Rural Missouri Hospital Awarded USDA Healthcare Grant, Funds Telepharmacy

News-Leader.com out of Springfield, Missouri writes in their Daily Planner section about a new USDA grant awarded to Citizens Memorial Hospital in Bolivar:

Citizens Memorial Healthcare was awarded a $457,500 grant last month from the U.S. Department of Agriculture to fund educational projects and expand health care services in rural Missouri.

CMH received the grant for a program to manage medications. Rural residents can connect to a pharmacist in the evening and from remote locations with what's called a telepharmacy. The program computerizes managing prescriptions and improves the time it takes to review medication orders. The award was received by Susan Sanders, telehealth coordinator for CMH.

Vermont Telepharmacy Pilot Program Keeps Outpatient Pharmacy Services Alive in Rural Vermont

Keith McGilvery of WCAX News writes about a state-board approved rural outpatient telepharmacy program that has been running in Plainfield, Vermont for 2.5 years. Even though there's no pharmacist in town, one from Colchester remotely councils patients via a live video link, with a vending machine dispensing drugs to a technician.

The program is expanding Hardwick soon, and "telepharmacies are also up for discussion in Danville, Barton, Concord."

"HealthWatch" Video:

Idaho Pharmacy Regulations Revamp Provides for Remote Supervision of Technicians, More Changes Later

The Idaho Statesman offers this about Idaho's huge pharmacy regulations overhaul:

REWRITING THE RULE BOOK The board is nearing the end of a three-year effort to rewrite the rules governing pharmacies and other places that dispense medications, such as hospitals and nursing homes. The agency wants to dump the 102 pages of rules created over the years to eliminate antiquated language and extend regulation to some areas that haven’t had it before.

PROPOSED MAJOR CHANGES Two areas the board hopes to regulate more closely are telepharmacies and machines that dispense medications.

Telepharmacies permit pharmacy technicians to fill prescriptions under the supervision of a pharmacist, usually some distance away. In some cases, the technician may be in a small hospital that has a pharmacist for only a short period each day. Idaho has a couple of pilot programs now in telepharmacy. As the programs expand, the state will look at regulations. The machines dispense medications either to pharmacists filling prescriptions or to customers who come into a pharmacy to pick up prescribed medications. Pharmacists can put filled prescriptions into the machines that customers can access with a personal code, ending the need to stand in a long line.

THE PROCESS The board hopes to go to the Legislature in January to repeal the existing rules.

HOW YOU CAN BE HEARD A meeting is planned at 9 a.m. Wednesday, June 22, at the Idaho State Board of Pharmacy office, 1100 Shoreline Lane, Suite 300, Boise. Comments may also be directed to Mark Johnston, executive director, at mark.johnston@bop.idaho.gov.

TO LEARN MORE Go to the Board of Pharmacy’s website at http://bop.accessidaho.org.

Missouri USDA Funds Rural Hospital District's Telepharmacy Program

Last month, the Rural Development division of the Missouri USDA announced funding for telecommunications, distance learning and telemedicine projects in the state. Among those was:

Citizens Memorial Hospital District, in the southwest Missouri community of Bolivar, received $457,500 for implementing a telemedicine program that centralizes the management of medications. The tele-pharmacy allows rural residents to connect to a pharmacist during evening hours and from remote locations and computerizes the management of prescriptions which greatly improves the timely review of medication orders plus generally improves the efficiencies in all aspects of a pharmacy operation.

Several other telehealth grants were awarded but they didn't specifically mention whether their projects included anything pharmacy specific.

ASCP 2011 Spring Conference Provides a Telepharmacy "Education Session"

The American Society of Consultant Pharmacists' Spring Conference & Exhibition is running from May 17th through 19th, 2011 in Las Vegas, Nevada. Among their education sessions is an entire lecture about remote pharmacy called "Telepharmacy - A Future Alternative," held from 2:00 PM - 3:15 PM on Tuesday, May 17:

This session describes the operation of a telepharmacy medication dispensing system that provides medication dispensing services among a network of six community health clinics. After attending this session, participants will have a clear picture of how telepharmacy technology can be applied to dispensing of medications and may be able to apply some of the knowledge and practice experiences learned in this session into their dispensing practices. At the conclusion of this activity, the participant will be able to: 1. Describe the operational components of a telepharmacy system; 2. Identify the regulations and protocols that enable a telepharmacy to operate; 3. Describe the advantages and challenges of using a telepharmacy for dispensing services in an ambulatory/community setting; 4. Review potential telepharmacy error sources and suggest methods to reduce dispensing errors; 5. Discuss telepharmacy service patient satisfaction and service outcomes. Universal Activity Number: 0203-0000-11-009-L04-P; 1.25 contact hours

