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    NONFOODS: Pharmacy Workflow Management: Refill 'em up

    Giant of Landover is automating its way to a more convenient method of serving pharmacy customers.

    Brad Dayton, director of pharmacy systems for Ahold USA division Giant Food of Landover, Md., refers to the new automated refill prescription pickup kiosk at its Reston, Va. store as the pharmacy operation's equivalent of Hertz Rent-A-Car's #1 Club Gold service.

    "When you rent a car under that program, it's ready for you with your name flashing on a board," he says. "You just pick it up and go, and you're in and out in five minutes. From a pharmacy perspective, nobody's offering this in the area."

    The key to the program is a unit called the ScriptCenter, made by San Diego-based Asteres, Inc. It's a high-security kiosk that qualified shoppers can use to retrieve prescription refills without needing to visit the pharmacy -- which means they can be served anytime, even when the pharmacy's closed.

    "It's a way to extend the pharmacy's hours of service," says Dayton. "The grocery store is open a few more hours than the pharmacy. The kiosk gives refill patients a couple more hours in the evening and one more hour in the morning to pick up their medication. Customers who are hurried on the way to work can still get their prescriptions without the pharmacist being there."

    No stranger to automation

    Giant is no stranger to automation of pharmacy functions. As well as Kirby Lester manual tablet counters in every one of its 173 pharmacies, the retailer operates ScriptPro robotic prescription dispensers at 16 locations, including the store with the ScriptCenter.

    Here's how it works: Once consumers complete one-time registration allowing them to use ScriptCenter, they order their refills as they would normally, and the pharmacist refills the prescriptions as usual. However, instead of being placed behind the counter, each finished prescription is placed in a sealed, bar-coded bag and loaded into the ScriptCenter.

    To retrieve refills, consumers enter their usernames and passwords, select their prescriptions, swipe their payment cards, and sign the unit's electronic signature pad. The kiosk locates, verifies, and delivers the prescriptions into an electronic bin that then opens for customer access.

    Security is crucial. "The patient opts in, enrolls with our assistance on the unit, and creates his or her own unique user ID and password," says Dayton, "and that's the only way he or she can access the prescriptions."

    Given that it holds multiple prescriptions for retrieval, the kiosk isn't small, and supermarkets planning on installing one would need more space than for a typical ATM. According to Dayton, it's approximately six feet wide and more than six and a half feet tall, weighs 1,400 pounds, and is bolted to the floor.

    "It's very secure -- it would be next to impossible to break into the unit without creating a very large commotion," he adds. "It has an ATM-like camera on it, so we're able to see who's using the machine, in case someone tries to access a prescription illegally."

    Although the kiosk has the capability to operate 24/7, Giant limits its availability to store hours, and the pharmacist holds ultimate decision-making power on what it can dispense and to whom.

    "We're doing refills only, for which [customers] have already consulted with a pharmacist," says Dayton. "It's primarily for maintenance medications that they get often. A patient can opt in for the program, but if we decide so -- maybe the pharmacist thinks he needs to talk to the patient more often -- they may not be eligible for the service."

    Additionally, when the Reston store is open but the pharmacy isn't, customers can use a phone attached to the kiosk to speak to a pharmacist at another Giant pharmacy that is open.

    The Reston store opened the ScriptCenter the end of November and began to promote it shortly afterward. So far, usage of the machine has been strong. "It met our expectations of where we thought we would be a month and a half out, and signup and usage continue to grow," says Dayton. "I think the pharmacists are most pleased with the fact that it gives them another way to service their customers and it frees them up a bit to focus on those customers who really need to speak with them. Plus, if this alleviates the line at the pharmacy, I think everyone's happier."

    He even sees the kiosk as a nice alternative for consumers who get their refills by mail. "They still have the convenience, but unlike mail, they'll have a pharmacist available, either in the store or by the phone at the kiosk," he explains.

    While Dayton plans to expand installations of the ScriptCenter if its success continues, the kiosk won't show up in another Virginia store for at least a year. "The Virginia Board of Pharmacy granted approval for a yearlong pilot program for that store and that store only," explains Dayton. "They'll review whether we can continue or not."

    The same goes for Maryland, where Dayton plans to install a second unit. "We just received approval from the Maryland Board of Pharmacy to put a unit in there, with a few different restrictions than in Virginia," he says. "There, it's only allowed to be used when the store's pharmacy is open."

    While this kind of regulatory red tape may slow deployment of the kiosks a bit, it's to be expected, since the welfare of the consumer is under consideration. "The Board of Pharmacy's job is to protect and serve the public," says Dayton. "They look to see that the machine is no different from the normal practice of pharmacy, that the patient is serviced in the best way, and that the public health is taken care of as if it were done by a human instead of a machine."

    As far as Dayton is concerned, meanwhile, no matter how automated his pharmacies become, he'll make sure they'll continue to remain accessible to the consumer.

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