Telepharmacy Results in Better Care!

... when a local pharmacist is not available, of course.

Pharmacy Practice News published an article in its July 2010 issue called Does Telepharmacy Result in Better Care? (free login required, or use bugmenot). As evidence that it does, they offered up an article by Judy L. Rose, PharmD, U.S. Public Health Service captain and clinical pharmacy director for Alaska Native Medical Center. She reports that pharmacists consult with clinical patients via video teleconferencing equipment, and:

Approximately 40% of our telepharmacy interventions lead to clinical improvements in several medication management areas, including drug order clarification, dose/interval changes, drug duplication, drug therapy recommendations, start/stop medication or change in drugs. Additionally, 38.7% of the interventions led to safety improvements, including better monitoring for drug allergies, drug interactions, contraindications and improved weight-based dosing. (No pre-telepharmacy measurements were available for benchmarking, so our percentages reported reflect the absolute number of interventions divided by the number of prescriptions.)
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Our results are clear: Telepharmacy can help remote hospitals deliver high-quality pharmaceutical care, despite staffing and resource challenges.

Here's an article published in Pharmacy Today from way back in 2005 about their program's success in improving care and reducing costs while providing comprehensive pharmacy services called Telepharmacy delivers comprehensive services in rural Alaska (PDF).

Additionally, Judy put out a study in 2007, Improved and Expanded Pharmacy Care in Rural Alaska Through Telepharmacy and Alternative Methods Demonstration Project (Original PDF) and this informative presentation for the 2008 USPHS Scientific & Training Symposium in San Diego, California (PDF):


What's blocking outpatient telepharmacies from serving the medically underserved in Ohio?

Ironically enough, it seems it is the Ohio State Board of Pharmacy.

Back on the subject of the original article mentioned in this blog post, Does Telepharmacy Result in Better Care?, Pharmacy Practice News also offers a second opinion, this one from Tim Benedict, Assistant executive director of the Ohio State Board of Pharmacy. Tim says, "Compared with Ohio, the states that allow telepharmacy are larger and more sparsely populated. The board feels telepharmacy isn’t relevant for our geography and populace."

I wonder if the populace which he acknowledges live 30 minute+ drives from pharmacies in Ohio would concur. He mentions a Pharmacist in Charge is required at every pharmacy as an obstacle, although plenty of other states still manage to have outpatient telepharmacy programs while satisfying the rule. Unless I'm reading his text incorrectly, he also implies that physicians can serve the medication needs of patients as well as pharmacists can and that pharmacy technicians are more likely to divert controlled substances than doctors. Does anyone know where to find numbers as to whether this is true?

Thankfully, he does mention:

The board has approved several off-site pharmacies to receive the new orders from the hospital and then enter into the hospital computer system to perform utilization review and either approve or reject the order. Furthermore, the board recently approved the use of a dispensing machine placed in an emergency room for use in after-hours situations. The physician creates the prescription in the hospital computer and then provides the prescription to the patient. The prescription contains a bar code. The patient takes the prescription to the machine and the machine reads the bar code and provides the drug to the patient. There is a telephone connected to the machine for patient counseling with a pharmacist. The pharmacist is located in another state.

Good news that they at least allow applications of clinical telepharmacy!