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.

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.

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.

USDA Visits, Blogs About Minnesota Outpatient Telepharmacy

The Daily Globe out of Worthington, Minn. writes about the USDA's state director of Rural Development, Colleen Landkammer visiting the Adrian telepharmacy with Senator's Al Franken's representative to congratulate the community and talk up telepharmacy's benefits for rural communities:

Sterling Drug pharmacist Bryan Hagen (right) explains new telepharmacy procedures to (from left) Rep. Tim Walz staff member Matthew Wohlman, USDA Rural Development director Colleen Landkammer and Sen. Al Franken representative Nate Arch during a presentation of a rual business enterprise grant Tuesday afternoon in Adrian.

Hagen said the telepharmacy project has worked well thus far.
“We understand the importance of healthcare access in rural Minnesota,” he said, adding that the telepharmacy is “just what we need” to keep service in small, rural communities. Since the Sterling Drug Telepharmacy debuted, Hagen said he has received calls from other communities interested in the concept, from Fulda to Winnebago.

The USDA also subsequently blogged about it, saying:

“The telepharmacy was a unique and cost-effective way for Adrian to provide access to the services of a local pharmacy,” said Colleen Landkamer, USDA Rural Development State Director. “City officials recognized the need for a local pharmacy to remain in town and took immediate actions to make it happen.”
...
“Sterling Drug is happy to be able to bring back pharmacy services into Adrian,” said Bryan Hagen, a pharmacist at Sterling Drug in Worthington. “The telepharmacy model is a great way to keep healthcare in smaller communities where accesses to those services are important to the communities.”

Arizona Outpatient Telepharmacy Program gets Federal Earmark

On US Congresswoman from Arizona Gabrielle Giffords' website, under 'Fiscal Year 2011 Appropriations,' she highlights several earmarks she referred to the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies. One interesting item, referred to Giffords by State Rep Bradley is listed below:

Telepharmacy – Marana Health Center, Inc., 13644 North Sandario Road, Marana, AZ 85653 - $200,000, HHS-HRSA: Funding will be used to establish a telepharmacy in the MHC Primary Care Health Center at the TMC Campus to provide low-cost pharmaceuticals to uninsured and underinsured patients utilizing the 340B drug program. This service would be available to patients at six MHC satellite clinics in east and central Tucson, encompassing over 145,000 people. This is an important use of taxpayer funds because the only pharmacy services currently available in this area are commercial pharmacies, none which provide low-cost prescription drugs. Click here for a letter of support from Arizona State Representative David Bradley.

Looks like an ambulatory care telepharmacy operation is in the works in urban Arizona!

Minnesota Retail Telepharmacy Receives Another Grant

According to this Associated Press article, funds just keep rolling in for the rural community of Adrian, Minnesota's retail pharmacy that employs remote supervision of a pharmacy technician by a pharmacist in another MN city:

The southwestern Minnesota community of Adrian is getting $99,999 to help finance small and emerging businesses. Adrian has already identified the Sterling Drug tele-pharmacy for initial financing, and expects the grant will help create or save six jobs.
The Minnesota projects are among 44 nationwide receiving more than $4 million in stimulus funding.

Previously, the Adrian telepharmacy received a loan and a private grant. Now we're seeing more USDA federal funding for telepharmacy projects!

Medicare Grant Preps Idaho Clinics for Telepharmacy System

The Idaho State Office of Rural Health guided three grant applicants to some Flex Grants provided by the Medicare Rural Hospital Flexibility Program in August. Benewah Community Hospital and Harms Memorial Hospital were able to implement Electronic Medical Records while Syringa were a bit more advanced:

Syringa Hospital and Clinics ($23,392): Utilization of a telemedicine robot program to increase access to health care services; development of electronic prescribing connectivity for use of Electronic Health Records and in preparation for eventual telepharmacy. Partners: Saint Alphonsus Regional Medical Center and Irwin Drug.

Michigan Health Clinic Receives Rural Development Grant for Remote Pharmacists

Baldwin Family Health Care, which operates a number of family medical clinics in Michigan, is another recipient of the 2009 Distance Learning and Telemedicine Grants from the US Department of Agriculture:

The DLT project connects the applicant with remote pharmacists through tele-pharmacy. Off-site pharmacists will provide prescription dispensing and patient consultation to patients at Baldwin.

The total amount awarded was $52,400. With $13,875 in additional funding, the total project cost is $66,275, according to the USDA's DLT reports (or original PDF) recently released.

