ED Vending Machines Fill Prescriptions, Raise Questions

Jul. 19--Slide your debit card into an ATM, and you can get some cash. Slide your debit card into a new machine in Mercy Hospital's emergency room and you can get some heavy-duty painkillers or antibiotics.

Mercy, in Council Bluffs, is the first hospital in the Omaha area and one of a handful of health care centers in Iowa to get a pharmacy vending machine aimed at outpatients.

State pharmacy officials aren't aware of any machines in Nebraska, but the machines are drawing attention here and nationally.

The machines, stocked and fully automated, are touted for their convenience. They are aimed at a growing consumer demand for accessible health care.

Pharmacy organizations are concerned about the safety and security of machines dispensing drugs directly to consumers.

"You cannot treat prescription medications like candy in a vending machine," said Carmen Catizone, executive director of the National Association of Boards of Pharmacy. "(Medications) are dangerous and need to be monitored for patient safety."

The Nebraska Pharmacists Association agrees.

"Patient safety needs to be more important than patient convenience," said Joni Cover, the association's executive vice president.

The machines provide a touch screen like an ATM. After the physician writes a prescription, patients enter a code number and birth date. The machines then dispense prescription and over-the-counter drugs such as asthma medications, painkillers and ointments for skin rashes.

Cover said her group's concerns aren't based on worries that the machines could replace pharmacists. The association worries that the machines could give the wrong medication or the wrong amount.

The association also is concerned over the absence of a pharmacist who could talk in person about side effects and other questions.

Mercy, an Alegent hospital, and InstyMeds, the Minnesota-based manufacturer, said the machines are safe.

A phone mounted on the machine connects the consumer at no charge to an InstyMeds pharmacist or pharmacy technician 24 hours a day, seven days a week.

Since InstyMeds introduced its machines seven years ago, the machines have dispensed more than 300,000 prescriptions without any problems, said Matt Sneller, an InstyMeds vice president.

Mercy's machine was installed in April and has dispensed more than 200 prescriptions without any problems, said Michael Tiesi, operations director for pharmacy services at Mercy.

Mercy was interested in the machine because, unlike some hospitals, it does not have a pharmacy for outpatients. Only patients treated in the emergency room can use Mercy's machine, located in the ER's waiting room.

The machine is convenient for patients treated late at night, saving them the hassle of stopping at a pharmacy on the way home, Tiesi said.

In Iowa and elsewhere, the machines are primarily in emergency rooms and outpatient surgical centers. But the company said there is potential to expand them into medical clinics on cruise ships or those at airports and truck stops.

InstyMeds has 75 machines in six states: Iowa, Minnesota, Wisconsin, North Dakota, Michigan and Indiana. The other Iowa machines are at Pella Regional Health Center and Medical Partners of Glenwood, an outpatient clinic.

Sneller said InstyMeds is interested in placing machines in Nebraska. He said the machines could be particularly useful in small towns that lack 24-hour pharmacies.

Nebraska law and pharmacy regulations have conflicting provisions on the machines, making it unclear whether they even would be allowed in the state, said Kevin Borcher, chairman of the Nebraska Board of Pharmacy.

He said use of the machines probably will be addressed next year in a bill on pharmacy automation that is pending in the Nebraska Legislature.

The machines are not addressed in Iowa law, said Lloyd Jessen, executive director of the Iowa Board of Pharmacy.