Drugs Without Delay

It's fast. It doesn't take breaks. And it never asks uncomfortable questions about your health.

But are emergency room patients ready to get prescription drugs from a vending machine?

Since early January, dozens of patients have used a blue ATM-like drug-dispensing machine inside Valley Hospital Medical Center's emergency department.

The InstyMeds machine requires a written prescription and a special code before it dispenses prepackaged drugs.

Valley Hospital patient Michael Johnson used it last week and said it saved him at least an hour of waiting at a pharmacy.

That would have been less time spent getting better, said Jim Holtz, emergency room director for Valley Hospital.

Minutes after typing in a special code and his birthday Johnson's prescribed drugs, in labeled bottles, dropped into the bin at the base of the machine.

The process was similar to grabbing a soda, bag of chips or candy bar from a vending machine, only the items are to help Johnson feel better, not make him fat or give him cavities.

"Our thinking is, if you come to the emergency room and spend time waiting for a physician, you shouldn't have to spend another two hours at a pharmacy," Holtz said.

The machine is stocked with prepackaged medications, including antibiotics, decongestants, painkillers and inhalers, Holtz said.

Patients pay the retail price. If they are covered by insurance, they pay their co-pays at the dispenser using cash or a credit card.

Like real pharmacists, InstyMeds submits a claim to the insurance company.

Valley Hospital is the first in Nevada to install such a machine in its emergency department, and others are likely to follow, according to officials from the Nevada State Pharmacy Board.

Louis Ling, an attorney for the regulatory body, said the pharmacy board has fielded numerous requests from medical care providers and pharmacies to install technology that dispenses medications faster.

"Pharmacists by and large like the new technology, because it frees them to spend more time explaining prescriptions to their customers," Ling said.

"There is a real advantage to this technology."

The pharmacy board recently approved a request from Longs Drugs to install machines similar to Valley Hospital's that would be used to complete prescription refills during regular store hours. Longs has 24 stores in Nevada.

After a patient submits a request to Longs for a prescription refill, either by phone or online, the pharmacist would place the packaged medicines in the automated dispensing machine. Upon arriving at the pharmacy, patients would log into the machine using a user name and password and swipe a credit or debt card to obtain their medications.

Longs Drugs uses automated dispensing machines at 18 California stores, according to a company spokeswoman.

The technology has proven popular and successful in getting prescriptions to patients quicker. But Ling said state regulations must be followed to install and use them.

When InstyMeds, based in Minnesota, approached the pharmacy board about installing its machine at Valley Hospital, Ling said there were no regulations for their use in emergency rooms.

Company officials worked with the pharmacy board to develop regulations, which include restricting the machine's use to emergency rooms, requiring that patients have the option of taking their prescriptions to a community pharmacy, and limiting the quantity of each drug dispensed.

Ling said the course of therapy dispensed by the machine must be relatively short, typically less than a 30-day supply. The regulations also require that all drugs be stocked and managed by InstyMeds.

In order to receive access to the machine, a physician types the patient's prescription into a computer. The computer, which is connected to the InstyMeds machine, prints out a written prescription and a special code. The physician double checks the written prescription and hands it to the patient.

The patient types the code from the prescription, along with some personal information, into the machine's touch-screen. As the machine fills the order, it automatically checks the accuracy of the prescription three times, labels the medication and dispenses it.

If patients have a question about their prescriptions, they may use a telephone next to the machine to call a pharmacist.

Holtz said interpreters are available for patients who speak languages other than English.

All medications are shipped to the hospital from InstyMeds, and the machine itself alerts the company when its medication supply is low.

"The machine knows if it is out of a particular drug or if the drug has expired,'' Holtz said. "It pre-orders for us.''

Bob Bang, director of sales and marketing for InstyMeds, said the company has sold more than 100 systems nationwide. Half of them are in hospital emergency rooms.

Holtz sad roughly 40 percent of the emergency room's discharged patients opted to use it since it became available earlier this month.

Contact reporter Annette Wells at awells @reviewjournal.com or (702) 383-0283.