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:

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.

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...

Two Telepharmacy Services Operating in Minnesota Highlighted, Adrian Update (Audio & Video)

Dan Gunderson of Minnesota Public Radio has a great article with multimedia about the two telepharmacy services currently operating in Minnesota with multimedia and some great info. Click here to read the article or listen using the flash player below:

Interesting points:

The Catholic Health Initiative ePharmacy went on line in March of 2009. It now serves 16 hospitals in North Dakota and Minnesota.

Minnesota law doesn't allow telepharmacies, so each one requires an annual waiver by the state board of pharmacy. Minnesota now has nine approved telepharmacies. The board is considering possible changes in the law.
...
There were questions when the telepharmacy project started. Skeptics wondered if pharmacists would make more mistakes filling prescriptions over a video link. Rathke says North Dakota State University recently completed a four-year study which found no difference in the error rate.
...

Thrifty White currently has four telepharmacy sites in North Dakota and four in Minnesota.
Weippert said he expects continued growth in telepharmacy in the six Midwestern states Thrifty White covers.

Catholic Health Initiative's ePharmacy program services hospital pharmacies while Thrifty White services outpatient pharmacies.

Minnesota 2020 also updates us with a video they produced on the telepharmacy in Adrian, MN that Sterling Pharmacy remotely supervises:

South Dakota Hospitals Contract for Telepharmacy Services

The South Dakota Department of Health awarded 20 grants to rural hospitals for various projects last week. Among the Medication Error Reduction projects was:

DeSmet – Avera DeSmet Memorial Hospital $15,000) – mobile point-of-care computer system for the tele-pharmacy program.

I couldn't find anything about what exactly their telepharmacy program entailed so I searched the South Dakota Pharmacy Board meetings website. I still didn't find anything specific about their program, but interestingly I did find a slew of other approval requests for after-hours pharmacy services for rural hospitals:

December, 2010 Meeting:

• After Hours Remote Order Entry: Gettysburg Memorial Hospital/St Mary’s Healthcare, Pierre.

October, 2010 Meeting:

• Applications have been submitted and the following sites have been approved for after hours order entry: Pioneer Memorial Hospital, Viborg; Sanford Hospital, Webster; Sanford Vermillion Medical Center; Custer Regional Hospital; Lead-Deadwood Regional Hospital, Lead; Rapid City Regional Hospital Psychiatric/Recovery; Rapid City Regional Hospice House; Same Day Surgery Center, Rapid City; Sturgis Regional Hospital Pharmacy; Spearfish Regional Hospital Pharmacy; Spearfish Regional Surgery Center.

• A motion was made by Liebe, and seconded by Nielsen to adopt “Guidelines for Approval of Variance to Weekly Pharmacist Inspection to Remote Telepharmacy Sites” and “Remote Telepharmacy Site Visit Report” as proposed by Huether. Yes votes by Liebe and Nielsen, with Marla Hayes abstaining. Motion carried.

• Nielsen made a motion to approve the variance request submitted by James Stephens for twice monthly pharmacist visits to two telepharmacy sites in Eagle Butte and Faith. Motion seconded by Liebe. Yes votes by Liebe and Nielsen, with Marla Hayes abstaining. Motion carried.
  

June, 2010 Meeting:

• Doug Smith, Sanford Health, described plans and requested approval for Sanford Health to contract with Cardinal Health pharmacy services for after hours remote order entry in rural hospitals. Jerri Ann Haak, Sanford Mid-Dakota Medical Center provided additional comments on patient care benefits of this service. Patient medication safety will be enhanced by providing timely pharmacist review of all medication orders. Motion by Nielsen to approve this service. Seconded by Liebe. Motion carried. Huether stated that the Cardinal Health pharmacy and eight pharmacists are licensed by our board.

• Applications have been submitted and the following sites have been approved for after hours order entry: Sanford Hospital Canton-Inwood; Deuel County Memorial Hospital, Clear Lake; Sandford Mid-Dakota Medical Center, Chamberlain; Douglas County Memorial Hospital, Armour; Avera Sacred Heart Hospital, Yankton; Marshall County Hospital, Britton; St. Michael’s Hospital, Tyndall; Avera St. Luke’s Hospital, Aberdeen; Avera Queen of Peace Hospital, Mitchell; and Wagner Community Memorial Hospital, Wagner.
  

