ZERO misfills with RxMedic ADS Dispensed Drugs. PERIOD!

Category: Pharmacy Advances Written by Dr. Charles Shively / November 5, 2014

Do You Have Misfills?

Probably…with many unrealized or not noted. With over 3.5 Billion prescriptions filled yearly by some approximately 250,000 pharmacists human error must occur.

National data compiled by the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) has estimated about 1.5 million preventable adverse drug events occur every year---many of which are attributable to errors made by pharmacists. The number of prescriptions filled daily by pharmacists can result in pharmacist malpractice or pharmacist negligence legal challenges. Pharmacists Mutual Insurance Company regularly identifies the principal errors that occur in pharmacy as they assess safe practices in a community pharmacy…which helps them determine the yearly costs they charge pharmacists for malpractice insurance. The principal errors made:

Wrong Drug Dispensed 52%

Wrong Strength Dispensed 27%

Wrong Directions Given 7.4%

… representing 86.4% of pharmacy errors that could have been prevented.

How many wrong dispensed drugs per year or wrong dispensed strengths per year occur in your pharmacy? RxMedic ADS ensures NO misfills for the drugs it dispenses. Unbelieveable?

Avoiding “Misfill or Miscount” Conversations

With most RxMedic ADS users filling between 50-75% of their prescription medications through their ADS unit(s), RxMedic greatly reduces the opportunity for total misfills or miscounts in any pharmacy. It is axiomatic that all pharmacy personnel typically feel a sudden panic when a customer/patient uses the word “MISFILL” or “MISCOUNT” in their conversation. Whether a pharmacist, certified pharmacy tech or cashier first hears the word, the emotional challenge and mental thoughts are the same: “Oh, no.”

I’ve known this feeling. Within my days of pharmacy service in high volume retail chain pharmacy, it was always a question of when, not if, I needed to file the “challenge event” notice in the computer system software. This of course initiated a series of events…most of which cost the organization money…which required completion by one or more corporate individuals in addition to the pharmacist.

When was the last time you filed a misfill report or dealt with a misfill/miscount challenge? Depending upon the organization in which you work, and the process by which prescriptions flow, I suspect those using RxMedic ADS rarely feel the stress…if they are like me. Does RxMedic ADS misfill? NO!

Although existing national data regarding misfills/miscounts doesn’t differentiate between manual and automated filling, my experience confirms RxMedic ADS has ZERO misfills/miscounts for the drugs it dispenses…continuously. What’s your experience?

Why No Misfills by RxMedic ADS?

The process by which medication is added to or entered into the dispensing cells of any RxMedic ADS mandates accuracy…easily confirmed for any medication addition through pharmacist verification. If every prescription medication entry is confirmed correctly by the pharmacist, RxMedic NEVER makes a mistake. No stress! Any medication placed into the dispensing bins of any RxMedic ADS requires system acceptance and matching of medication bottle barcode, dispensing bin barcode (which ties to cell location in the ADS, cell calibration for size and shape of the dosage unit, specific medication package size NDC and dosage unit photo) with quantity added.

What is the process by which medication is replenished into any RxMedic ADS dispensing bin? Using the computer screen prompts to guide one through the process, the steps typically take less than 1-2 minutes to complete. Note: ADS does not need to be stopped or paused during medication replenishment.

Step 1. Touch the Replenishment Selector picture on the main RxMedic screen (always present)

Step 2. Using the location indicated on the inventory screen, remove the medication cell from the ADS

Step 3. Use the ADS barcode scanner and scan the barcode on the bulk medication container

Step 4. Verify the information provided on the Medication Information screen matches the bulk container medication

Step 5. Record the quantity, lot number and expiration date of the medication on the computer screen (addition to inventory)

Step 6. Scan the appropriate Dispensing Bin and add the quantity of medication desired to the Dispensing Bin.

Step 7. Touch the Complete icon on the computer screen.

Step 8. Return the Dispensing Cell to its proper location.

Step 9. Replenishment is complete.

Nearly all available currently available medications which can be dispensed from the RxMedic ADS are in the system database which is regularly updated. At the Community Care Pharmacy, we have had to “add” only three (3) NDC’s in 2 years into the system database to allow medication dispensing bin “commissioning” and replenishment. This immediate ability to add new drugs greatly reduces the oft aggravation of new drug selection availability that occurs in typical retail settings due to slow central system updates.

Are There Really No Misfills by RxMedic ADS?

To confirm our experience with Stella (our RxMedic ADS) at Community Care Pharmacy, I’ve summarized comments by ten (10) RxMedic ADS users from their experience. Many have used RxMedic ADS for longer than 3 years. Why not call one of the listed pharmacies and speak with the prinicipal?

#misfills By RxMedic ADS last 12 months

Smith Drug Forest City, NC John Higgins, PIC/Owner 0 828.245.4591

Linton Pharmacy Linton, IN Jeff Dorris, PIC/Owner 0 812.847.1978

Arlington Pharmacy Arlington, WA Gene Henley, PIC/Owner 0 360.435.5771

Sadler-Hughes Apothecary Clinton, SC Walter Hughes, PIC/Owner 0

//This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it. 864.833.4000

PC Community Care Pharmacy Clinton, SC Charles Shively, PIC 0 864.938.3933

Edwards Wellness Pharmacy Ayden, NC Horace Tripp, PIC/Owner 0 252.746.3126

Pay Less Family Pharmacy Sparta, TN Alan Tatum, PIC/Owner 0 931.836.3187

Medicap Pharmacy Benson, NC Jodie Lumbrazo, PIC 0 919.938.3800

Medicap Pharmacy Mooresville, NC Gavin Houchins, PIC/Owner 0 704.799.6870

Rhoads Pharmacy Hummelstown, PA David Lutz, PIC/Owner 0 717.566.2525

Does a RxMedic ADS cost less than corporate/legal expense to negate misfills?

Clearly the maximum possible expense event associated with any misfill is the customer/patient lawsuit for wrongful death with legally proven pharmacist malpractice (now more prevalent with new guidelines regarding the accepted legal standard of care definition for pharmacists) and negligence (failure to provide an accepted standard of care).

However, consider the steps and costs any pharmacy or pharmacist must endure with any level of misfill challenge (not to mention the personal stress). For cost estimates, $60/hour is used for pharmacist time, $15/ hour for pharmacy tech time, $80/hour for pharmacy corporate individuals and $250/hour for lawyer service. For brievity, I have summarized the possible costs below. If an itemization of the possible activities, steps and costs please contact me directly. This email address is being protected from spambots. You need JavaScript enabled to view it..

A comparison of these costs with RxMedic ADS ownership is presented below (for a SINGLE misfill event):

Total Cost/Customer Challenge (No lawsuit) $ 1090-57,500

Total Cost/Customer Challenge (with lawsuit) $ 350,000-1,250,000

Typical RxMedic ADS Purchase Cost: $150,000

Typical Monthly Maintenance/Support Cost: $750

Typical RxMedic ADS Monthly Lease Cost: $ 3500

With this information at hand, what feels best?

Factors Impacting Any Pharmacy Automation Purchase Decision

Time Savings. Adjustable Volume Capability. ErrorLESS production. Misfill cost elimination. Are there more advantages? Yes…and future articles will share more opportunities we RxMedic ADS daily users experience which impact the decision to get involved with a RxMedic ADS system.

By the way, Stella (our Community Care Pharmacy RxMedic ADS) is looking forward to standing by Max, our soon to be added second RxMedic ADS.

Best of the New Year to each of you.

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Thank for sharing!

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