2010 Award Finalist

Deployment of Remote Pharmacy Technology to Support Patient Care

Category - Improving Safety

The Problem

Sunnybrook's Holland Centre is one of the leading orthopaedic centres in the country, performing 2200 hip and knee replacements each year for patients from across the province of Ontario. The problem was that the Holland Centre was not a feasible location for retail pharmacy, so patients being discharged had no access to prescribed pain medication and other medicine. These mostly elderly patients, many with mobility limitations, had to try to fill their prescriptions outside the Holland Centre in downtown Toronto pharmacies or in their local communities when they returned home. Many of these patients travel a long distance to the Holland Centre, so waiting until they were closer to home before filling a prescription for pain medication represented a significant challenge. In addition, some medications prescribed at the Holland Centre are not readily available at community pharmacies. Finally, follow-up with patients does not occur for six to eight weeks after surgery, so there was no way to ensure patients were complying with medication instructions.

The Innovation

PharmaTrust, a Canadian company based in Oakville, developed the MedCentre, a kiosk which allows access to pharmacy services. These services include the ability to fill prescriptions and dispense medication using advanced robotics combined with a comprehensive monitoring and safety system, controlled remotely by a pharmacist who communicates face to face with the patient throughout the entire dispensing process via videoconferencing. On February 23, 2010, the Holland Centre MedCentre went live, giving patients and their families full-time access to pharmacy counselling services and allowing them to fill their prescriptions before leaving. Two to four days after discharge, a pharmacist makes follow up phone calls to all patients using the MedCentre to ensure patients are continuing to take their medication, and are successfully managing their pain. This ensures pain is adequately managed, patients and family members can have medication questions answered, and patients can get home as quickly as possible. Later this year, the first 3rd Generation MedCentre will be deployed at the Holland Centre, replacing the first machine. This MedCentre operates at even faster speeds, can hold approximately 2000 different medications, and can be equipped for both pill counting and refrigeration.

The Results

Holland Centre patients report being very impressed by the convenience of the MedCentre, and the additional level of care and concern for their wellbeing that is demonstrated by the provision of pharmacy counselling services after discharge. After six months of operation, nearly 1,000 prescriptions had been filled through the MedCentre. That number has continued to increase, and it is expected that in the near future, some 50 percent of Holland Centre patients will be using the MedCentre kiosk.

Next Steps

A formal study of the MedCentre project is underway. Funded by Sunnybrook, PharmaTrust and the Health Technology Exchange (HTX), this study is using survey feedback and in person focus groups to evaluate patient awareness, acceptability, and experience with the MedCentre, and will identify areas where improvements can be made in order to increase patient acceptance of the service.