Minnesota SBP Grants More After-Hours ROE variances

After a host of after-hours order entry variances from the Minnesota State Board of Pharmacy recently, more hospitals requested and recieved variances in their March 9th, 2011 meeting:

Mayo Health System hospital pharmacies – remote after hours order entry –

Variance Committee recommends approval

o Fairmont Medical Center 200992-002

o Lake City Medical Center 261637-001

o Springfield Medical Center 200325-001

o St James Medical Center 200891-001

o Waseca Medical Center 200753-1

o Immanuel St Joseph Hospital 200743-001

European Association of Hospital Pharmacists 2011 Vienna Congress Lecture Will Touch on Telepharmacy

The 16th Congress of the European Association of Hospital Pharmacists is taking place starting at the end of this month, March 30th through April 1st, 2011 in Vienna, Austria. At least one of the lectures, "A need for hospital pharmacist specialization?" will touch on "Providing telepharmacy services to rural and remote areas."

Ontario Hospitals Request Bids for Remote Medication Order Review

The Wellington Health Care Alliance in Ontario, Canada has posted a request for proposal for a 1 year contract for a Canadian firm to do order review and entry for three sites for 1 year:

Notice Description:

Telepharmacy Coverage for Wellington Health Care Alliance

Wellington Health Care Alliance is a relationship between North Wellington Health Care and Groves Memorial Community Hospital. We operate three sites:

Louise Marshall Hospital, Mount Forest
Palmerston District Hospital, Palmerston
Groves Memorial Community Hospital, Fergus

Term of Contract will be 1 year from May 1, 2011 to April 30, 2012

Service Requested
• To provide telepharmacy coverage for 2 corporations and 3 hospitals that includes medication order review and pharmaceutical advice to staff and physicians

VA to "Soon" Roll Out Telepharmacy Services in Butler, Pennsylvania

In an article about their tele-dermatology program, VA Butler makes a quick mention that they "will soon expand to include Tele-Smoking Cessation and Tele-Pharmacy." No real information as to whether they'd be providing the service or receiving the service seems to be available.

Colorado State Board Approves Telepharmacy, Remote Dispensing in Rural Hospital

The article from the Lamar Ledger from the beginning of the month says it all:

The Prowers Medical Center Board of Directors approved obtaining USDA grant funding to place a tele-pharmacy service at the Holly Medical Clinic. The tele-pharmacy will allow people who receive treatment at the Holly Medical Clinic to get medicine from the tele-pharmacy. Described as similar to an ATM, the machine will be located in the Clinic and will allow those who receive treatment at the Clinic to get their medications in Holly, rather than driving 30 miles to Lamar to refill or obtain new authorized prescriptions. The machine will require identification and will be a benefit to those who live a long distance from Lamar, Prowers Medical Center CEO Jim Fairchild said. It is not the hospital's goal to take business away from pharmacies, he added. Installing the tele-pharmacy machine will simply benefit those patients who can't make the trip to Lamar, Fairchild said.

DrugTopics has Suggestions for State Boards, Praises Remote Chemo Prep

The newest issue (Feb 15th) of DrugTopics has two articles about telepharmacy. The first is by Ned Milenkovich, PharmD, JD. He has some suggestions for the state boards who haven't written telepharmacy rules yet: Get with it, and do look to other states. Excerpt from Page 2:

Many state pharmacy laws and regulations are devoid of language regulating this area. Telepharmacy is still a novelty, and there is a lag in implementation of new laws after professional and technological innovations are deployed.

Moreover, in the few states where telepharmacy laws exist, there is a lack of uniformity among the various states' measures. Implementation of comprehensive and uniform state laws and regulations would provide a more certain medium for telepharmacy for the marketplace and patient population.

With regard to state laws and regulations in the telepharmacy arena, establishing requirements that any technology used must be able to electronically link drug product at the remote site back to the original packaging from the drug manufacturer would ensure patient safety and offer a de minimus chance of medication dispensing error. By electronically sending the drug product's bar-code information from the remote site back for comparison with the manufacturer's bar code, the electronic indicia of the drug can be confirmed without human intervention.