Missouri Hospital District receives USDA telepharmacy grant

The Scotland County Memorial Hospital District, serving Scotland and Schuyler Counties (Memphis area) in northeast Missouri received a $62,622 grant from the US Department of Agriculture, as 1 of 4 Missouri grant recipients from this year's USDA Distance Learning and Telemedicine Program:

This project will connect a hospital, two clinic and a phamacy. The primary purpose is telepharmacy. There will also be upgrades to the existing video-conferencing system which supports remote consultation.

Read the full report here (or Original PDF).

South Dakota Hospital gets Huge Telepharmacy Equipment Grant

From the Rapid City Journal out of Rapid City, SD, comes this news:

Regional Health of Rapid City will receive a $386,549 federal grant to buy videoconferencing devices to link 15 sites, including rural hospitals as well as clinics, with regional medical resources at three sites in Rapid City. The grant was one of three Distance Learning and Telemedicine grants awarded in South Dakota last week by U.S. Department of Agriculture Rural Development.

Among the goals of the Regional Health project are specialty consultation, tele-dialysis and tele-pharmacy, as well as continuing medical education for providers, according to a Rural Development news release.

North Dakota Company Recieves Federal Grant for Telepharmacy Research

The United States Department of Agriculture awarded a company involved in starting the North Dakota Telepharmacy Project $80,000 in grant money to research Telepharmacy, reports the Storm Center Blog out of North Dakota:

Evidence shows MTM reduces the use of unnecessary physician and hospital services by reducing adverse health events and in the end total health costs. Research under this grant will be conducted with pharmacies across North Dakota to determine a model for the delivery of MTM services to remote pharmacies.

The results of the research will be used to expand the Telepharmacy Project there.

Telemedicine Lobbyists Meet with North Dakota State Legislators

An excerpt from Senator Tom Seymour's blog:

Mr. Howard C. Anderson, Executive Director, State
Board of Pharmacy, provided information regarding
health information technology. He said North Dakota
State University has received a federal grant relating
to telepharmacy, and the university has awarded a
contract to Catholic Health Initiatives to implement a
telepharmacy program. He said the telepharmacy
program consists of a central site where pharmacists
and technicians receive information regarding orders
for drugs from the prescribing physicians in rural
health care facilities. He said the orders are reviewed
by the pharmacist using the specific patient's
information. He said the project would function more
effectively if the pharmacist could access the patient's
medical record at the facility and enter the
recommendations or approval directly into the record.
A copy of the information presented is on file in the
Legislative Council office.
Ms. Kimber Wraalstad, President and CEO,
Presentation Medical Center, Rolla, provided
information regarding health information technology.
She said health information technology is important to
increasing the quality of patient care. She said health
information technology applications are expensive to
implement and maintain. She said several North
Dakota critical access hospitals in the state are
experiencing operating losses and are not able to
purchase health information technology applications.
She said hospitals in Bottineau, Rolla, and Stanley are
working together on health information technology
projects and 10 health care facilities in the northwest
part of the state have formed the Northwest Alliance
for Information Technology Projects to research and
implement health information technology applications.
A copy of the information presented is on file in the
Legislative Council office.
In response to a question from Senator
Christmann, Ms. Wraalstad said hospitals rely more
on each other for assistance with health information
technology because the North Dakota Healthcare
Association and the North Dakota Long Term Care
Association do not have expertise in health
information technology.

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.

Source

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

Lobbying results in Federal funding for Telepharmacy

In an article about Pennsylvania U.S. Senator Bob Casey's federal earmarks, Centre Daily Times reports:

• INRange Systems spent more than $60,000 last year on lobbying. It received $1.6 million for a telepharmacy robotic device unit in Altoona.

ASHP Keeps Federal Government Officials In The Loop On Rural Pharmacy Issues

ASHP recently met with staff from the Health Resources and Services Administration's offices of Rural Health Policy (ORHP) and Pharmacy Affairs as part of a series of ongoing meetings about important Society initiatives to improve pharmacy practice and patient safety in rural settings.

During the meeting ASHP staff presented information on the Society's new Pharmacy Technician Initiative, which partners with state affiliates to push for standardized education, training, certification, and registration requirements for pharmacy technicians. ORHP staffers discussed opportunities for ASHP to work with state offices of rural health policy to advance Initiative.

The meeting participants also discussed ASHP's support for federal legislation that includes pharmacists in federal student loan repayment programs and the expansion of telepharmacy services in practice settings.

ASHP will explore ideas for research ORHP can conduct on topics such as access to pharmacy services in rural healthcare settings.

Source

Lawmakers pass drug vending bill

by The garden Island

Posted: Sunday, May 04, 2008 - 12:17:25 am HST

The state Legislature on Tuesday unanimously passed a controversial bill that will allow pharmacists to use remote dispensing machines to help low income residents in rural areas improve their access to prescription drugs.

