Robotic Medicine Dispensers Pillage Jail's Cost Savings
by John E. Dannenberg
ROBOT, a $1 million automatic pill dispensing system installed at the Contra Costa County (California) jails in February 2005 and advertised to save the county $240,000, has so far instead cost the county $60,000 in overtime pay for people to supplant the non-functional machinery. A May 25, 2006 Contra Costa County Grand Jury report, subtitled Who Drugged ROBOT?, branded the program an apparent failure in both mechanical operation as well as in cost/benefits.
In September 2004, Contra Costa County leased three ROBOT systems for five years for $971,082. (See: PLN, May 2006, p.27.) The contract justification forecast savings from replacement of the pharmacist with a pharmacy technician ($89,000), simplification of the drug formulary ($100,000), and efficiencies from daily instead of monthly dispensing ($60,000). When comparing total reductions ($249,468) against lease costs ($196,616), the projected annual savings were $54,852. But the grand jury found these savings illusory.
First, the vendor only delivered two of the three ROBOTs, and both of those were still not operational as of May 2006 due largely to lack of a project manager. Second, the jury determined that replacement of the pharmacist with a technician and simplification of the formulary had already been achieved without ROBOT. Third, the county had incurred added overtime costs including at least $60,000 of health services information technology (IT) staff time and an undetermined amount of sheriff IT staff time. No one has been minding the store, the report concluded, due to delays from lack of coordination and failure to assign a project manager. Moreover, three-fourths of the anticipated savings attributable to the hardware had been achieved without it. Thus, the economic justification for the ROBOT system was flawed.
The grand jury recommended that the sheriff and health services departments get all three ROBOTs operational by September 30, 2006. It further admonished the county administrator to do a better job of cost/benefit analyses in future contracts. Finally, it ordered the administrator to install a project manager to take responsibility for multi-department projects such as this.
But a glaring omission from the report was whether prisoner healthcare -- the ultimate touchstone of ROBOT's performance improved or worsened during the intervening year of non-operation. See: New Automated Drug Dispenser In County Jails, Contra Costa County Grand Jury report No. 0605.
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