Trade Article
The Pharmacy of the Future?
Winston-Salem Health Care Takes New Approach

In the lobby of Winston-Salem Health Care Pharmacy, patients take numbers and watch lighted signs that indicate the next patients being served. On one side of the room, patients pick up prescriptions at a counter in front of large racks of filled bags. At windows on the other side of the room pharmacists counsel patients who are dropping off prescriptions.

But behind the scenes, Winston-Salem Health Care Pharmacy looks more like a manufacturing facility than a traditional pharmacy: 400 feet of conveyor belts weave around shelves and work stations with a quiet whir of machinery and activity. From the QS/1 workstations throughout the pharmacy to the OptiFill automated dispensing machine carrying pill bottles around the room, Winston-Salem is an example of how automation can transform a pharmacy.

Why automation?
Winston-Salem Health Care Pharmacy is a part of the Novant Health system, and the pharmacy and associated physicians in Winston-Salem make up the preferred provider network for R.J. Reynolds employees. This large patient base, in addition to the pharmacy's non-R.J. Reynolds patients, mean that the pharmacy fills between 1500 and 2000 prescriptions per day.

Pharmacy IT Coordinator Bob Moser says that technology helps Winston-Salem Health Care achieve an important goal: better service for the pharmacy patients.

Since installing the QS/1 system and the other tools the pharmacy uses, Bob has seen the average wait time for patients picking up refill prescriptions fall to seven minutes, half the previous time. For new prescriptions, the time has stayed about the same - "And we're working on ways to decrease that time," says Moser - but pharmacists counsel all patients.

Making Pharmacy Faster
About 50% of Winston-Salem Health Care's daily prescriptions come in through the pharmacy's IVR (Interactive Voice Response) system. So making this system as efficient as possible was a key to increasing the automation in the pharmacy.

Patients used to be required to wait 24 hours to pick up refills after calling the IVR. Now, the IVR queue has a wait time of just six hours. The difference? A 17.1 enhancement to QS/1's RxCare Plus that allows the pharmacy to sort IVR requests by due date and time.

Another tool that keeps prescriptions moving faster in the pharmacy is Internet claims, which take, Moser says, just 3-5 seconds, vs. the 45-55 seconds that dial-up claims took. "I'm a big believer in PowerLine," says Moser.

And back in the shipping area of the store, Winston-Salem Ianthe Nivens raves about the difference QS/1's inventory reorder function has made to the pharmacy: "What used to take two employees two full days, now takes one person just a couple of hours."

Patient Safety
The automation in Winston-Salem's pharmacy has made using the pharmacy more convenient for patients, but patients also benefit from increased safety features.

After pill bottles are filled from the OptiFill machine, they are routed by checking stations where pharmacists and technicians compare a live image of the pills - taken by the OptiFill machine before the bottle is capped - with an online reference image and with QS/1's images and imprints information. The bottle label is also compared to an image of the paper prescription, scanned in when the patient drops off the prescription. And at the station where prescriptions are bagged and labeled for patient pick-up, technicians cannot print bag labels unless the prescription has been checked by a pharmacist.

It's about people...
Winston-Salem's automation has created a much less stressful work environment for the pharmacy's employees. The 16 pharmacists and 18 technicians rotate stations and tasks after their lunch breaks, meaning that no one has to do the same thing all day long.

Moser gestures at the automation in evidence around the room. "This has not eliminated any jobs. It allows us to be more efficient with what we have."

In fact, Moser says, the automation in the pharmacy has freed up the pharmacists for patient care programs out of the pharmacy. "We started a Coumadin clinic and a diabetes clinic, and we're starting a lipid clinic. Now our pharmacists can spend time on clinical activities that they didn't have time for before."

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