Senate Bill 2459 evolved through a mixed batch of criticism, including pages of testimony from several Kaua‘i pharmacists.

“It was contentious at times,” state Sen. Gary Hooser, D-Kaua‘i, said Friday. “There was a lot of misunderstanding about the intent of the legislation, but I’m confident that we’ve provided a good compromise.”

Kalaheo Pharmacy Manager Catherine Shimabukuro in late March testified that the bill fails to meet the guidelines of the National Association of Boards of Pharmacy.

“It is clear to me that the intention of the Legislature is to provide prescription care to those who are without insurance,” she says. “This is a noble goal but misguided in its approach to a solution. There are many other avenues that can address this need and all are viable and doable without rewriting the laws that govern the practice of pharmacy.”

Among her arguments, Shimabukuro says there is ample access to pharmacies — negating the need to have remote dispensing machines.

There are some 227 permitted pharmacies in the state, which has a population of nearly 1.3 million residents, according to the state pharmacy board.

State Rep. Roland Sagum, D-16th District, said access means more than physical locations.

“The pricing of these subscription drugs is much cheaper than they can get at a pharmacy,” he said. “It’s for our people who are poor and the indigent.”

The bill, which sunsets in five years, will allow Ho‘ola Lahui Hawai‘i to resume the telepharmacy service that ended two years after it started in October 2005.

Ho‘ola Lahui, a federally qualified health center and Native Hawaiian health care system with offices in Lihu‘e, provides drugs to patients at Kaua‘i Veterans Memorial Hospital in Waimea and Samuel Mahelona Memorial Hospital in Kapa‘a.

“This is especially important for uninsured patients who would not otherwise obtain the drugs they need to improve their immediate health,” Ho‘ola Lahui Board Director Grace Kamai says in her testimony. “HLH provides these medications at a reduced cost to those who otherwise would not be able to afford these medications. The technology allows HLH to reduce costs further by having a central pharmacy location ... dispense acute medication at each clinic.”

Ho‘ola Lahui’s remote dispensing pharmacies were stopped in April 2007 after the state Board of Pharmacy clarified the rules that a pharmacist must be on-site to dispense medications from the machines, Kamai said.

This negated the need for the technology, increased the costs to dispense the necessary medications and decreased patient access to the drugs, according to David Peters, Ho‘ola Lahui chief executive.

Brian Carter, the pharmacist in charge at Lihu‘e Professional Pharmacy, questioned the health center’s motives.

“Ho‘ola Lahui has received money from the federal government to provide aid to the poor and needy people of Hawai‘i,” he said. “What Ho‘ola is doing is using the money that they have received, in good faith, to profit for themselves and put the pharmacies that have served this community for the past 50 years out of business.”

There are 10 independent pharmacies and seven chain retail pharmacies serving Kaua‘i by Carter’s count.

The state pharmacy board chair, Dr. Elwin Goo, testified in favor of the bill with amendments to track the remote dispensing pharmacies.

“The board supports the practice of remote dispensing and believes it is a technology that should be afforded to all pharmacies so that all residents of this state can be afforded easier access to prescription medications to meet their health care needs,” he says. “The board understands and sympathizes with the concerns of the legislature of the financial impact on the small independent pharmacies; however, this bill is not about financial gain or the prosperity of a business, but of the safe dispensing of prescription medications.”

Sagum said the bill is not meant to damage the business of established pharmacies.

“With our economy changing, our needy are getting bigger,” he said. “Many are having a hard time even buying groceries. We want to help them get through this transition time.”

Hooser said community health centers can dispense to very low-income people certain prescription drugs at the cheapest rate available to anyone.

Offering a hypothetical scenario, he said a patient can go to the health center where a doctor will prescribe medication and then have it filled at a remote pharmacy machine.

“It’s not like a vending machine at a shopping mall,” Hooser said. “It’s very controlled. Only certain medications are allowed to be dispensed and an off-site pharmacist does the record keeping.”

The patient will also be in contact with a technician via two-way sound and video monitoring devices, he added.

For more information, visit www.capitol.hawaii.gov.

Source

Baird Secures Funding for Pharmacy Programs in Rural Communities in SW Washington

Washington, D.C. - One of the biggest challenges facing the country is health care; and in rural communities a lack of access to care is compounded by a shortage of doctors, pharmacists, and allied health care professionals. To help address part of the problem, Congressman Brian Baird (WA-03) secured $550,000 for the Western Washington Rural Health Care Collaborative (WWRHCC) to implement a telepharmacy program. The funding was included in the House Labor, Health and Human Services, and Education Appropriations Act Conference Report for 2008.

