Shortly after the 25-bed critical access hospital lost its full-time pharmacist seven years ago, it began a pilot telepharmacy project with Sacred Heart Medical Center in Spokane, about 110 miles northeast of Othello.
Today, the hospital has round-the-clock pharmacy coverage for its patients, a rarity for a hospital its size. Less than 2% of small hospitals – those with less than 50 beds – provide 24-hour pharmacy service.
“Rural hospitals have a hard time keeping a pharmacist and this has been a lifesaver for us,” said Othello Community Hospital nurse Rhonda Golladay, who manages the hospital’s pharmacy program. Othello was the first of what are now eight rural Washington hospitals connected through videoconferencing and other technology to Sacred Heart’s pharmacy.
While the shortage of available pharmacists confronts hospitals across the country, it is particularly acute in rural America. The ratio of pharmacists to population is lower in rural areas, with only 66 pharmacists per 100,000 people, compared to 78 pharmacists per 100,000 nationwide, according to the American Pharmacy Association. Only 12% of pharmacists practice in rural areas.
While the shortage isn’t expected to run its course anytime soon, Golladay believes telepharmacy can ease the pain for many rural hospitals. Under the program, Othello nurses enter medication orders into the pharmacy computer, then fax a copy of the original orders to Sacred Heart for review by a pharmacist. The pharmacist reviews the dosage and drug interactions and completes the order entry in the computer. After Sacred Heart’s pharmacist approves the order, a nurse at Othello swipes an identification card and types a password into an ATM-like machine that dispenses medications. The nurse enters the patient’s name and selects the appropriate drug, which causes the machine to open the drawer containing the drug.
Telepharmacy also enables rural hospitals to refill the dispensing machines with medications, which Othello usually does about three times a week. The Washington state Board of Pharmacy approved that refill method when hospitals don’t have on-site access to pharmacists. Through the videoconferencing network, pharmacists at Sacred Heart can watch nurses at the rural hospitals refill the drawers to ensure the accuracy of a drug’s placement.
The program has led to a dramatic reduction in the hospital’s medication error rate, which today stands at 0.1%. “Before telepharmacy, we had medication errors at least twice a month … a doctor wrote a prescription, and it was misread or misinterpreted because of illegible handwriting,” Golladay said. “We have not had one of those errors in five years.”
Golladay said nurses are pleased that they can communicate with pharmacists who understand intravenous drugs and other medication issues that hospitals face. “Many small rural hospitals depend on their retail pharmacist who may come in one or two days a week,” she said. “But we need hospital pharmacists. [Telepharmacy] provides the basic foundation for hospital pharmacy services in small rural communities.”
This article 1st appeared in the April 16, 2007 issue of AHA News
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