February 4, 2002

The UConn Health Center pharmacy has partnered with the Department of Correction to purchase an information system and two robots to automate dispensation of medicines in the state's prison system.

The Health Center delivers medical care to the state's prison population through Correctional Managed Health Care.

The robots, which prepare and package prescriptions for inmates, save time and money and improve safety and security dispensing drugs in the prison facilities. Correctional Managed Health Care is the first correctional health system in the country to use a robot medication-dispensing system. Since the program started in July, the Los Angeles County Jail has also moved to such a system.

Formerly, medication in the prison system was prepared by an outside vendor using a card system: Medicines were packaged on cards by type, industrial sized, but similar to the consumer packaging for Sudafed or Benadryl. To fill an order, a health care worker had to flip through the cards, find the medication, remove it from the card, and give it to the inmate.

The new system packages an inmate's prescriptions for the week and states what day and time they should be taken. To dispense each medication, the health care worker tears off the correct prescription package and gives it to the inmate.

Here's how it works: An order for a prescription for an inmate comes in to the pharmacy by fax from a facility. The computer sends it to the robot. The robot is a metal cabinet about 5 feet long, 6 feet high and 4 feet wide. Inside are 520 cells, each cell holding from 100 to several thousand pills. The inmate is to receive one pill for his condition in the morning and at night.

The robot will select the cell conforming to the type of medication required; rotate the cells until the correct one is poised above the dispenser; drop the pill into a little plastic bag; seal it; and put the inmate's name on it and time of dispensation. It will do this 13 more times, then expel the order. Pharmacy staff take the sealed prescription, a long strip of individual packages, roll it up, and put it into the container to be sent to the facility. The inmate's medicine for the week is thus taken care of. Depending upon the condition being treated, an inmate could receive seven or eight medications in three different packages for morning, noon and night. The medications are not dispensed until they are supposed to be taken.

There have been some challenges in ensuring the system is up and running. "It's a new system," says Stephen Verdolino, pharmacy director, "and we're working through the details. It's more complicated than just installing it and turning it on."

Despite the occasional glitch, the innovation is deemed a success. "We couldn't do this manually if we wanted to," says Verdolino, watching the machine prepare prescriptions. "It would take scores of people."

The project is expected to result in significant savings. Each of the pharmacy's two robots cost $325,000. Verdolino estimates that the robots save $200,000 a year in the cost of drugs and administration alone. In addition, when the program was launched, the Health Center, as a public institution, became eligible for lower drug prices. And, as a participant in the University Health System Consortium, even more aggressive drug savings may be obtained from vendors.

Pharmacy robots were previously being used in other long-term care facilities, but the idea to adopt them for the prison system came when Department of Correction pharmacist Thomas Macura began to think about methods of improving controls, reducing medication errors, and saving time. His ideas led to discussion that eventually resulted in the robots.

The experiment in Connecticut has raised the interest of prison health officials in neighboring Massachusetts, New York and Rhode Island, and the federal Bureau of Prisons. Pharmacists have made presentations about the system at two national meetings.