Similarly, laws and regulations should require that captured images of the drug product and prescription that are labeled and dispensed at the remote site must be retrievable and reviewable by the pharmacy and pharmacist at all times.

Finally, telepharmacy laws and regulations should provide for proper counseling by means of video technology that enables pharmacist and patient to interact directly.

The second article is by Fred Gebhart, called "Technicians key to telepharmacy success in North Dakota" and it praises technicians' roles in telepharmacy. The article's section that might be new to my readership also comes on the second page:

Techs prepare chemotherapy and other IV medications in a typical sterile facility; the supervising is pharmacist linked electronically.

"Even if the pharmacist is sitting in the next room, telepharmacy can give you a higher level of oversight than you have with a traditional sterile-prep situation," he said. "Telepharmacy gives you clear, visual records of drugs, bar codes, syringes — every step of the preparation process."

Rural Washington Hospitals Awarded Telemedicine Grant, Will Upgrade Telepharmacy Equipment

The US Department of Agriculture's Rural Utilities Services, Distance Learning and Telemedicine Grant Program recently awarded $487,000 to the North Central Washington Health Collaborative (NCWHC), which includes Lake Chelan Community Hospital, as well as other rural public hospitals in Leavenworth, Brewster, Omak, Quincy and Goldendale. From the Kozi Community Radio station article:

The hospital, along with its partners, will receive $487,000 to upgrade and expand their telemedicine network to improve access and bring new healthcare services to the rural communities they serve.

As the coordinating facility in the North Central Washington Health Collaborative (NCWHC), LCCH's award will fund a new ultrasound machine, additional computerized radiology equipment and telepharmacy equipment for the hospital's childbirth and surgical center departments.

TrinityHealth Outfits North Dakota Hospital with Telepharmacy Equipment

Trinity Health's Foundation just released their "Report to the Community" for the fiscal year 2010, which ended June 30th. They received "nearly $700,000 in gifts" and dispersed this among their hospitals. A North Dakota hospital received part of it. From the release:

Kenmare Community Hospital

Exercise equipment for patients

Telepharmacy equipment to better serve the community

Unfortunately there are no more details.

VA Soliciting Bids for After-Hours Telepharmacy Service at Maine Hospital

The Federal Business Opportunities website has an offer from the Department of Veterans Affairs to remotely staff the Togus VA Medical Center in Augusta, Maine. Details as follows:

The Togus VA Medical Center in Augusta, ME requires after hours telepharmacy services for inpatients. This entails the vendor providing drug knowledge resources and pharmacist medication order review and entry services. This will include review of authorized physician medication ordered during "after hours" time periods that are scanned, sent, transmitted to or accessed by vendor. Pharmacists will enter via remote access, orders into VAMC medication order entry system. This contract is needed to relieve the present system of after hour's pharmacy orders. This work is presently being performed by VAMC TOGUS staff pharmacists on call and on overtime.

Solicitation Information: This telepharmacy contract will include a base year with 4 option periods at an estimated amount between $50,000 and $100,000 annually. The solicitation documents will be posted at the Federal Business Opportunities website (http://www.fbo.gov) on or about February 15, 2011.

So far there have been nine bids by providers from around the country, mostly from the Northeastern states.

PharmaTrust Receives More Canadian Government Funding

The Industrial Research Assistance Program, under Canada's National Research Council (NRC-IRAP) is contributing an addition $300,000 to PharmaTrust to "support the software and engineering development activities required to deliver a working prototype of MedHome™. From the press release:

The funding will enable the further development of MedHome™, a personal medication management system that addresses the critical issue of medication compliance, helping patients safely and effectively manage their own medications.

Rural Idaho Hospitals Look to Telepharmacy to Offer Better Healthcare Services

George Prentice of the Boise Weekly details the use of two machines in Idaho's rural Adams County Health Center named Beatrice and Norman that dispense drugs approved remotely by a pharmacist in Ontario, Oregon. Live video via Skype allows for remote patient consultations should the patient want it. From the article:

You can't believe how thrilled our providers are," said Langston-Groves. "We had this installed here after obtaining a special order from Gov. Otter."

The success in Council has led Langston-Groves to consider duplicating their effort to nearby Valley County where, by all accounts, the need is as great.

...

