Telepharmacy owes a lot to Sen. Dorgan

As dean of North Dakota State University’s pharmacy program and director of the North Dakota Telepharmacy Project, I was pleased to see the recent AP article published in The Forum on our telepharmacy program. This program is the first of its kind in the country, and it shows what North Dakota is capable of accomplishing when academia works together with rural communities and private businesses to achieve a common goal.

The purpose of the North Dakota Telepharmacy Project is to restore, retain or establish pharmacy services in medically underserved rural communities of North Dakota through the use of telepharmacy technology. Through this program, a licensed pharmacist at a central pharmacy site supervises a registered pharmacy technician at a remote telepharmacy site in the processing of prescriptions for patients. Currently 67 pharmacies are involved in the project – 22 central pharmacy sites and 45 remote telepharmacy sites. Of the 67 pharmacies involved, 44 are retail pharmacies and 23 are hospital pharmacies.

Twenty-nine (55 percent) of North Dakota’s 53 counties are involved in the project and two in Minnesota. Approximately 40,000 rural residents have had pharmacy services restored, retained or established through the North Dakota Telepharmacy Project since its inception in 2002. The project has restored valuable access to health care in remote medically underserved areas of the state and has added more than $12.5 million annually in economic development to the local rural economy.

The only thing missing in this article was acknowledgment of the important role Sen. Byron Dorgan, D-N.D., played in making this program possible. Through Dorgan’s efforts on the Senate Appropriations Committee, he helped provide more than $3.3 million in federal support to NDSU to ensure that this program became a reality.

I can honesty say that North Dakota would not have this nation-leading telepharmacy program today without Dorgan’s help. Considering the impact this program has had locally, regionally and nationally, I believe Dorgan deserves some credit and recognition for his efforts regarding this terrific program.

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Info on Author: Charles D. Peterson, Pharm.D., Dean, Professor, and Principal Investigator
North Dakota State University College of Pharmacy, Nursing, and Allied Sciences
Info on Dorgan: http://www.votesmart.org/bio.php?can_id=53332

Pharmacy Students Working Toward “Closing the Gap”

Excerpt:

Finally, the event ended after a “Call to Action” panel moderated by Roshini Epasinghe, consisting of three student pharmacists from the UCSF School of Pharmacy: Serena Huntington, Megan McCurdy and Martha Prieto. Advocates for the cause, these three student pharmacists spoke to their experiences and involvements with serving the underserved. Huntington focused on her current Schweitzer Fellowship, which is aimed at improving health outcomes through preventative medicine.

McCurdy shared her experiences in serving the underserved internationally in Mexico this past summer, where she was able to shadow physicians and learn Spanish for a period of one month. Prieto spoke about her current involvement with telepharmacy and how her fluency in Spanish has helped her to serve the underserved Spanish-speaking populations of San Francisco.

The event concluded with a brief speech given by Epasinghe, advising fellow student pharmacists on career development and matters related to networking. The sponsoring organizations hope to make “Closing the Gap” an annual event, so be sure to support them in advocating for the underserved at next year’s event.

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Telepharmacy and ePharmacy: Siamese or discrete?

There's a new paper out in the International Journal of Healthcare Technology and Management addressing Telepharmacy and e-pharmacies.

State pharmacy board meeting Wednesday in Rothschild

The Wisconsin Department of Regulation & Licensing will hold its professional pharmacy examining board meeting starting at 9 a.m. Wednesday at the Cedar Creek Lodge, 805 Creske Ave., Rothschild.

The board is part of the state’s Department of Regulation & Licensing, which licenses and regulates 128 different types of credentials in 57 professional fields, including pharmacists’ licenses. It issues nearly 50,000 new credentials and it renews approximately 350,000 credentials every two years.

“This is a great opportunity for pharmacists in central Wisconsin, other health professionals and the general public to see the work of the Pharmacy Board first hand,” said Celia Jackson, the department’s secretary. “Holding this type of meeting outside Madison is part of a broader effort to make the work of licensing and regulatory boards more visible and accessible to the people of the state.”

Agenda items include discussing various issues related to filling prescriptions as well as a closed session to deliberate on possible disciplinary actions.