April, 2010 Meeting:

• Andrea Darr, Avera Health, requested approval for the after hours remote order entry services that will be provided at Avera McKennan to Avera DeSmet Memorial Hospital, Avera St. Benedict’s Hopsital, Avera Weskota Memorial Medical Center, Avera Hand County Memorial Hospital, Dells Area Health Center/Avera Health, Flandrea Medical Center, and Platte Community Memorial Hospital. This service will comply with the guidelines established by the Board and will be expanded to other Avera facilities in the future. Hayes moved for approval. Liebe seconded. Motion passed with a unanimous vote.

• Doug Smith, Sanford Health, reported the Sanford Health System is also planning to provide after hours remote order entry to their facilities. That service will be provided by Cardinal Health from a location in Illinois. Huether stated that the Cardinal Health pharmacy is licensed with our Board and the pharmacists who will be providing the service are in the process of obtaining licensure.

Catholic Health Initiatives Hospitals May Soon Use Telepharmacy

Michael Rowan, the COO of a 73-hospital corporation called Catholic Health Initiatives was interviewed by Becker's Hospital Review and states that they're predicting worker shortages and will employ the use of technology such as telepharmacy to process orders at smaller/more rural facilities:

... The same could be said for trying to address workforce shortages. More and more, we're finding these small, rural pharmacies can't afford 24-hour pharmacists. Electronically, we have ability to take pharmacy orders and electronically transport them to our 800-bed facility. CHI is positioned to do that, and we believe there is more and more opportunity to lessen workforce shortages and improve quality of care by being innovative the process of caring.

New Study: Telepharmacy an Effective Method of Providing Pharmaceutical Reviews

The Journal of Telemedicine and Telecare has released a new study out of Australia evaluating the effectiveness of remote pharmacist reviews of dispensed medications in rural hospitals without on-site pharmacists. Pharmaceutical review using telemedicine - a before and after feasibility study:

Only 42 of the 116 public hospitals in Queensland employ qualified pharmacists to staff their pharmacies. We undertook a feasibility study to determine if pharmaceutical reviews, undertaken face-to-face by a visiting pharmacist, could be replicated using telemedicine. The study was conducted in two phases, with the same pharmacist coordinating the project from the main hospital to two rural hospitals, which relied on supply nurses for all their pharmaceutical services. All inpatients admitted between October 2006 and May 2007 were included in the study. In Phase I the pharmacist made weekly visits to both facilities, to perform face-to-face pharmaceutical reviews of the current inpatients. In Phase 2, all pharmaceutical reviews were performed remotely by the pharmacist by telephone or videoconference. In Phase 1, 186 pharmaceutical activities were performed (mean 3.9 per patient). Of these, 78 pharmacist-initiated changes were recommended and 47 (60%) were implemented. In Phase 2, a total of 296 activities were performed (mean 3.1 per patient) and of the 140 recommendations made by the remote pharmacist, 74 (53%) were accepted. Of the accepted recommendations, there were 11 major interventions (those with a potential to prevent harm to the patient) in Phase 1 and 32 in Phase 2. There were no significant differences in the pharmaceutical activity rates in the two phases. Telepharmacy therefore may be an effective method of providing pharmaceutical reviews for patients in rural inpatient facilities, without an on-site pharmacist.

Thanks Louise Poulson, Lisa Nissen, and Ian Coombes!

Maine CAHs Receive Award for Patient Safety Solutions, Will Recommend Telepharmacy

A collaborative of Maine critical access hospitals has received the New England Rural Health Roundtable's President's Award for implementing new technology, practices and communication to improve patient safety over the course of 18 months and compiled the data:

MeHAF will support the hospitals' efforts to disseminate solutions generated by the project, including medication reconciliation, interventions related to high-alert medications, enhanced patient and staff education, and telepharmacy plans that more closely involve pharmacists in remote regions.

Here's the bulletin from GIH (Grantmakers in Health) with a bit more detail. MeHAF is the Maine Health Access Foundation, who made the announcement.

Pennsylvania Hospitals receive technology grant, hope to implement telepharmacy

The Pennsylvania Mountains Healthcare Resource Development (PMHRD) received a grant from Highmark, reports the Pittsburgh Tribune-Review in a pair of nearly identical articles. Dianne Emminger, VP of IS for ACMH Hospital commented on what they intend to use the grant for:

The funding will be used to purchase equipment and software, Emminger said.

