Preparing 3,200 prescriptions every day at the West Valley Detention Center in
Rancho Cucamonga, Calif., used to take four nurses four hours each. Now, it
takes one remote dispensing machine 45 minutes.
“This is truly 21st century for medication delivery,” said Terry Fillman, health
services supervisor for the detention center and the six other facilities in the
San Bernardino County Corrections Department.
After years of trying different delivery methods with little improvement, the county teamed up with Talyst, a medication management services provider, to develop a remote dispensing system that caters to the unique needs of correction facilities.
The result, InSite for Corrections, has transformed medication delivery from a slow, manual process into a real-time, automated system that dramatically reduces costly waste and improves patient care.
“We’ve eliminated by-hand processes,” Fillman said. “Now the only thing is
actually delivering the medication.”
The InSite System enables physicians to order prescriptions from a computer in the prison; a hospital pharmacist across the county to approve the order; and then a secure machine back at the prison to dispense the pills in individualized packets.
Before, the order-and-delivery process could take up to two days because medications had to be sent to the prison. Now, patients receive medications the same day they are prescribed, just as a patient would in a hospital.
“Why are our patients any different?” Fillman said. “I wanted my patient to get the next dose due that a physician ordered for them.”
The dispenser also improves accuracy by printing the patient’s information
on the packet, along with the name and description of each pill, down to the dosage, shape, color and markings. Nurses double-check that the right meds are going to the right person by comparing the pills with the description and the patient’s chart.
However, what makes this system so powerful for corrections is its ability to track inmates’ location and status in real time.
“We get enormous amount of movement in and out of the system, from one location to another,” Fillman said.
By linking the sheriffs’, corrections’ and pharmacy’s computer systems together, InSite knows the up-to-the-minute location of every inmate. When it’s time to prepare medications each morning and evening, the packaging machine only dispenses prescriptions for those inmates who are in the facility.
Before, the law required nurses to throw away thousands of medications they could not deliver because an inmate had moved, or when an inmate left the system before using a 30-day supply. With InSite, waste is almost entirely eliminated, equating to significant savings in the prisons’ $3.5 million medication budget, Fillman said.
Additional cost savings are realized in the time nurses can devote to other duties by having the dispenser prepare pills.
Saving money was key in gaining support from the county board of supervisors, Fillman said. The board approved $3.8 million to develop and implement the system, which took about 18 months. The county now has a dispenser in each of its seven correctional facilities and two in its hospital.
The redundancy is helpful should a machine malfunction (yet to happen) or
a facility loses power, which happened at the West Valley Detention Center.
When the backup generator did not come on, Fillman called another facility
and had the nurses there download the medication orders for his facility to their
machine.
“I was back in an hour and 15 minutes with 3,200 prescriptions for the next 24 hours,” Fillman said.
—Laura Petersen
California cost-cutter
Find this article online at Government Health IT
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