Telepharmacy can "improve patient access to pharmaceutical care"

A new paper by Annie Y. Lam and Dave Rose called Telepharmacy services in an urban community health clinic system appeared in the Journal of American Pharmacists Association last month:

Setting: Suburban western Washington State during 2007 to 2008.

Practice description: Five network clinics without in-house pharmacies are remotely connected to a central pharmacy to provide telepharmacy services.

Results: At five network sites, 12,000 patients received 3,282 new prescriptions per month with webcam-enabled consultations, 589 monthly refill prescriptions, 2,800 pharmacist-provided refill authorizations, and 250 medication assistance referrals. Antibiotics were the most frequently dispensed medications. Pharmacists commented that webcam-enabled interviews provided better privacy and longer counseling duration. Six new staff members (one pharmacist and five pharmacy technicians) were added. Workspace and staff responsibilities were reassigned to facilitate medication prepackaging and ADDS prescription processing.

Conclusion: Expanded application of telepharmacy technology can improve patient access to pharmaceutical care beyond remote medication dispensing to include point-of-care refill authorization and medication assistance referrals. Further research to explore patient-focused services and to assess economic, humanistic, and clinical outcomes of telepharmacy services is needed.

More and more indicators are pointing to telepharmacy being a good way to improve patient care.

New Legislation Paves Way for Remote Dispensing in Ontario, Canada

The Ontario legislature passed Bill 179, which will allow remote dispensing in the province:

The new legislation will permit PCA Services Inc. of Oakville to roll out its PharmaTrust(TM) Med Centres across the province - something the company has been working towards for four years. Once the regulations are in place, it is expected that Med Centres will be deployed to service patients in medical clinics, hospitals, employer facilities, retail locations, and remote communities that cannot economically support a traditional drug store.

Check out the press release. We've covered the remote prescription dispensing machine previously here at the Telepharmacy Blog, and also this legislation when it was first being considered. Here are some promo videos and news pieces from Youtube:


http://www.youtube.com/watch?v=gU30LnS2qso




http://www.youtube.com/watch?v=J-kGuOu1GQ0

Army, Navy, VA use of Kiosks, Automated Dispensing, Telepharmacy on the Rise

Christopher Prawdzik from the latest edition of Military Medical Technology wrote a review of the newest pharmacy technologies in use at various military pharmacy facilities called "Less Time to Fill: Advances In Pharmacy Automation Cut Costs, Improve Accuracy And Leave Pharmacists With More Time For Patient Care":

For example, the Navy’s Pensacola, Fla., command has about 11 remote sites in addition to the Pensacola Naval Hospital. Using ScriptPro’s Telepharmacy system, any pharmacist on duty at any of these sites can accept a call at a station and verify that prescriptions are accurate. This includes verifying pictures of individual drugs with the actual filled prescription.

One big bonus of such systems is that instead of spending exorbitant amounts of time on what are essentially administrative or inventory matters, the technology allows pharmacists to do what they were trained to do. That includes understanding the medication needs of patients and ensuring that drug combinations, if multiple drugs are involved, do not lead to adverse interactions.

He talks about automation in use (Omnicell) at Walter Reed, unmanned kiosks where patients pick up prescriptions, and the telepharmacy system in the above quote from the article.

Establishment of Health Information Exchange Facilitates Telepharmacy Service

InformationWeek published an interesting article today about Health Information Exchanges (networks for sharing patient information between health-systems) in the United States. Marianne Kolbasuk McGee highlights a specific network, the Western Washington Rural Health Care Collaborative where by virtue of the fact that they use an Information Exchange, the hospitals are able to provide telepharmacy services to each other:

The exchange will initially provide the smaller hospitals, some of which have fewer than 25 beds and are located 35 or more miles from other healthcare providers, with telepharmacy services. Patient data, such as allergies, medications, lab results, and demographic information, is collected in a central repository, and pharmacists at one of the facilities can remotely provide assistance to other hospitals.

The article also mentions how 20 billion federal "stimulus" dollars have made it to or are destined for Healthcare IT needs of various health-systems around the US. Health Information Exchanges are one major result, and apparently provide a ready infrastructure for telepharmacy services.

Two quick Telepharmacy updates

Photo by Tammy Lawson

First, Tammy Lawson of the Times Republican reports that the US government is building a new Veterans Affairs (VA) clinic in Marshalltown, Iowa whose pharmacy will be serviced by remote pharmacists. This no doubt sprung from their other work in Iowa where they identified the program as one of their best and most efficient.

Second, an update on Comprehensive Pharmacy Services' newly acquired remote pharmacy division, now with a new name, comes from a small article buried in Memphis' Commercial Appeal online magazine:

Rx Remote Solutions

Comprehensive Pharmacy Services has renamed its newly acquired remote-order-entry division to Rx Remote Solutions.

Memphis-based CPS bought Napierville, Ill.-based RxKnights Inc. in June for an undisclosed amount.

Rx Remote Solutions employs pharmacists at a call center who answer calls from health care facilities including hospitals, nursing homes and behavioral health centers.

The pharmacists will have access to the facilities' patient files and will be able to review and approve medication orders even late at night.

It will be interesting to see how they do entering the remote pharmacy market around the US. You can bet the Telepharmacy Blog will be covering it.

Remote Order Entry constitutes "great leadership", gets hospital recognized by state hospital association

The Kansas Hospital Education and Research Foundation will recognize 5 hospitals in Kansas for innovative health care solutions tomorrow at the Kansas Hospital Association conference in Wichita, according to Josh Heck of the Witchita Business Journal. There were 2 co-winners and 3 honorable mentions:

Via Christi’s honorable mention is for its ePharmacy program to reduce medication errors.