ACMH Hospital will partner with the other hospitals and care centers to provide residents those services, which are in short supply in rural communities, Emminger said.

Emminger gave some examples of how the technology could be used.

...

Another would be tele-pharmacy where remote pharmacists would enter orders into the systems of hospitals that do not have 24-7 pharmacist

...

"The specific projects are still being evaluated for feasibility," Emminger said.

The district of hospitals already has a fiber optic network in place from a grant they received in 2008, so the infrastructure is already in place.

Two Telepharmacy CE Presentations at NRHA

UPDATED! There will be two telepharmacy presentations that you can get CE credits for at the National Rural Health Association's "Medication Use in Rural America" conference in Kansas City, Missouri on September 10^th (Conf. Starts the 9^th). David Conejo of Red River Regional Hospital in Bonham, TX, along with Emily Alexander and Becky Harvey of Envision Telepharmacy are presenting:

A telepharmacy case study: Escaping the past and planning for the future
Patient safety, manpower shortages and cost containment help determine the best practice model when hospitals reevaluate pharmacy services. Hear a case study of a critical access hospital in rural Texas using electronic supervision of pharmacy technicians. Topics include obstacles encountered, redirection of resources, a clinical management program addressing medication patient safety goals, and expanding pharmacy services.

Next up is REACH IN (Resources to Enhance the Achievement of Community Health for Indiana)'s presentation entitled Launching your telepharmacy program: It's not about the technology which will "assess the role of community pharmacists by pharmacists and patients in Health Profession Shortage Areas."

Here's a PDF of the entire agenda. See the NRHA website for more details.

Kansas Hospital to Provide Telepharmacy Service to Rural Areas

Mt. Carmel Regional Medical Center in Pittsburg, KS is looking into delivering remote pharmacy services to rural Kansas. See this article in Pittsburg's Morning Sun newspaper:

Thanks to the telemedicine unit Moran toured Friday, that access has improved greatly over the past couple of years. Members of the Midwest Cancer Alliance demonstrated the equipment — which was purchased thanks to funding that Moran helped secure — by showing Moran a mock workup of Mt. Carmel CEO Jonathan Davis. In the demonstration, Davis and his “physician” were able to converse with a doctor over teleconference while giving the doctor information about Davis’s heart and pulse.
Davis said the technology could be used in a variety of ways, but added that it came in especially vital with cancer patients who could gain access to top-notch cancer physicians without having to travel long distances. Davis said they were currently developing ways to use pharmacy consults for areas without pharmacists as well.

VA hints at retail telepharmacies for rural Alaskans

In a press release issued by the senior US Senator from Alaska, Lisa Murkowski, Secretary of Veterans Affairs, Eric Shinseki, spoke at a hearing of the Senate Appropriations Veterans Affairs Subcommittee and responded to questions about the VA's future approach to delivering prescription health benefits to veterans in rural areas of the state:

Cross said the VA could help Alaska through “outreach clinics,” such as those slated for Juneau and Homer, and rural health initiatives, including telemedicine programs and prescription deliveries by mail so that veterans don’t have to visit a pharmacy.

“We have much to learn and much innovation to bring forward in regard to our veterans in Alaska and we look forward to working on that,” he said.

Considering that the VA has a good idea of what telepharmacy can offer, and the head of the VA is testifying that this is more or less what they have in mind to the Senators who are going to appropriate the money, it's a good bet it will happen.

Kansas State Board of Pharmacy reviewing new telepharmacy rules for retail and hospital pharmacies

Sarah Green of the Kansas Health Institute writes about upcoming telepharmacy regulation for both retail and hospital pharmacies in the state of Kansas:

The Kansas Board of Pharmacy has new regulations addressing telepharmacies under review, said Debra Billingsley, the board’s secretary.

A task force has met for the past several years to determine what regulations would best allow the expansion of telepharmacies without hurting existing brick-and-mortar businesses.

...

The new regulations are now being reviewed by state agencies; once the Department of Administration and the Attorney General’s office approve the regulations, a public hearing will be conducted. Billingsley expects the regulations to be finalized by the end of the year.

A separate task force recently began meeting to address telepharmacy operations in hospitals.

...

