabled payers to improve formulary program compliance, collectively saving millions of dollars while potentially increasing patient and physician satisfaction.
The coalition noted that the bulk of the over 3.7 billion prescriptions issued last year were still written manually, generating the need for an estimated 150 million phone calls from pharmacists to physicians’ offices for clarification on handwriting, dosing, and other issues. Up to 40% of prescriptions require reworking at the retail pharmacy before they are dispensed to the patient, according to NACDS. Membership in CaféRx is open to all
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