CASE STUDY
noritsu-rx.com
explored other options. “Let’s just say all the research I did and references I spoke with kept pointing
to Noritsu being the right choice for us.” As a bonus, the company had St. Louis-based technicians
less than an hour away.
Ultimately, Medicine Express opted for two NX4000 strip pouch packagers for high-volume
dispensing and two Benjamin Tray stations for split-dose, one-off or less frequently used
medications. They also have an NV 3 verification system for visual verification, which checks the
contents of each pouch against a library of images uploaded by the pharmacy.
Once the system was installed, Noritsu sent a technician out to train pharmacy staff how to export
prescriptions to the machine and begin transitioning long-term communities. “He taught us how
to keep the system going, the types of service messages we might see and how to clean the
machine,” says Automation Lead Technician, Carly Thomas. According to Powers, the trickiest part
of their implementation was that they weren’t ready to transition every community until they were
completely comfortable. “I wanted to be sure we knew this one inside and out before we transitioned
fully.” Some facilities and patients were also not comfortable moving to Noritsu’s strip pouches at
first anyway because they’d gotten familiar with the traditional blister packs. So, in the beginning,
the pharmacy had six employees simultaneously operating the two systems – old and new – which
made scheduling difficult. “At the end of the day, however, because Noritsu’s technology was so
user-friendly, and the margins were telling us that it was a well-oiled machine, we were able to
transition fully about a month earlier than planned,” says Powers.
THE RESULT – ENHANCED EFFICIENCY AND ACCURACY
First and foremost, the NX strip packaging machines deliver an incredibly efficient process, Powers
says. Where previously it might have taken hours to run a single community – it now takes about
45 minutes with Noritsu’s system and strip pouches. It’s also easier for long-term care nurses to
make medication changes. “Most of our communities were on a standard 28- or 30-day cycle,” she
explains. “Noritsu’s technology allows us to run shorter cycles for them – and we’ve successfully
converted everyone to a 14-day cycle with no impact to our bottom line.” This reduces medication
waste when changes are needed, or a medication is discontinued. The strip pouches are also
extremely easy to use, which makes them ideal for assisted living or long-term care at home
patients who are independent with their medications.
According to Powers, it’s Noritsu’s NV verifier that’s been a game changer for Medicine Express’s
business model. During implementation, the pharmacy team took several images from various
angles of each pill they dispense to record the unique markings, size and color. They now repeat
this process with each new medication they offer. “When we run a patient or a community cycle,
we feed each strip pouch into the NV,” explains Powers. The NV takes a picture of every pouch
and can identify what should be inside from the barcode printed on it. The system then references
the images of the pills in the pouch with actual images in Medicine Express’s library. When that’s
complete, pharmacists can review computer images of all pouches – including those flagged in red
that the NV couldn’t verify. “Before Noritsu’s visual verification, we had to physically look at every
pill in every bubble for every patient to verify that it was correct,” says Powers. “Now we only have to
look at about 4%, our average pouch check rate.” And even with that rate, she says, the issues are
usually unrelated to an inaccuracy but have been flagged for things like a broken tablet or an oil-filled
pill like Vitamin D that doesn’t reflect the light correctly.
Not only is the NV faster and more accurate than relying on a pharmacist’s manual checks, but
images of pouches are stored so it’s easy to go back and review what was delivered if a nurse or
patient has a question. “The quality assurance we gain from the NV’s
visual verification is something I can’t imagine doing without now,”
Powers states.
“
“
The quality
assurance we gain
from the NV’s
visual verification
is something I can’t
imagine doing
without now.”
We've reduced
labor by 15% and
cut production
time for multidose
cycles by 66%.”
Emily Powers, Pharm. D.
President
~ Medicine Express
Emily Powers, Pharm. D.
President
~ Medicine Express