Slew of articles about pharmacist shortage

There have recently been quite a few articles about pharmacist shortages, not only in the US, but all around the world. This growing trend (the shortage) gives rise to innovative pharmacy practicies, such as the use of telepharmacy.

From "University of Pittsburgh School of Health and Rehabilitation Sciences Student Wins American Telemedicine Association 2007 Student Paper Award":

Remote areas often experience shortages of professionals and technical resources crucialto the delivery of services related to specialized medical fields.

From "From refugee to aspiring pharmacist, humanitarian":

There is a shortage of doctors and pharmacists in Kenya and Ethiopia.

From "Hospitals desperate for nurses using prized bait":

Hospitals have been contending with a nurse shortage for years, but the problem is expected to worsen. In California, the shortfall is magnified by state rules that require one nurse on duty for every five patients in a hospital and by population growth.
In many cases, the efforts also have targeted other hospital jobs difficult to fill, such as pharmacist, radiology technologist and physical therapist.

From "Health Care Officials Urge Youth to 'Make it in Scrubs'":

Currently, California has nearly 230,000 Registered nurses (RN) working full or part-time, according to the latest Legislative Analyst’s Office
(LAO) May 2007 report, “Ensuring an Adequate Health Workforce: Improving State Nursing Programs.” California ranks 49th in nurses per capita and 43rd in pharmacist per capita. By the year 2015, health experts estimate California will suffer a shortage of 17,000 doctors.

From "Customer Choice Plays More Significant Role in Prescription Drug Selection, Opinion Research Corporation Survey Finds":

With the rapid growth in the number of prescription transactions and a shortage of pharmacists, the role of the pharmacist had to become more operational," says Shea. "As technology evolves, I believe pharmacists will see their role becoming more influential and returning to a more advisory position. As a result, pharmacists may end up being one of the greatest influencers in the drug selection process.

University of Pittsburgh School of Health and Rehabilitation Sciences Student Wins American Telemedicine Association 2007 Student Paper Award

Award first ever given to student paper

PITTSBURGH, June 19, 2007 — University of Pittsburgh School of Health and Rehabilitation Sciences (SHRS) graduate student and doctoral candidate, Richard M. Schein, of Clifton, N.J., was recently awarded the American Telemedicine Association (ATA) 2007 Student Paper Award for his research in telemedicine.

The award was given in recognition of Schein’s presentation, “Telerehabilitation: Expanding Access to Wheelchair Provision and Service Delivery,” which was presented at the ATA Annual Conference in Nashville last month. This award is the first of its kind for the ATA.

“Richard's abstract was originally peer-reviewed by the ATA 2007 Peer Review Committee and was accepted for presentation at the annual conference,” said Jordana Bernard, senior director of ATA. “The award was based on the quality of both his written paper and oral presentation. We are very excited for him and the award is well deserved.”

The award-winning paper covered the following points about the importance telerehabilitation in rural areas:

Telerehabilitation offers many new opportunities to provide rehabilitation services in alternative ways and in different clinical settings. Remote areas often experience shortages of professionals and technical resources crucialto the delivery of services related to specialized medical fields.

Rural providers are often isolated from advancements and technologies used in larger metropolitan centers. As a result, when an individual in a rural area needs an assessment, a specific treatment, or both, patients may have to travel long distances to receive the specialized health care necessary to address their needs. This impacts both the health care providers and the patients. There are more people in need of the services of assistive technology specialists than there are regional clinics to serve them. The durable medical equipment industry has seen new coverage guidelines implemented by Centers for Medicare and Medicaid Services recently for wheelchairs (i.e. mobility assistive equipment)of who can perform these assessments.

The assessment of the user’s needs and matching the user with an appropriate wheeled mobility and seating intervention as well as fitting and training isessential for successful outcomes.

The rapid improvements in telecommunications technology also have the potential to improve the delivery of services to people with disabilities and those who are elderly. Transmission of voice, image, and data could provide a means for experts in wheeled mobility and in other rehabilitation aspects to provideconsultation to other health care professionals and consumers.

“This award is a testament to Rich's hard work and dedication to the project as well as recognition to the field of rehabilitation,” said Mark Schmeler, Ph.D., instructor at the University of Pittsburgh in the department of rehabilitation science and technology and principal investigator on Schein’s project. “People are living longer and surviving diseases and injuries more than in the past. Therefore needs are growing especially in rural areas. Telerehabilitation is emerging as a mechanism that warrants more consideration in the health care community to serve more people in an appropriate and cost-effective manner.”

Schein received a B.S. in rehabilitation and disability studies with a concentration in medical rehabilitation from Springfield College. Upon graduation, he came to the University of Pittsburgh to pursue a Master’s of science degree in rehabilitation science and technology as well as a certificate in assistive technology. He is currently a doctoral candidate in the SHRS within the department of rehabilitation science and technology. He has been working for the Rehabilitation Engineering Research Center on Telerehabilitation, where his research has focused on remote wheelchair prescription and consultation via telerehabilitation. Schein has been involved in clinical research for the past four years in areas such as seating and wheeled mobility, telerehabilitation, as well as funding and policy as it relates to assistive technology. He is also a member of the Rehabilitation Engineering and Assistive Technology Society of North America and the ATA.

