The Challenge: In a multi-billion dollar industry, every second of time wasted in a repetitive action can add up and drastically affect your bottom line. When it comes to pharmacies, pill counting transactions have become the biggest allocation of a pharmacist’s time. There are number of pharmacy automation companies that offer great equipment to help solve this problem. These innovators are concentrating their efforts to increase the rate at which counts can be performed while maintaining a high level of accuracy.
With the growing competition there is a large variety of automation equipment available to pharmacies. The purpose of this case study is to break down two competing types of counting machines and to see, which one offers the best return on investment. The Torbal DRX-500s pill counting scale will be analyzed head to head with a generic optical pill counter. This case study will look at speed, accuracy, maintenance, and features.
The Facts: The DRX-500s pill counting scale and optical pill counters utilize very different methods to achieve the same goal. When performing a count the DRX-500s takes an initial sample of pills in order to determine their average piece weight. The NDC code of the drug is scanned so it can be linked to that pill weight. Once the average piece weight (APW) is determined it is stored in the scales internal database for future counts. The pill count is determined by taking the total weight of the pills poured and dividing that total weight by the average piece weight stored in the scale data memory.
Optical pill counters work by detecting each pill that passes its optical sensors. Pills are poured into the top of a chute and slide through the machine being scanned by photosensors or lasers, as they pass. The machine reads the total pill count when the last of the pills are through.
Both of these automated methods of counting present a significant reduction in the amount of time it takes when compared to performing a count by hand. The DRX-500s counts by weight and after the initial average piece weight is determined and stored, counts can be as simple as scanning the NDC code and pouring. The total time to complete a typical prescription count is less than 20 seconds. A full transaction includes taring a vial or container, scanning the NDC code, and logging the transaction. The counting process can be viewed here http://www.youtube.com/watch?v=9ogwQuutI2c&feature=player_embedded.
The only additional time that should be calculated into the process is that of periodic updates. A drug’s APW is typically updated once every 60 days in order to compensate for changes in the total pill weight which can occur over time. The scale reminds the operator to update, which is performed during a routine count. The counting time is increased by only 6 seconds during an update.
When using TORBAL pill counters in a network configuration, updating process is spread among all pharmacies. In this configuration model, updating for most pharmacies is essentially unnoticed (i.e. an update performed by any pharmacy is instantly made available to the rest of the pharmacies on the network).
Optical pill counters require most of the same steps (taring is not required) when performing a count. The operator scans the labels and pours the pills into the machine and lets it do the rest. For a typical transaction the time it takes to perform the count is usually 17.15 seconds. There are some issues with this method however.
“Pouring Too Quickly” on an optical pill counter will force the operator to perform a recount. When pills pass through overlapped, the photosensors must detect the overlapped pills and count accordingly. When pills are poured in quickly multiple overlaps may form and the sensors will stop the count. Recounts significantly increase the average time to perform a counting transaction.
Optical pill counting speed and accuracy are also often compromised by accumulated pill particles and dust leading to frequent cleaning. This is not only a counting problem but the source of cross contamination. The total time required to set up cleaning supplies, disassemble the unit, and perform cleanings, significantly increases the average time per prescription count when done frequently enough to prevent counting errors and cross contamination.
Accuracy is as big of a concern as speed when performing a count. No pharmacist wants to sacrifice accuracy in order to increase the speed of his counts. With the price of certain pills rising, taking a chance on accuracy is not something most store owners can afford to risk.
When counting with a scale, the only variable is the actual weight of the pills. Other than this there are no other factors which can affect the accuracy of a count. Torbal DRX-500s pill counters are NTEP certified specially for pill counting. The DRX-500s exceed the accepted tolerances listed below:
Maintenance and Acceptance Tolerances
in Excess and in Deficiency for Count.
Indication of Count
Tolerance (piece count)
0 to 100
101 to 200
201 or more
In accordance with these guidelines, Torbal DRX-500s scales are 99.9% accurate. Torbal also optimizes their counts with their Advanced Pill Counting Accuracy feature (APA). APA works by recalculating the average piece weight during the count without any real interaction from the user. The additional step adds minimal time to the counting process. The pharmacist simply needs to pause within a predetermined count interval during large counts and the scale will automatically perform the recalculation.
For optical pill counters accuracy is not maintained by NIST standards. There are different specifications used for the accuracy of these machines depending on the brand. Higher end models do hold an accuracy of 99.9% when counts are performed correctly, and the machine is cleaned at proper intervals.
Cross contamination also has a large effect on the accuracy of an optical pill counter. Pill residue and dust, left over from counts can accumulate, blocking the path of the sensors and detectors. When the sensors don’t have a clear view of the pills being counted, it is easy for miscounts and errors to occur.
“Pouring Too Quickly” or pouring directly into the funnel hole on certain optical equipment will cause counting errors. These errors are the result of the detectors inability to see discrete pills when they pass in clusters.
When dealing with powerful, high-tech equipment there can be maintenance costs incurred in order to stay functioning at an optimal level. These costs may be direct, but many times they accumulate through the time spent maintaining the product. Costs come from general maintenance, cleaning, and cross-contamination prevention.
DRX‐500s pill counters require a periodic update of the drug database. Updates are performed semi-automatically during routine counting. The updating process accumulates to only 11 hours per year with an approximate cost of $175.00. When done by a single independent pharmacy the process is fast, simple, and requires little user interaction. When done by a network of pharmacies, their cost is amortized over the network groups and may be reduced to insignificance in a large network (20 or more pharmacies). Since the pills are poured directly into a vial or disposable weighing boat, without contacting any of the mechanical parts, there is no cross-contamination or cleaning necessary, saving extensive time.
