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Company says drug-dispensing machines not especially vulnerable

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Nico Savidge
August 29, 2013

JANESVILLE—Despite a recent case involving a Janesville doctor accused of using a medication-dispensing machine to obtain painkillers, a spokeswoman for the company that makes the machine said they are no more susceptible to fraud than pharmacies.

When Dr. Richard N. Barney wanted to get painkillers, he wrote out prescriptions in the names of patients and picked up the drugs for himself, according to an indictment filed in federal court Wednesday.

He didn't have to go to a pharmacist to pick up those drugs, however. He needed only visit the InstyMeds machine at Beloit Memorial Hospital where, authorities said, the automated medication dispenser filled Barney's fake prescriptions.

Barney went through that process 15 times, according to the indictment, on a few occasions visiting the machine three times in one week.

Mercy Health System officials became aware of the criminal investigation Wednesday, Vice President Barb Bortner said. Barney was on personal leave as of Thursday, Bortner said.

The case would appear to expose a vulnerability of the vending machine-style dispensers.

But a company spokeswoman and one pharmacy expert said Thursday the same thing could have happened at a pharmacy counter.

“A doctor could easily write themselves a prescription and go to a pharmacy,” InstyMeds marketing manager Emily Caroon said. “It's really no different.”

The machines carry medications people need quickly—antibiotics, inhalers, antihistamines and, yes, painkillers—and can be available 24 hours a day, Caroon said.

They also give hospitals a relatively simple way to provide commonly prescribed medications without opening a whole pharmacy counter, she said. That's particularly useful in small towns.

“In some of our locations, they don't have a pharmacy within 50 miles,” Caroon said. “To have that there versus the patient trying to get to a pharmacy, that's huge for some people.”

InstyMeds work as if an ATM was crossed with a soda vending machine, essentially.

When a doctor prescribes a medication, the patient has the option to pick it up at an InstyMeds location inside the hospital.

The doctor enters a prescription into InstyMeds' computer system and gives the patient a voucher with a unique code. Patients then enter their code into the machine's touch-screen interface and pay with credit cards or cash.

That's when InstyMeds goes to work, selecting one of the pre-filled bottles inside that matches the strength and number of pills prescribed by the doctor—verifying with barcodes to ensure it's picked the right bottle.

After a few minutes, InstyMeds says, the medication pops out and the patient can pick it up.

The Minneapolis-based company has about 200 machines in hospitals around the country, Caroon said, including 53 in Wisconsin and four in Rock County.

Ed Elder, director of the Zeeh Pharmaceutical Experiment Station at UW-Madison, says machines such as InstyMeds reduce the busy work of counting pills and let pharmacists be more effective.

Still, the system is not without its risks—perhaps, if he went to a pharmacist, someone would notice a doctor picking up three Percocet prescriptions in his patients' names each week, for instance.

Those pharmacies can be vulnerable to fraud too, Caroon pointed out.

A doctor could go to three pharmacies scattered around town to fill those prescriptions, and the pharmacists there wouldn't know, Caroon said.

The automated machines would at least have an electronic record through its credit card readers showing who was paying for the medications, she said.

By themselves, Elder said, the machines do not make fraud more likely. If they do contribute to fraud, it will be because of the people using them, he said.

"I don't know if the machine itself is going to contribute to that or if it's more the lack of controls in the specific setting in which it's used,” Elder said.

And when it's a doctor who decides to fraudulently prescribe medications, Elder said, there aren't many checks available to keep him or her from getting those drugs.

“Can you blame the machine for the failure of the system when it's just one part?” Elder said.



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