US Navy's Worldwide Outpatient Telepharmacy Program to be Extended to Inpatients, Army, Air Force?

An article by Kate Traynor from next month's ASHP News interviews the the Navy's telepharmacy program project manager, Lieutenant Commander Marc Young (Lt. Justin Eubanks pictured above). From the article:

"We have a lot of sites, more than the other two services, that have technicians only," Young said of the Navy. "Some of these branch clinics with these technicians are literally almost like closets. They’re very small pharmacies; they’re doing 80 prescriptions a day, in some cases, with one technician."

"It’s difficult to hire folks in those places as well to get people to move to some of our remote locations," Young said.

Through telepharmacy, the technician-run pharmacy at the remote Mountain Warfare Training Center in Bridgeport, California, has access to pharmacists at the Robert E. Bush Naval Hospital in Twentynine Palms, California, Young said.

The article also mentions the Navy is waiting on funds to determine whether they'll expand the program to their inpatient pharmacies around the world and that they're talking to the Army and Air Force as well. There are also some interesting numbers on Navy pharmacists and technicians. Great, insightful article.

New Study: Many US States Neglect Setting Any Telepharmacy Policy

In a new study in the American Journal of Health-System Pharmacy (AJHP), the "Current practices and state regulations regarding telepharmacy in rural hospitals" were examined for a good number of US states. Through a series of interviews with board of pharmacy directors, a team out of the University of Minnesota including Michelle Casey, Todd Sorensen, Walter Elias, Alana Knudson, and Walter Gregg found:

Results. Although telepharmacy is addressed in NABP’s model pharmacy practice act, many state boards are just beginning to address it. The model act addresses the practice of pharmacy across state lines, and the state board directors interviewed generally agreed that pharmacists should be licensed in the state where they are providing the service. States differed on whether a pharmacist should be required to be physically located in a licensed pharmacy and how much time the pharmacist should have to spend onsite. Telepharmacy models being implemented in hospitals in several states incorporate long-distance supervision of pharmacy technicians by pharmacists. The models being implemented vary according to area, state regulations, hospital ownership, and hospital size and medication order volume. Most hospitals reported that they track medication error rates, and some said error rates have improved since telepharmacy implementation.

Conclusion. The application of telepharmacy in rural hospitals varies across the United States but is not widespread, and many states have not defined regulations for telepharmacy in hospitals.

Arkansas: Medical Center Provides Telepharmacy for Disaster Relief, Reduces Errors

In an article in online magazine "Lifestyle" called White River Medical Center Uses Meta Pharmacy System to Support Distance Medication Dispensing, Holly Meyer of tells a tale of two medical centers in North Central Arkansas, one providing remote order entry to the other in the absence of an on-site pharmacist:

This remote link allows WRMC pharmacists to provide remote medication order entry and real time review of medication orders for appropriateness of doses, as well as screening for medication allergies and drug-drug interactions. Although 35 miles away, SCMC functions as a virtual nursing unit of WRMC, allowing nurses at SCMC immediate access to medications in their dispensing machines. Two goals are achieved with this arrangement - orders for every patient are reviewed and verified by a pharmacist and nurses have access to medications without using an antiquated medication cart fill each day.

"Implementation of this unique technology has had a significant impact on patient care through the reduction of medication errors, adverse drug reactions and drug-drug interactions," explained Jody Smotherman, PharmD, Co-director of Pharmacy Services at White River Medical Center. "It has also produced improvements in employee and nursing job satisfaction as well as improved drug charge capture. A major unexpected benefit was realized in February of 2008 when an F-3 tornado struck Mountain View, destroyed part of SCMC and forced the closing of the pharmacy area. Without our remote order entry and automated dispensing machines, there would have been no access to medications after the storm."

Another advantage of telepharmacy: disaster relief!

North Dakota Telepharmacy Project Continues to Expand

Candie Helseth wrote an article in Prairie Business Magazine about Kathy Nelson, a North Dakota pharmacy owner who remotely supervises technicians dispensing medications in a retail setting. The NDTP's stats were highlighted a bit as well:

The use of telepharmacy technology is growing in North Dakota, which in 2001 became the first state to approve legislation allowing retail pharmacies to operate in remote areas without requiring a pharmacist to be physically present.

In the decade preceding the creation of the North Dakota Telepharmacy Project, the state had lost 26 pharmacies. As a result of the state’s telepharmacy project, 40,000 rural residents in North Dakota have had pharmacy services restored, retained or established, according to Ann Rathke, the coordinator of the state’s telepharmacy project.