Hospital pharmacy gets robotic helper

By Katherine Sather
Seattle Times Eastside bureau

ELLEN M. BANNER / THE SEATTLE TIMES Cheryl Byrd, a pharmacy technician at Evergreen Hospital Medical Center, checks the suction on the arm of "Ernie," the hospital's new robotic pharmacist. The machine prepares medication for patients.

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When most patients at Kirkland's Evergreen Hospital Medical Center are asleep, the robot comes to life.

Its machinery thumps like a heart beating as it moves around the hospital pharmacy, preparing prescriptions. In a little more than an hour, he'll ready 1,500 doses of medication.

Ernie, or Evergreen Robot Noticeably Improving Efficiency, is a new $3 million addition to pharmacy staff. The robot uses bar codes to match each drug dispensed with an electronic patient profile, helping prevent errors, said Bob Blanchard, pharmacy director.

Evergreen is one of two hospitals in Western Washington and four in the state that use a Robot Rx, produced by McKesson Automation. In Seattle, Veterans Affairs Puget Sound Health Care System purchased a larger model in 2001 after bar codes became mandatory in veterans pharmacies nationwide

Blanchard anticipates bar codes eventually will be required in all hospital pharmacies. The Joint Commission on Accreditation of Healthcare Organizations recommends that all hospital pharmacies use the technology by 2007, he said.

"It's the future," he said. "Safety is the main benefit."

Efficiency is another plus. The robot can prepare a 24-hour medication supply for in-house patients, about 1,500 doses, in a little more than an hour. The same task used to take three people about three hours to complete, Blanchard said.

Now, staff only label the medications with bar codes. Ernie does the rest.

The machine looks like a mini space ship. A door opens into an octagon-shaped room, 12 feet long diagonally, stocked with more than 400 racks of medicine. Each dose is labeled with a bar code that tells Ernie what it is and where it should be stored. Affixed to the center of the room is a mechanical arm that scans the bar-coded medicine and places it on its designated rack.

"The robot stocks itself," Blanchard said.
 
When staff give Ernie a computerized order, his arm buzzes to the correct row of medication, grabs it with suction cups and drops it into an envelope that is bar coded with the patient's profile.

For the first two weeks, pharmacists checked all of Ernie's orders. No errors were found. Now staff randomly check 10 percent of the medication each morning.

"We can be sure all the meds that come out of the robot are correct," Blanchard said.

The Robot Rx at Veterans Affairs Puget Sound prepared almost 1.3 million doses last year for in-house patients at its Tacoma and Beacon Hill locations, said Eric Chantelois, an in-patient pharmacy supervisor.

"Research shows using it decreases certain predictable errors," he said. "We're very excited about it — we've really led the drive to move to automation."

It its three years of use, their Robot Rx has displayed only one error. On rare occasions, the machine will drop a packet of medication. But the robot tightly manages inventory. It discards expired medication and never misplaces a prescription, Chantelois said.

At Evergreen, pharmacy staff hope for Ernie to eventually dispense 93 percent of the medication that is distributed to patients in the 244-bed hospital. Medication that needs care such as refrigeration is prepared by staff.

"The technology is such that it's been tested and it's reliable. Given the volume of patients we see, it makes sense," said Amy Gepner, a spokesperson for the hospital. "It's a safety initiative."

Ernie is being purchased with a seven-year lease along with 23 automated medical cabinets placed throughout the hospital.

But staff are more fond of the robot.

"Some people call it Ernestine," Blanchard said.

Katherine Sather 206-464-2752 or ksather@seattletimes.com