"Rural communities face many challenges, especially when it comes to access to quality and comprehensive health care services,” said Congressman Baird. “Pharmacists provide crucial services, and yet, there is a tremendous shortage of registered pharmacists in rural communities throughout Southwest Washington. In fact, none of the Critical Access Hospitals in the region have 24/7 pharmaceutical services or full-time pharmacists on staff. This funding will allow residents access to prompt service, medication information, and healthcare management services that could be critical to their overall health.”

Telepharmacy programs allow a licensed pharmacist at a central location to supervise technicians at a remote site through the use of state-of-art technologies. The technician prepares the prescription, and the pharmacist communicates in real time to the technician and patient through various audio and visual means. This project includes providing equipment, Pxyis automated systems software, and training to rural hospitals.

"By using state of the art technologies, residents in medically-underserved communities can receive all the services they normally would from an on-site licensed pharmacist,” continued Congressman Baird. “This is an innovative approach that can assure the delivery of safe, high quality pharmacy services.”

President Bush has threatened to veto this bill.

Source

CONGRESS: Senate bill includes $7 million for N.D.

North Dakota is in line to receive $7 million in federal funding for economic development and health care initiatives, according to North Dakota Sens. Kent Conrad and Byron Dorgan.

The funding is included in the Fiscal Year 2008 Labor and Department of Health and Human Services Appropriations bill, according to Conrad and Dorgan.

The bill goes next to a House-Senate conference committee, which will iron out the differences between the two chambers.

The bill includes $1.5 million for UND's proposed Center for Forensic Research. The money will be used to build a multifunctional building at UND that would be used to conduct post-mortem examinations that would help solve crimes and identify unknown health problems and public health hazards.

The facility would help reduce the workload on the State Medical Examiner's Office and provide a valuable educational opportunity for students at UND's School of Medicine and Health Sciences. Other funding will support projects across the state - from an energy technology training program at Bismarck State College, to a Job Corps management program in Minot, to a new vocational education program in Belcourt.

“I'm proud of the work we were able to do in this bill both to continue support for some projects that have proven to be important, and to start some new initiatives that will help move our state forward,” said Dorgan, a member of the Senate Appropriations Committee. “Bismarck State College has a world-class education program, and this will allow them to continue building their reputation as a training hub for power plant operators. And projects like the NDSU Telepharmacy Project help expand access to health care for small communities that struggle to maintain basic health care services.”

“The research conducted at our universities and colleges is resulting in significant advances, both in North Dakota and across the nation,” Conrad said. “By continuing to invest in technology and advanced sciences, we continue to enhance North Dakota's reputation as a hotbed for scientific research while growing our state's economy.”

Here is a list of the other projects included in the bill:

-- Bismarck State College National Energy Technology Training and Education Project, $1 million: This funding will be used to develop a new Instrumentation and Control component to BSC's electronics and telecommunications technology program. The program will enhance BSC's nationally known program to prepare students to run power plants.

-- Minot State University Job Corps Program, $750,000: The funding will be used to expand MSU's customized master's degree program for Job Corps management personnel. The school will add a multi-track program that allows students to earn a Master of Science in management or a Master of Science in information systems, and a graduate certificate in knowledge management.

-- North Dakota State University Telepharmacy Project, $1 million: The funding will be used to expand NDSU's groundbreaking program by providing remote rural hospitals access to 24/7 pharmacy service by connecting them to a central hub using videoconferencing technology. The telepharmacy project has provided pharmacy service to more than 50 rural communities in North Dakota and Minnesota, where residents would otherwise be forced to drive long distances to fill a prescription.

-- North Dakota State College of Science Center for Nanoscience Technology Training, $1 million: This funding will be used to support the North Dakota State College of Science Center for Nanoscience Technology Training in Wahpeton. The Center provides students training in advanced courses related to nanoscience. The program will graduate its first students in the spring of 2008.

-- Marketplace for Kids, $500,000: This funding will support a number of daylong regional events in North Dakota that helps students explore entrepreneurship and self-employment through the recognition and development of their inventive, critical thinking and problem-solving skills. This year, more than 16,000 students participated in Marketplace for Kids.

-- Great Plains Autism Project, $500,000: This funding will be used to establish a program at Minot State University that provides training, research, diagnostic and treatment services for North Dakota children and youth diagnosed with autism spectrum disorders.

-- Turtle Mountain Career and Tech Ed Program, $750,000: This funding will be used to develop and implement a Career and Technical Education Program at Turtle Mountain Community College in Belcourt. The program will provide vocational and technical training to tribal residents and help boost the economy of the Turtle Mountain Reservation.

Source