Drug dispensing kiosks come north

Filling a prescription in Northern Ontario will soon be as easy as getting cash from an ATM.

PCA Services Inc. of Oakville is negotiating with several hospitals, family health teams and other health-care organizations to bring Pharma Trust drug dispensing kiosks to the North.

Equipped with two-way audio and video and stocked with 330 different medications, the Pharma Trust Med Centres link patients with pharmacists in a Toronto area counselling centre via a secure broadband connection.

“The pharmacist has complete control over the dispense,” said PCA Services’ co-founder and CEO Don Wahl. “Before the medication is released to the patient, the pharmacist makes a professional decision just like in a pharmacy.”

The patient inserts the prescription slip into a scanning device, sees and speaks with the pharmacist and pays for the medication using cash, credit or debit card. The unit prints a label in accordance with the pharmacist’s instructions, affixes it to the container and dispenses it to the patient.

“The Pharma Trust Med Centre is perfect for Northern Ontario,” said Wahl. “There are a lot of communities in Northern Ontario that don’t have pharmacy services. I’m a privileged person because I live in the Greater Toronto Area. I have all kinds of services available to me that people in Northern Ontario don’t have.”

Wahl sees Pharma Trust Med Centres in hospitals, family health team clinics, pharmacies and remote Aboriginal communities.

“Imagine one of these machines going into a community that has no doctor and no nurse practitioner,” said Wahl. “You can walk up to the machine, touch the screen and you’re instantly talking to a pharmacist. Whether you have a prescription or not, the pharmacist will be able to triage you. And if it’s an urgent situation, you can be transferred to a physician. It’s urgent care on demand.”

The link to physicians is not currently set up, but it’s easily accomplished technologically.

In the next five years, Wahl hopes to have 3,000 Med Centre kiosks in place across Canada.

“It’s also perfect for an existing pharmacy. Just like an ATM, it allows the pharmacist to offer 24-hour service even when the pharmacy itself is closed.”

The Med Centres can be leased and paid for from drug revenues, said Wahl, so there is no up-front cash cost.

The only unit currently in operation was installed at Sunnybrook Health Sciences Centre in September 2008 and has performed with 100 per cent accuracy, according to PCA Services.

There have been mixed reviews from pharmacists, but overall, patients, physicians and health-care administrators have responded positively.

“We didn’t develop this technology to destroy the pharmacy industry,” said Wahl. “We developed it as a tool that would allow them to augment their services just like the ATM allows banks to augment their services.”

Some critics have bought into the concept after being invited by Wahl and his colleagues to view a demonstration.

“One guy was trying to organize an Internet campaign against us, so we called him and said, ‘Come on down. You may as well see it.’” Following the demonstration, he emailed the company to ask about acquiring kiosks for two hospitals in his area lacking on-site pharmacies.

PCA Services is hoping to partner with pharmacists to manage the drug inventory and provide remote, video counselling to patients using Med Centre kiosks in outlying communities. After business hours and on weekends, the pharmacist can make arrangements to have the Pharma Trust counselling centre take over.

The drug inventory can be customized for each location, said Wahl. “If it’s in an emergency department, we’ll stock it with products that are used for acute emergency purposes such as antibiotics and analgesics. If it’s used in a specialty practice such as cardiology, it will be customized for that practice.

“In all cases, we sit down with the physicians in that facility, review their prescribing requirements and customize the inventory based on their clinical needs.”

The kiosks are currently able to accommodate up to 2,000 dispenses, but plans are in the works to increase that to 5,000. There are also plans to add refrigeration for insulin and vaccines and to introduce pill counting technology. Currently, all of the drugs are dispensed in prepackaged containers.

If a prescription is for six pills and the bottle contains 12, Pharma Trust staff currently have to deliver the medication to the patient’s home, transfer the prescription to a pharmacy or return it.

Legislation requiring the physical presence of a pharmacist for the dispensing of drugs is about to be amended to pave the way for the adoption of the technology. According to Wahl, the enabling legislation was fast-tracked through the personal intervention of Health Minister David Caplan, whose wife, Leigh, works as a nurse at Sunnybrook.

“He was at Sunnybrook having his eyes examined and she said, ‘David, you have to come and see this. It’s really cool.’ So she dragged him over and one of our pharmacists gave him a demonstration.”

Security shouldn’t be a problem because the kiosks won’t contain oxycontin, percocet or other drugs that thieves would be interested in. Tip sensors, motion detection alarms and other built-in security systems will alert staff at the PCA Services counselling centre to any tampering with the units. 

Vandals will be visible through the video link, their pictures can be taken and counselling centre staff can “tell them to go away or call the police,” said Wahl. n