But administration at McCall Memorial, which just three months ago joined the St. Luke's network of hospitals, isn't so sure they want to see a low-cost clinic near their turf. Two weeks ago, hospital administrators told the McCall Star News that "adding more medical providers could damage our long-term financial viability." But officials back-pedaled a bit when BW asked about the proposal.

"We're going to do a formal assessment to determine the need," said Lee Rhodes, CEO of St. Luke's McCall.

"I really hope the hospital doesn't try to shut this effort down," said Backus. "With these hard times and people struggling as much as they are, I don't know why folks aren't jumping at this. There's no way that a low-cost clinic in Donnelly is going to be, in any way, competition toward a large medical facility in McCall."

Considering that McCall is less than 13 miles away from Donnelly, I don't think it's a big logical leap to worry about considering what the McCall Memorial "administrators" said. Hopefully they will put peoples needs before their own profits...

Kansas Sets New Telepharmacy Regulations

Out of the January Kansas Register comes the announcement that Kansas has drafted new regulations for Telepharmacies:

K.A.R. 68-17-1 through 68-17-9 is a set of new regulations to address telepharmacy branch pharmacies. The following is a summary of the new regulations:

K.A.R. 68-17-1. Definitions. This regulation defines terms used in the telepharmacy branch pharmacy regulations.

K.A.R. 68-17-2. Status of telepharmacy branch pharmacy. This regulation addresses the status of the telepharmacy branch pharmacy and limits the number of such branch pharmacies a retail pharmacy may have.

K.A.R. 68-17-3. Requirements for approval of location. This regulation establishes the requirement that each location of a telepharmacy branch pharmacy must be approved by the Pharmacy Board and establishes criteria for approval.

K.A.R. 68-17-4. Application for approval of a telepharmacy branch pharmacy. This regulation establishes the requirement of an application for a registration of a proposed telepharmacy branch pharmacy and establishes the required content of the application.

K.A.R. 68-17-5. Equipment requirements. This regulation establishes requirements for equipment in a telepharmacy branch pharmacy and its use.

K.A.R. 68-17-6. Minimum operating requirements. This regulation establishes operating requirements that must be met when a telepharmacy branch pharmacy is open for operations and dispensing drugs.

K.A.R. 68-17-7. Minimum security requirements. This regulation establishes minimum security requirements for the physical location of the telepharmacy branch pharmacy.

K.A.R. 68-17-8. Renewal registration. This regulation establishes the requirement that the registration of a telepharmacy branch pharmacy be renewed with the renewal application of the parent pharmacy by application to the Pharmacy Board.

K.A.R. 68-17-9. Fees. This regulation establishes the fees for the registration and renewal of a registration for a telepharmacy branch pharmacy.

This article from the Kansas Health Institute details problems that gave rise to the new regulations, the reasoning behind the rules, the model they followed in drafting them, and when they're likely to be encoded:

“We should definitely have those approved in March,” she said.

The regulations initially met resistance from retail pharmacists worried that telepharmacy operations would hurt their business.

“A lot of of people were concerned it was going to impact their brick-and-mortar pharmacy,” she said. “We’re trying to make sure we're not doing that. They don't want a Walgreens or somebody in Kansas City setting up a location in their town that doesn't have to be manned by a pharmacist.

"There was some fear we were going to come up with something like that," she said. "But that wouldn't have been acceptable to anybody. We'd rather you go to a real pharmacist in a real pharmacy, but if you're someplace where there’s not a real pharmacist, we want to make sure there's another option.”

2011 North Dakota Rural Health Information Techology Grants Help Expand Telepharmacy Services to Rural Hospital

Blue Cross Blue Shield of North Dakota put out a press release about the recipients of their Rural Health Grant Program Awards for 2011. Of the $375,000 awarded and seven recipients selected, one was a rural hospital that provides remote pharmacy services. The grant allows them to expand the program further:

Ye Olde Medicine Center of Park River plans to use the funds to expand the Park River telepharmacy services to Drayton, N. D. Drayton recently lost pharmacy services due to the retirement of their pharmacist. This is a cost-effective and efficient way to ensure continuing pharmacy services to the community and to support the local medical providers.

2009: Ross Memorial Hospital in Lindsay, Ontario Receives Pharmacy Services via Telepharmacy

I just came across an entry in the Canadian Journal of Hospital Pharmacy that highlights Ross Memorial Hospital in Lindsay, Ontario receiving pharmacy services remotely Mon-Fri from an undisclosed pharmacy. The rest of the work is "tech-check-tech".