Via Christi added to that effort Tuesday by signing the first hospital outside of its own health system as a subscriber to ePharmacy.

Hiawatha Community Hospital was added following a month-long test period. With the program, an ePharmacist reviews orders for the hospital seven days a week through a remote order entry system under which hospitals scan or fax orders.

As you can see, Via Christi (which we've been covering here) is really turning heads with their "ePharmacy" (aka Telepharmacy) program. They do remote order entry for outlying hospitals, and according to the article, just had Hiawatha Community Hospital sign on.

Ontario company attracts "dozens of countries" to its retail telepharmacy machine

Charlene Close of 680 News out of Toronto did an informative write up on Patient Care Automation Services, Inc from Oakville, ON:

Patient Care Automation Services Inc. (PCAS) is the developer of the PharmaTrust® MedCentre which is designed for use in hospitals, pharmacies, medical clinics and workplaces. About a dozen countries are already interested in the product.

It operates much like an automated bank machine - insert your paper prescription into the machine or pick up a phone, it then connects electronically via video to an actual pharmacist who can answer any questions the patient has and then sign off on the prescription before the drugs are dispensed.

The company received a $1.5-million grant from the National Research Council of Canada today that will assist in further development and marketing it across Canada, the U.S. and the UK.

This is the company the Canadian government expressed an interest in within a press release from October 13th, and was previously covered here at the Telepharmacy blog.

UPDATE 1: October 28, more press on the Telepharmacy machine: Fierce Healthcare ran this article, complete with announcements from Canadian government officials from the National Research Council and the Minister of State for Science and Technology's office about funding the project. The article also has new info about the system's use:

Currently, trials are taking place at Sunnybrook Hospital in Toronto, under the supervision of the hospital's pharmacy; there are production sites at the Albany Clinic, in Toronto, and Cambridge Memorial Hospital, in Cambridge, Ont.

The system is under evaluation as a pandemic response platform by researchers at the University Health Network and the company has also just recently received approval to deploy its system in select locations in the UK.

UPDATE 2: Nov, here is the National Research Council's official statement.

A bunch of Press Releases from companies touting telepharmacy

Media Advisory/National Research Council Canada: Government of Canada to Announce Significant Investment in Local Company That Will Benefit Health Care:

PCAS is the developer of the PharmaTrust^TM MedCentre, a telepharmacy dispensing and primary care system. The system is designed for applications in hospitals, pharmacies, medical clinics, workplaces and other locations, providing patients with convenient and safe access to prescription drugs.

Baxa Announces IntelliFlowRx™ to Become DoseEdge™ Dose Management System:

The addition of Preparation Modes earlier this year allowed the system to filter and control the dose queue so that oral dose prep, extemporaneous compounding, tele-pharmacy and TPN manual additions can be tracked in addition to IV dose preparations. DoseEdge also was expanded to support TPN processing – allowing orders to be received from the Baxa Abacus™ Order Entry Software.

Hyland honors customers at OnBase Training & Technology Conference who use the ECM software suite in new ways to get notable results:

Thrifty White Pharmacy - Maple Grove, Minnesota

Operating in five states in the northern Midwest, Thrifty White serves rural communities through 89 drugstores, as well as eight Telepharmacy Stores in communities where access to a pharmacist was not previously available.

Pharmacy Techs' education, roles increasingly expanded, now includes telepharmacy

Modern Medicine's Fred Gebhart published an article today about pharmacy technicians increasing role in running pharmacies and the expanded training and CE that is being required of them in today's (especially in health-systems) pharmacy environment:

More accreditation activity sounds good to Barbara Lacher, BS, R.Ph.Tech, associate professor and assistant director for the North Dakota State College of Science Pharmacy Technician Program. NDSC modeled its technician program based on pharmacy programs focused on professional education. "We don't train somebody to work 'just retail' or 'just hospital,' " Lacher said. "We educate techs to work in all settings, just as we educate pharmacists to work in all settings. That's why we are comfortable with technicians running telepharmacy operations where there is no pharmacist. We know that our techs aren't just trained to perform specific job functions; they're educated professionals."

The underlying cause (a major shortages of pharmacists) isn't mentioned, however, leaving technicians as the only option to run the pharmacy for many health systems, especially in rural areas. While they are increasingly well-trained and educated, patients still need the better-yet educated eye of a pharmacist making the final call on what medications are delivered, making telepharmacy a great option for communities lacking on-site pharmacists.

South Dakota hospital pilots telepharmacy program

The Lawrence County Journal fills us in with an article on the new telepharmacy pilot project in South Dakota's Lead-Deadwood Regional Hospital:

The total cost of the telepharmacy equipment was just more than $27,000 and will save more than $106,500 annually. Funding was provided in part by a payout from the dissolution of the Western Plains Health Consortium, in part by the LDRH Foundation, with the remainder covered by contingency funding.

The telepharmacy unit’s home setting, which is in LDRH, has two high-resolution digital cameras: One observes the activity of the pharmacy tech. The other allows the pharmacy tech at LDRH to display the medication, the label and the physician order so the medication dispensed can be visualized in real time by the pharmacist located in Spearfish or Rapid City.

The system also allows the pharmacist and pharmacy tech to have a visual/audio conversation.

“A pharmacist does not have to be on site,” Smith said. “It saves us significant personnel expenses in pharmacy wages.”

A smaller blurb with much less info was also printed in the Prairie Business Magazine out of North Dakota.