Remote dispensing is used in health care environments to describe the use of automated systems to dispense (package and label)

prescription medication A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The r ...

s without an on-site pharmacist. This practice is most common in

long-term care Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long-term care is focused on individualized and ...

facilities and

correctional institutions A prison, also known as a jail, gaol (dated, standard English, Australian, and historically in Canada), penitentiary (American English and Canadian English), detention center (or detention centre outside the US), correction center, correcti ...

that do not find it practical to operate a full-service in-house pharmacy. Remote dispensing can also be used to describe the pharmacist controlled remote prescription dispensing units which connect

patients A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care ...

to a remotely located pharmacist over

video Video is an electronic medium for the recording, copying, playback, broadcasting, and display of moving visual media. Video was first developed for mechanical television systems, which were quickly replaced by cathode-ray tube (CRT) syst ...

interface to receive counseling and medication dispensing. Because these units are pharmacist controlled, the units can be located outside of typical healthcare settings such as employer sites,

universities A university () is an institution of higher (or tertiary) education and research which awards academic degrees in several academic disciplines. Universities typically offer both undergraduate and postgraduate programs. In the United States, ...

and remote locations, thus offering pharmacy services where they have previously never existed before.

A typical remote-dispensing system

A typical remote-dispensing system is monitored remotely by a central pharmacy and includes secure, automated medication dispensing hardware that is capable of producing patient-specific packages of medications on demand. The secure medication dispensing unit is placed on-site at the care facility or non-healthcare locations (such as Universities, workplaces and retail locations) and filled with pharmacist-checked medication canisters. When patient medications are needed, the orders are submitted to a pharmacist at the central pharmacy, the pharmacist reviews the orders and, when approved, the medications are subsequently dispensed from the on-site dispensing unit at the remote care facility. Medications come out of the dispensing machine printed with the patient’s name, medication name, and other relevant information. If the medication stock in a canister is low, the central pharmacy is alerted to fill a canister from their bulk stock. New canisters are filled, checked by the pharmacist, security sealed, and delivered to the remote care facility.

Perceived advantages

In theory, access to dispensing services 24 hours a day in locations previously unable to support full pharmacy operations. Advocates for remote dispensing additionally claim that the service provides focused, uninterrupted and personalized time with a pharmacist as the system manages the physical dispensing process while the pharmacist simply oversees it. Certain prescription dispensing units can carry over 2000 different medications tailored to the prescribing habits of local healthcare providers. Furthermore, remote dispensing terminal manufacturers state that this technology can facilitate patient

continuity of care Transitional care refers to the coordination and continuity of health care during a movement from one healthcare setting to either another or to home, called care transition, between health care practitioners and settings as their condition and car ...

between prescriber and pharmacist.

Disadvantages

While some may purport that travel time to pharmacies is reduced, this point has been negated by an Ontarian study published in the journal ''Healthcare Policy'' as over 90% of Ontarians live within a 5 km radius of a pharmacy. Remote dispensing also places a physical barrier between the patient and pharmacist, limiting the pharmacist's ability to detect a patient's nonverbal cues. A patient with alcohol on his or her breath would go undetected via remote dispensing, increasing the risk for dangerous interactions with drugs such as tranquilizers,

sleeping pills Hypnotic (from Greek ''Hypnos'', sleep), or soporific drugs, commonly known as sleeping pills, are a class of (and umbrella term for) psychoactive drugs whose primary function is to induce sleep (or surgical anesthesiaWhen used in anesthesia ...

, narcotics, and

warfarin Warfarin, sold under the brand name Coumadin among others, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent st ...

to name a few. This problem may be amplified through telecommunication service disruptions, which were reported in previous studies examining the utility of remote dispensing technology. Remote dispensing has the potential to undermine the services offered by physically present pharmacists. Hands-on patient training on

inhaler An inhaler (also known as a puffer, pump or allergy spray) is a medical device used for delivering medicines into the lungs through the work of a person's breathing. This allows medicines to be delivered to and absorbed in the lungs, which prov ...

s and

glucose meters A glucose meter, also referred to as a "glucometer", is a medical device for determining the approximate concentration of glucose in the blood. It can also be a strip of glucose paper dipped into a substance and measured to the glucose chart. ...

is not feasible with remote dispensing, and administration of injections is impossible without a physically present pharmacist. Other cognitive services such as in-depth medication consultations are also impractical to conduct over such audiovisual technology, which do not provide acoustic privacy for the patient, nor do they meet mandatory criteria for conducting such services that require an “in-person discussion” to occur. Furthermore, the variety of drugs offered by remote dispensing is limited in comparison to traditional pharmacies, which in the province of

Ontario Ontario ( ; ) is one of the thirteen provinces and territories of Canada.Ontario is located in the geographic eastern half of Canada, but it has historically and politically been considered to be part of Central Canada. Located in Central C ...

are required to maintain a dispensary of at least 9.3 m² in area, far greater than that of any remote dispensing machine.{{cite web, title=Regulations Under Drug And Pharmacies Regulation Act, url=http://www.ocpinfo.com/Client/ocp/OCPHome.nsf/web/DPRA+-+Regulations, work=Drug And Pharmacies Regulation Act, publisher=Ontario College of Pharmacists, accessdate=April 18, 2012

References

Automated teller machines Pharmacies

A typical remote-dispensing system

Perceived advantages

Disadvantages

See also

References