"Art is one of the best employees I've ever seen," said Shannon McAtee, RPH, pharmacy information and technology manager at Gwinnett Medical Center. He never takes a lunch break or a vacation, isn't moody and rarely has a sick day.

"Considering that he's very sophisticated technology ¨ with computers, lasers and hydraulics ¨ I'm amazed that he has so few problems, but we definitely miss him when he's down," McAtee said.

Art, short for automated robot technology, has been helping the Gwinnett Medical Center pharmacy fill prescriptions since 2003.

The McKesson Robot-Rx computerized system fills one room of the hospital's pharmacy. The round room's walls are filled with pegs on which thousands of bags of medications with bar-code labels hang.

At the center of the room, a robotic arm whirls around, searching for the correct bar code for each medication that a patient needs. The arm suctions the medicine from the peg and drops it into the patient's envelope or onto a conveyor belt, where it will be loaded onto a 24-hour cart or sent by vacuum tube to a nursing station.

When not pulling prescriptions, the robot restocks the inventory with barcoded packages that are prepared by a packaging service.

"Art does two primary jobs in the pharmacy. He fills about 80 percent of the medications needed by hospital patients for our 24-hour cart fill," said Michael Naughton, Pharm.D., pharmacy director. "Traditionally, that would be done manually by pharmacists at night when there are fewer new orders coming in.

"The robot can also fill most of the 'first doses' of a prescription. That's the amount of a newly prescribed medication that the nurse would need to give the patient before the next 24-hour cart fill."

In one day, the robot fills about 3,000 to 4,000 prescriptions for the 24-hour cart and another 500 first doses. It takes about 70,000 packages a month to stock the robot.

"The technology hasn't replaced anyone, but he's helped us serve a growing hospital population without having to add staff," Naughton said.

From the standpoint of efficiency and safety, the robot is a real asset. Checks and double-checks within the system make sure that the robot pulls the right medications for the right patients, and pharmacists randomly check carts before they go out. The number of potential errors has decreased.

Even though pharmacy robots are common in large hospitals, most drugs don't come in individual packages with bar codes and not every hospital has fully implemented a bar-code system.

"We have to pay a service to repackage the medication and maintain the hardware and software of the system," Naughton said. "We also have a dedicated manager in the pharmacy who is responsible for the robot, the interface of pharmacology, robotic and hospital software, and the automated dispensing machines on hospital oors that stock 'as-needed' medications."

McAtee said dealing with the technology had been a "baptism by fire," as pharmacy school didn't cover robotic technology when she got her degree.

"I'm seeing more informatics courses listed in the journals now, so I think it's a growing part of pharmacy," she said.

Naughton expects technology to play a larger role in the pharmacy.

As safe and accurate as robots can be, they can't replace pharmacists. They can't talk to patients about drug interactions and side effects or fill IV, ointment or custom prescriptions. They can't make sure medications get to the right oor on time.

"The robot helps us be more efficient in the face of growing patient populations and demands and supports us in the safe and accurate dispensing of medication. Our focus is always patient safety," Naughton said.