Automated Teller Machines (ATMs) were a novel idea for banks many years ago. Today you can find one almost anywhere. That same concept is now being applied to prescriptions, and clinics and patients are the beneficiaries. One urgent care clinic in Jackson could be the first in Tennessee to use this technology, and patients are enjoying the convenience of having their prescriptions filled before leaving the doctor's office.

 

When Drs. Jimmy and Melanie Hoppers opened Physicians Quality Care, they knew they wanted to have an in-house pharmacy for the convenience of their patients. "When you go to see the doctor you are going to be there anyway," said Jimmy Hoppers. "Why have to go to the drug store to stand in line and wait for your prescription to be filled when you already don't feel well? With our in-house dispensing unit we can eliminate one stop on the road to getting better."

 

"The system is perfect for one-time acute care prescriptions, such as antibiotics or seasonal prescriptions such as Tamiflu, which has been our prime prescription filled so far," Hoppers said. "We do not use it for prescriptions that require refills. All our prescriptions have the same co-pay or retail price as in a pharmacy, and in some cases we may actually be a little cheaper, so there is certainly no added cost to the patient for the convenience of using our system. Our formulary is based upon the clinic's prescribing habits, from antibiotics to eye drops and even generics. If the medication is a liquid, a measuring bottle is dispensed along with the prescription. Patients also are given a drug education sheet to carry home just like they would get from a retail pharmacy."

 

InstyMeds, which is used by Physicians Quality Care, is a fully automated system that allows patients to have their prescriptions filled at the clinic in less than five minutes. The dispensing unit has the safety, security and convenience of an ATM machine and even resembles one. The machine requires about as much space as a soda machine and operates much like an ATM — only more hi-tech — as the system includes VPN and HL7 interfaces and a real-time camera link.

 

"The company has an impeccable track record over the seven years it has been in business." said Hoppers, who has the only one in Tennessee and will be a model for clinics throughout the state. "InstyMeds has machines in clinics in ten states. Through their triple bar-code system, they have dispensed more than one million prescriptions without error."

 

"We looked for over a year for an in-house system that would allow us to fill prescriptions. Every one we looked at was either too expensive, labor intensive, slow or did not take insurance," said Hoppers. "InstyMeds was the only system we could find that provided the exact service we were looking for. It is a seamless system. The prescription information is scanned into our practice management software when the patient checks in and, if they choose to use our in-house system to fill their prescription, we are ready to go."

 

Just like a retail pharmacy, the dispenser accepts major credit cards and debit cards for co-pay or retail purchases. For cash purchases, the clinic accepts the money and uses an in-house debit card to make the purchase from the machine. The system accepts all commercial insurance plans and co-pays and it dispenses the same medications that a retail pharmacy does. Insurance information and co-payment amounts are already in the clinic's system from when the patient first checked in to see the physician. This information is then linked to the InstyMed program, analogous to a patient's providing insurance information at the pharmacy.

 

"We tell them about the machine when they first come in and ask them as they are leaving if they would like their prescription filled here," said Hoppers. "If they say yes, we give them a printout with a discrete number that is linked to their prescription, insurance information and their medical record."

 

The system only fills prescriptions that are generated at Physicians Quality Care and is not designed for prescriptions that need to be refilled, such as birth control or blood pressure medications. Hoppers points out that the machine is not appropriate for every clinic or specialty. "It is not a cost-effective system if your clinic is not filling at least 250 prescriptions a month."

 

The machine requires no additional personnel at the clinic, is fully automated and has a dedicated telephone that immediately connects patients with the InstyMeds call center to handle any questions regarding medications, how to use the dispenser, insurance coverage or to talk with a pharmacist. The call center is staffed around the clock by technicians and pharmacists, so patients can contact InstyMeds even after they have left the clinic.

 

Inventory is maintained by InstyMeds via a camera system housed within the machine. As prescriptions are filled, the system takes note and anticipates demand. The system tracks the clinic's prescribing habits and stays one step ahead. Medications are shipped overnight for personnel to re-stock the machine. Four clinic personnel are responsible for restocking which takes about 15 minutes depending on usage.

 

The system's bar coding system ensures that medications cannot be restocked incorrectly. When a sleeve of medication is removed and replaced with a new sleeve the system recalibrates its inventory. This means that any medication can be placed in any open slot. A system report is also run to confirm which medications need to be replenished and medication usage is tracked in real-time, eliminating the need for time-consuming manual inventory. The clinic can run reports showing what medications have been dispensed, which ones need to be restocked and the number of printed prescriptions issued.

 

The medications in the machine are pre-packaged for dispensing based on standard dosing amounts. When the patient enters his or her unique seven-digit code and birth date, the system starts the dispensing process. If at any time or for any reason the barcode check fails, the system drops the medication into a discard bin and restarts the process. Any medication that is not dispensed is shipped back to the company. "The system is so sensitive, even a spec of dust on a bottle will kick it out," said Hoppers.