The University of Pittsburgh Schools of the Health Sciences include the schools of Medicine, Nursing, Dental Medicine, Pharmacy, Health and Rehabilitation Sciences and the Graduate School of Public Health. The schools serve as the academic partner to the University of Pittsburgh Medical Center. Together, their combined mission is to train tomorrow’s health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care. For fiscal year 2005, Pitt and its institutional affiliates ranked seventh nationally among educational institutions in grant support from the National Institutes of Health (NIH).

For more information about this award or the Schools of the Health Sciences, please visit www.health.pitt.edu

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Automated dispensing units ready for American homes

A couple of articles came out a while ago about some new hardware with web controls that you can remotely administer.

FDA Grants Clearance To INRange System's Electronic Medication Management Assistant - EMMA™

EMMA the Magic Medicine Cabinet Approved by FDA to Deliver Medicine with Pharmacy Web Commands

Coincidentally, a vulnerability was found in another Pharmacy program around the same time. This is the first time I've really heard of such a thing. I guess healthcare applications just aren't abundant enough out there accessible on the internet to cause it to be a big deal -- until these automated dispensing units hit American homes, that is. It's going to be interesting to see how long it takes these things to be hacked.

Pine Bluffs finally has a pharmacy ... sort of

A video link and drug vending machine make the Telepharmacy possible.

By Jennifer Frazer
jfrazer@wyomingnews.com

CHEYENNE - No matter what it looks like, the drugs in a new Pine Bluffs machine aren't snacks. They're just dispensed that way.

With a prescription in hand, Pine Bluffs patients can now watch the amoxicillin for their strep throat be pushed out by a turning piece of coiled metal behind glass just as they would their daily sugar fix.

There are a few differences, however. There's no coin slot or button pad. Instead, a pharmacy technician in Pine Bluffs and pharmacist in Cheyenne - connected by video link - handle the dispensing of the drug.

After lacking a pharmacy for more than six years, the Hoy's Drug Pine Bluffs Telepharmacy opened for business on Feb. 21. It has only been inoperable one day since then, said Dr. Douglas Parks, a physician at the UW TriCounty Clinic whose lobby holds the telepharmacy, because the phone lines between Cheyenne and Pine Bluffs were down.

"People coming in with illness are just thrilled to be able to fill their prescription before they go home without having to travel somewhere," Parks said.

The machine is filling about 10 prescriptions a day, resulting in a savings of 600 to 900 miles of travel time and gasoline per day.

That means a lot to people, Parks said, particularly at current fuel prices.

"If you're driving an old Ford truck, it's a $30 trip to get your $12 prescription filled," he said.

And it's a great help to senior citizens who can't drive and formerly had to depend on getting their medicine through the mail.

The installation of the machine paves the way for other communities in Wyoming to take advantage of the technology, Parks said.

"Off the top of my head, I can think of eight to nine communities in similar situations," he said, "They have (doctors) but no pharmacy services. So I'd anticipate we'll be seeing this technology used in other communities in the state in short order."

Pine Bluffs resident Wendy Rohde has been very appreciative of the telepharmacy - she's been using it since the day it opened for her four foster children, she said. It has saved her at least one trip a week to Cheyenne to fill prescriptions, a savings of about $15 per trip - and an hour and a half in the van.

"I don't know if you've ever driven 45 minutes with a 4- or 5-year-old, but let me tell you, it can be something," she said. "And that's one way."

What the machine cannot offer, by law, is controlled substances like many prescription painkillers. That poses a problem, Parks said, for patients who break an arm or have teeth extracted in Pine Bluffs. They must still make the trek to Cheyenne to get their prescriptions filled.

Back in 2004, Parks' medical group approached several Cheyenne pharmacies about telepharmacy, but only Hoy's expressed interest in it.

"We're interested in helping out the community," said Jim Massengill, president of Hoy's Drug, of the reason they decided to pursue the telepharmacy in Pine Bluffs.

Though Hoy's knew there was potential for a drug store in Pine Bluffs, after the eye-opening cash layout they had to make to place a branch of their pharmacy in Cheyenne Regional Medical Center - more than $500,000 - they weren't prepared to lay out that sum of money again soon.

The telepharmacy seemed the ideal compromise.

But the organizers soon realized it was not yet legal to install one.

Working with Sen. Wayne Johnson, R-Cheyenne, and Rep. Rodney "Pete" Anderson, R-Pine Bluffs, they got a bill passed to legalize the machines in 2005. The state Board of Pharmacy approved rules the following year.

Though at 10 prescriptions per day the branch is not yet profitable, Massengill hopes with time it will be.

"It's totally a community service so far," he said, "but it has a lot of potential, it's growing each week, it's getting a little bit better, but it's going to take quite a bit of time before it gets there."

When a prescription is brought to the pharmacy, a pharmacy technician faxes it to the Hoy's in Cheyenne, where a pharmacist enters the information into the computer, which dispenses the drug back in Pine Bluffs. A label also is printed, and the Cheyenne-based pharmacist checks the appearance of the pills, the label and other information via video link.

Though the telepharmacy currently carries only about 100 drugs, any other drug stocked by Hoy's main branches can be delivered by the next business day.

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