The pharmacy at the Student Health Center is a hive of activity. For the 10 pharmacists and technicians working behind the counter -- whether talking to patients or answering calls -- cold and flu season is a hectic time of year.
But for Rex, a technician of sorts, today is like every other: eight or so hours devoted to counting pills and filling hundreds of prescription bottles -- over and over and over again.
Rex doesn’t mind the monotony. Rex is a robot.
Technically, he’s a collating control center robotic prescription-dispensing machine, but “Rex” (think, Rx) is so much easier to say, according to Doris Guanowsky, senior associate director of University Health Services (UHS).
For the thousands of students, faculty, staff and retirees who purchase prescription medication from UHS every year, Rex might very well be “the guy” who poured those little allergy or cholesterol pills into their amber-colored bottles.
“It’s this kind of automation that is enabling the UHS pharmacy to serve and care for students, employees and retirees,” Guanowsky said. “Though it’s not typical for a college health center to have this type of technology, it’s necessary for Penn State because of the high volume of patients we treat and prescriptions we provide each year.”
In 2013–14, UHS filled more than 163,000 prescriptions, anywhere between 600 and 1,000 each day, according to Jim Gill, the chief pharmacist and pharmacy manager at the health center. That’s a lot of patients to talk to, insurance claims to file, pills to count, bottles to fill and labels to print.
Rex the robot -- who functions and looks much like a high-tech version of a snack-food vending machine -- was brought on board to help meet the growing demand for quickly filling the health center’s most prescribed medications. Today, Guanowsky and Gill estimate Rex does about 60 percent of the pharmacy’s counting.
Though it’s not rare for retail pharmacies worldwide to use this type of robotic dispensing equipment, it is uncommon for universities (especially models like Rex that can hold nearly 200 kinds of medication).
In addition to Rex, the UHS pharmacists use a computer system, QS/1, to keep track of customers’ orders and organize the daily prescription-filling queue. Plus, patients can use an online portal (RxLion) or an automated call-in service to request refills.
The pharmacy runs on information technology, but Guanowsky can still remember the old days in Ritenour Building when Penn State pharmacists used a typewriter to print their labels. “We still have that typewriter somewhere -- but the tape has been dried out for a long time,” she said. “Sometimes I don’t know how we would manage without the IT.”
Like most pharmacies, the one at UHS is laid out with precision: everything has its place. In addition to a sun-filled storefront that sells over-the-counter medication, first-aid supplies, yoga mats and more, there’s a station for students and employees to pick up their prescriptions and a private area for patient consultations. The working space behind the front counter is divided between drug storage and two separate areas for fulfilling student and mail-order prescriptions (the pharmacy will ship to anywhere in the continental United States for just a couple of dollars and to any Penn State campus location for free).
Amid the bustle, Rex lives large in the center of the workroom. He’s the combined size of two refrigerators, beige with gray-tinted glass front doors and filled to the brim with 180 of the most common drugs the pharmacy dispenses.
Hour after hour, his mechanical arm moves along a track -- back and forth, up and down at 90-degree angles -- in search of the one cell (arranged in a grid of hundreds) that holds the sought-after medication. His arm then counts and scoops the exact amount of the drug into the appropriate sized bottle, prints a label, slaps the sticker on the bottle and spits it out of the machine. A pharmacist or technician takes it from there.
“Rex doesn’t take work away from our human employees; he makes us more efficient and enables us to focus more on patient care and other pharmacy tasks,” Gill said. “We wouldn’t be able to serve as many people as we do without Rex -- he’s very important to our mission to keep the Penn State community happy and healthy.”
In addition to being fast, the robot is ultra-precise. Unlike with humans, it’s not possible for Rex to miscount, get distracted or grab the wrong bottle off the shelf. He is programmed to ensure the right patient gets the right medication at the correct dosage.
But the first step is feeding him.
Rex holds hundreds of thousands of pills, and he has to be filled with new inventory throughout the day. Every drug in the pharmacy (and in the United States) is assigned a National Drug Code: a barcode that identifies the type of medication, the milligram amount and the manufacturer of the drug. Each of Rex’s cells is assigned a specific pill, so that each time a pharmacist refills Rex he or she has to scan both bottle and cell barcodes to make sure the two match and the cell is filled with the proper medication. From there, Rex counts pills and fills prescriptions based on the daily queue, which he accesses by interfacing with the QS/1 computer system.
The robot’s efficiency helps keep prescription costs low for customers, according to Guanowsky. “Typically, a three-month supply of a drug from the health center will cost less than a 30-day prescription at a retail pharmacy -- plus, we offer generic formulations whenever possible,” she said.
But the robot can’t do everything -- he isn’t able to refill liquids, ointments, inhalers or medications that come in packs, and it’s also not possible for him to counsel customers: the part of the job Gill likes most. “Rex helps us connect people with people. Because he’s in the back filling, we can be answering calls, talking to patients and working at the front desk,” he says.
And while Rex might be able to count a heck-of-a-lot faster than the average person, no matter the innovation, Penn State patients can count on the health center’s pharmacists to be available to pull up a chair, sit down and talk. And that’s something that will never change.