TORONTO - Large green and white kiosks that resemble bank machines but instead take prescriptions and dispense medicine 24 hours a day are coming to hospitals and remote communities in Ontario.

While supporters of the so-called "pharmacy in a box" call it the future of the profession, the profession itself says it could never fully replace the pharmacist-patient relationship.

The ATM-like kiosk, which dispenses pills like a vending machine, has a video screen linked to a real pharmacist who can talk to the patient and has full control of the medication being dispensed.

"We see this concept, this idea of two-way video conferencing to a pharmacist, as the way of the future in health care," said Tom Closson, president of the Ontario Hospital Association.

The kiosk is the beginning of a virtual approach to the delivery of health services in Canada, Closson added.

Four of the machines have already landed in Toronto-area hospitals, the association said. Eight more kiosks will be added to hospitals and remote areas across the province in the coming months.

With a prescription, a patient can pick up a phone attached to the machine and reach a pharmacist through video conference 24 hours a day.

A pilot project at Sunnybrook Hospital in Toronto has dispensed hundreds of prescriptions without a single error since last March, the association said.

Closson said the machines are highly efficient and convenient for consumers, but added the greatest advantage is that they make better use of pharmacists.

Pharmacists working in traditional institutions often find themselves bogged down by jobs that could be done by technicians, said Closson. He cites pill counting as one chore that pulls pharmacists away from their counselling role.

Pharmacists are cautiously curious about the new machines.

Dennis Darby, CEO of the Ontario Pharmacists Association, said the kiosks were another tool for pharmacists and understands that there is a place for remote dispensing.

However, he said the machine could never replace the face-to-face relationship between a health care provider and a patient.

"They should see the same pharmacist, we hope, because typically they're on a number of medications and a kiosk like this won't know whether you're on a number of medications," Darby said as he outlined some of the concerns for those on several medications, especially seniors.

Pharmacists are also trained to look for forged prescriptions, and Darby said with a scanned copy it could be harder to detect.

The kiosks are made by the Oakville-based company, PharmaTrust.

The successful introduction of the self-serve pharmacy was contingent upon legislation introduced by Ontario's health minister which passed last December. The kiosks will only be widely available once regulations, which the Ontario College of Pharmacists is working on, are in place.

The machines will mostly be located in hospital emergency rooms and will be valuable to a customer unable to access a 24-hour pharmacy, or too ill to make the trip.

Like many ATM machines, which allow a customer to select a language preference, the patient will be able to request a pharmacist who speaks a particular language.

"The second a Japanese-speaking pharmacist logs in, the network of all machines speaks Japanese," said Peter Suma, chief operating officer and co-founder of PharmaTrust.

People living in remote areas can now access a health care professional within seconds, Suma added.

"There are towns in Ontario where the pharmacy is an hour away," he said.

The company is installing a system near Georgian Bay on an isolated First Nations reserve that does not have a pharmacy or a doctor's office.

"This isn't about replacing 100 per cent. Your TV didn't replace your radio," Suma said, drawing an analogy in order to stress the point that machines won't replace full pharmacy visits.

Still, Closson added: "If I look way out to the future, I think you're going to see more and more of this."

The company said the machine is safe to use, because a pharmacist is able to control it as it fills the prescription.

The heavy machines, made of steel, are also rigged with alarms in case anyone attempts to break in, said Suma.

Narcotics would be available in the machines located in hospitals, but not the kiosks inside community health centres.

Darby said he wouldn't want to see the machines dispense narcotics or controlled substances.

"I think the future (of pharmacy) will be more pharmacists providing more care directly to patients," he said.

"I think technology like this has a role. Where will it be in the future? We don't know that yet."