On the other hand, optical pill counters do require frequent cleaning. The machine needs to be disassembled and thoroughly cleaned in order to avoid miscounts and cross contamination. The cleaning process must be performed several times per day or more often if handling dusty medications (especially uncoated generics). Typical, single-cleaning time lasts 4 minutes or longer and requires cleaning supplies. These costs can add up to 73 hours or $1,090 annually and can’t be amortized over a network of pharmacies.
In order to satisfy users, pill counters have been equipped with features that are tailored to a pharmacist’s applications. These features help with the ease and accuracy of counts. The high end (more expensive) optical pill counters offer features not seen on either the scale based counters or the less expensive optical counters.
All DRX‐500s models are loaded with features such as, RX Verification, Advanced Pill Counting Accuracy (APA), Pill Fragment Detection (PFD), Onscreen Instructions and many more.
Rx Verification – NDC Verification creates a safety check to ensure that the drug being counted matches the one called for on the prescription. The extra step helps to prevent human error from occurring. Typically the supply bottle is scanned first and then is compared against the Rx Label. If the two NDC codes match, then the count can continue.
Advanced Pill Counting Accuracy – Used to adjust for variations in pill weights, APA is a quick and effective feature that is initiated during counts. Pill weights can vary over time when transitioning from one LOT to another. This feature adapts the scale to any changes in weights and can increase accuracy during large counts (e.g. inventory counts). APA is seamlessly activated by pausing between specified intervals, during which the scale can recalculate the APW of the drugs being counted.
Pill Fragment Detection – PFD is a special feature used during counts to determine if a broken pill has been poured into the vial or weighing boat. The unique algorithm will detect if a certain percentage of the average piece weight has been added. The scale will immediately notify the operator to remove the fragment. In networked scales, an automatic e-mail notification is sent detailing the count the fragment was found in and the time it happened at.
The simple on-screen instructions add to the intuitiveness of the DRX-500s. By walking the user step-by-step through the counting process, there is essentially no room for error. This also saves time for first-time users.
Optical pill counters don’t utilize the APA feature as it is irrelevant to optical counting. Some high end optical counters show the pharmacist a picture of the drug called for in the script so that he can visually perform a verification function. This feature is not offered by the DRX-500s.
One common asset is that many of these counters do use Rx Verification in order to match the prescription to the supply bottle. The downside is that this feature is typically only offered on very expensive models.
When comparing automation equipment in the pharmacy industry it is important to focus on speed and accuracy, but most importantly value.
The DRX-500s and typical optical pill counters can perform counts in under 20 seconds. Torbal scales count by weight while optical pill counters use photosensors to record passing pills. The DRX-500s uses a few quick steps to prep for the count (including scanning the barcode) and then the scale will count the pills as fast as they are poured. Optical pill counters use a verification feature to ready the machine and then they must carefully pour the content of the bottle. This requires pouring at a controlled rate so that overlaps are not detected, which can cause an error in the count, thus resulting in a forced recount.
Both the Torbal DRX-500s and optical pill counters are specified at 99.9% accuracy when performing at their optimal levels. Torbal pill counting scales are NTEP certified and exceed NIST standards. Features such as Advanced Pill Counting Accuracy are designed to increase the accuracy of large counts.
The optical counters are not required to meet the same tolerances as weighing scales. There are models available with 99.9% accuracy, but they are high-end models and don’t take into account human error. Accuracy can be affected by a number of issues including pill dust, where residue builds up blocking the sensors, as well as pouring too quickly.
These issues tie directly into the maintenance required to stay operational. Optical machines require frequent cleaning in order to prevent obstruction of their photosensors. Cleaning is also necessary to eliminate cross-contamination. Unclean optical sensors can lead to problems down the road. These costs can add up to roughly 73 hours annually in a typical pharmacy.
The DRX-500s removes the need for cleaning by having the pills pour directly into a vial or weighing boat. There is no possibility of cross-contamination from a Torbal counting scale. Updating the APW’s time on the DRX-500s is approximately 11 hours per year and can be spread over a network of pharmacies.
To make their resources as efficient as possible, pharmacy owners look for unique features that are tailored around their applications. For this reason counting features are sought after by pharmacists to help simplify the process. The DRX-500s has many unique features such as Rx Verification, APA, PFD, and simple on-screen instructions. Higher end optical pill counters use Rx verification, but these are far less economically priced.
The amount saved using a Torbal DRX-500s counting scale is significant even after APW updating costs are added. Based on these values, a full return on investment can be expected in anywhere from 2.5 months to 7 months depending on the pharmacy’s daily volume of scripts. The value of the time saved can be viewed here http://www.fulcruminc.net/roi-calculator. Optical pill counters are more expensive and require even higher maintenance costs. When constant cleanings are added in the value of the product shrinks.
The Torbal DRX-500s yields the best return on investment in comparison. The value is unmatched and essentially pays for itself. This pill counting scale is even suitable for small pharmacies (100 scripts/day or less). The DRX-500s also offers the most features at its price point. It requires little maintenance and doesn’t cross-contaminate. By eliminating the need for having a compounding pharmacy scale (acts as 2 in 1) it yields additional savings as well.
All models are NTEP - certified as prescription scales with approved pill counting features, and meet handbook 44 requirements for a "Class A" prescription balance.View All Certifications
All TORBAL DRX pharmacy scales are available for purchase by Federal Government institutions under GSA contract terms and conditions.Read More
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