a. Medication Loading & Storage: Dispensing cell is originally filled by scanning stock bottle NDC and scanning cell location label. This produces a unique barcode for the drug in the robotics cabinet. (During this procedure, only one cell and one drug should be present on the control center in the vicinity of the barcode scanner.) PIN numbers are recorded throughout this process to record who has made each transaction.

b. Medication Containers: SP 200 cells are marked with a drug content label that is printed upon cell assignment and subsequent cell refilling. This label is applied to the front of the cell and it includes information such as cell ID number, drug NDC number, full drug name, date and time of refill, drug lot number, and drug expiration date.

• Pharmacy staff calibrates cells on-site in less than one minute. Steps include putting one unit in the flowgate area and tightening the thumb screw to the appropriate size. This adjustment maximizes counting accuracy for the medication.

c. Cross-Contamination: The robot dispenses tablets or capsules directly from the drug cell into the vial, avoiding cross-contamination.

d. Lot Number Control: The SP 200 maintains the lot number and drug expiration date associated with each drug in every cell. This information is clearly stated on the cell's drug content label. The system will not dispense medication from a cell if the lot expiration date has expired. In the event of a lot number recall, a system report may be generated to show dispensing activity for that particular drug lot number, thus identifying all patients who received it.

e. Inventory: The pharmacy software maintains a perpetual inventory of the drugs in every drug cell to ensure quality assurance and facilitate re-ordering. When dispensing occurs, the quantity is subtracted from the cell. A system report will list all the cells where the inventory quantity is low for a particular drug.

f. Removal of Drugs for Dispensing, Return or Waste: The SP 200’s dispensing process is tightly controlled through the pharmacy system’s interface program, PIN entry, and barcode verification. The combination of these controls promotes operational safety, security, and accuracy. The pharmacy system interface requires an exact NDC number match to select the proper drug, strength, and manufacturer for dispensing. (Without an exact match, the system will prevent the prescription from being filled by the robot.)

During prescription dispensing, the robotic arm moves to the proper cell location and scans the cell’s barcode. If the barcode is not read (because the cell is in the wrong location or the barcode is unreadable), the robot will not dispense medication from the cell. Only when the barcode match is made, the medication is dispensed. Then a prescription label, including auxiliary information, a line drawing of the drug and a physical description of it, is applied automatically to the filled vial.

g. Controlled Substances: The Pharmacy Manager will decide whether or not the SP 200 will dispense controlled substances in accordance with applicable state and federal requirements and regulations. The robotics cabinet may serve as a locked cabinet to secure and store controlled medications. Any drug that requires stringent quantity controls may be designated as requiring a manual recount for quantity verification.

• For tracking purposes, the SP 200 can determine when a controlled drug was requested, its script number, the patient’s name, script quantity, who filled the script, who verified it and who dispensed it to the patient. The patient’s electronic signature can be viewed to see who signed for the medication and when.

h. System Reports: The robot offers a variety of reports that help implement safety procedures in the pharmacy. These reports provide information on:

• System Maintenance – An activity log reflecting the completion of daily and weekly maintenance and other necessary functions, such as the refilling of drugs and vials.

• Inventory – Details information regarding drug cell transactions, including the operator initials associated with each transaction, such as a cell refill. Also shows the drug name, quantity, and cell location for each cell. Records partially filled scripts so that staff can alert patients to the out-of-stock situation. Staff is then aware of which medications need to be ordered, to whom they are owed and how much.

• Discrepancies – Logs any incorrect scan made by a system user. Tracks if the wrong drug product was scanned for storage in a dispensing cell, for example. This report indicates the number of times an incorrect stock bottle was selected to fill a medication dispensing cell—a “Near Misses” report.

• Activity – Shows transactions requiring security authorization, along with the operator initials associated with each transaction.