Following the meeting, participants are invited to travel a short distance to Marshfield Clinic Weston Center to observe a demonstration of a remote dispensing and telepharmacy operation.

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Houston Cronicle / AP Story comments

There were a number of comments around the web on the widely mirrored Associated Press story on the North Dakota Telepharmacy Project as well as the Telemedicine project at Texas Tech University. See the previous post for that story.
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Blog Post

Telepharmacy project expands across country

ARTHUR, N.D. — The days of walking down to the general store for prescription drugs are returning to rural America, thanks to a virtual pharmacy system that has been tested on the frozen prairie.

As recently as three years ago, many elderly residents in this area of southeastern North Dakota were forced to order their medications by mail. Now, customers have a real drug store and can talk to a real person who's connected to a pharmacist by the Internet.

"It's perfect," said Jim Williams, a longtime Arthur resident. "You can walk down there and it's done in a few minutes."

North Dakota lawmakers opened the door for the telepharmacy project by passing legislation in 2001, after dozens of rural pharmacies went out of business. The project began with 10 volunteer sites in 2002 and has grown to 67 locations.

The idea may be catching on in other places.

States that have changed laws to allow for remote pharmacies include Alaska, Idaho, Illinois, Montana, South Dakota, Texas, Utah, Vermont and Wyoming, along with the District of Columbia. More are on the way, the head of North Dakota's project said.

"We get calls every day from other states," said Ann Rathke, director of telepharmacy at North Dakota State University in Fargo. "A lot of states have used or have adopted in some way our rules, because they were out there."

Charles Peterson, dean of pharmacy at NDSU, said the rest of the country has been "watching and waiting" to see how the North Dakota project worked.

"Every state is struggling with, the most part, the same issues," he said. "Access to health care in a rural setting is a problem for everyone. We have shown that this is a solution."

Most telepharmacies are staffed with registered pharmacy technicians, who usually need about two years of schooling and earn about $15 an hour in North Dakota. Some registered nurses also have been trained for the job.

"You don't have the expense of a regular pharmacist," said Katie E. Thompson, a registered pharmacist who lives near Page. "That's the point of a telepharmacy."

The pharmacy technicians use remote cameras to show pharmacists the original signed prescription, computer-generated label, stock bottle where the pills are stored and the bottle the patient will take home. Once the prescription is approved, patients have a mandatory private consultation with pharmacists through real-time video and audio.

"We can do most of the things the pharmacists do except give professional advice," said Jennifer Joyce, the pharmacy technician in Arthur.

She can offer guidance on other matters, such as the weather, crop conditions, family events and high school basketball. Joyce knows all of her patients on a first-name basis. Many of them are there for more than just a bottle of pills.

"When they're sick, sometimes they just want people to listen to them," she said.

Rathke said it costs about $18,000 to set up a site in North Dakota, including equipment, installation and one year of Internet service. Telepharmacies pay an annual licensing fee of $175.

"It's not rocket science, and it doesn't cost a tremendous amount of money," Rathke said.

It does take some political will, Peterson said. In most cases pharmacy has more laws and rules than any other area of health care and many states are unwilling to make modifications or adjustments, he said.

"Finally, those other states that haven't in some cases been willing to talk about it, willing to even look at it, are being forced to look at it because North Dakota has proven this thing," Peterson said.

It hasn't been proven in every state.

The first telepharmacy in Texas opened in 2002 in the town of Turkey and has gained in popularity. But only a few more sites in Texas have popped up since then, said Debbie Voyles, director of telemedicine at Texas Tech University.

"Where there are no pharmacies, there are no doctors," she said. "Patients have to travel to see the doctors, so it's no big deal to them to have to pick up the prescriptions."

The Texas Tech pharmacy school is looking at ways to increase interest and is hoping to learn from North Dakota's success, Voyles said.

Don Turner, who runs the pharmacy in Turkey, said his clients are mostly elderly people who don't have access to transportation. The nearest pharmacist to the town of 400 people is about 50 miles away.

"It's a great thing for Turkey," Turner said. "I think it's just a matter of time for other small towns."

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