Eventually, once the regulations are in place, the hospital would like to provide access to its ePharmacy system to other facilities, including the state’s critical access hospitals in rural areas, Gagnon said.

“It’s going to be a big change in language of who can do what, and where you can be located,” he said. “It’s going to expand the opportunity to do new things. It’s going to be tricky to keep up with it from a legislative standpoint, as the technology continues to grow.

Add Kansas to the list of State Boards that are willing to admit that technology can help their citizens! The KHI article also has some updates from the news from about a year ago that Via Christi Health System is using telepharmacy to service outlying facilities. Green also gives a summary and update of North Dakota's telepharmacy activities:

Today, the state has 72 telepharmacy sites, arranged in a “hub and spoke” model, that provide services to underserved communities, Peterson said, many with populations between 500 and 1,000 residents. More...

Telepharmacy reduces rural critical access hospital medication errors

Cheryl Clark gives a very informative summary of the national telepharmacy report that the Telepharmacy Blog previously posted about, in HealthLeaders Media's newly published article, Can Telepharmacy Reduce Rural Critical Access Drug Mistakes? Yes:

A pharmacist service might be shared among hospitals in the same healthcare system, or in different healthcare systems. Or hospitals may join together to contract for telepharmacy services with a commercial telepharmacy company.

Several studies have concluded that such strategies can greatly improve medication safety in rural hospitals. Nationally, there is a growing shortage of pharmacists, but nowhere is that supply as lopsided as it is in remote parts of the country.

Telepharmacy helps resolve the challenge of getting pharmacists to review orders on an as-needed urgent basis when they otherwise would have to drive 45 miles across rugged mountain roads to get to the hospital.

Later, the summary highlights a unique application of remote pharmacy practice by Envision Telepharmacy from the report:

Having a pharmacist provide long-distance supervision of pharmacy technicians at a rural hospital has not been allowed, except through a pilot project run by a commercial company, Envision Telepharmacy.

Envision provides remote order review and entry, after-hours medication provision, electronic supervision of pharmacy techs and after-hours drug information and consultation.

However, the report said, "It was to recruit hospitals into the Envision telepharmacy pilot. Many hospitals had been operating in violation of state board of pharmacy regulations, but were not being cited. For some hospitals, it was a case of not wanting to solve a problem until it became one."

Quite a few reports, as well as the ISMP recently, have been commenting on the benefits of telepharmacy for a lot of rural communities. The research that this summary came from will most likely be used to shape the Obama administration's rural health policy, as it was funded by the Office of Rural Health Policy under the U.S. Department of Health and Human Services.

Nebraska Medical Center services rural hospitals, looks to expand to Iowa and Missouri

More good news out of Nebraska, with University of Nebraska Medical Center leading the way with their telepharmacy program:

Like many small, rural hospitals, the Howard County Medical Center in St. Paul doesn’t have a staff pharmacist.
But every one of the hospital’s pharmaceutical orders is checked by a pharmacist against the patient’s medical history and other scheduled medications.
It’s the kind of perk not required by law but is a standard at larger hospitals. Now, thanks to the University of Nebraska Medical Center’s new telepharmacy program, it’s available to rural hospitals, too.
“Prior to telepharmacy, we did not have that safety net in place,” said Jennifer Galvan, the hospital’s chief nursing officer. “The doctor ordered it, and the nurse gave it.”
The telepharmacy program, in which UNMC pharmacists review and enter medication information in a computer database from their homes, is one way rural hospitals like St. Paul’s are working to bridge the gap in accessibility that has historically hampered rural health care.

They are also looking for pharmacists to work remotely from home licensed in Nebraska, and surprisingly also say, "Pharmacy licensure in Iowa and Missouri required within 120 days of employment." Very interesting. Nebraska is coming up in the telepharmacy world! See the Telepharmacy Blog's telepharmacy in Nebraska category for full coverage.

ISMP: Telepharmacy a safe answer to dangerous pending pharmacy deregulation in Texas, TSHP & ASHP call to action

An update on Texas HB1924, the dangerous pending legislation in Texas that will effectively allow a nurse to dispense drugs before a review by a pharmacist in small hospitals. Michael Cohen, the president of ISMP (Institute for Safe Medication Practices) wrote a letter to Texas state Senator Jane Nelson regarding Texas HB 1924 (see "Texas to scrap regulation?"), where he mentions telepharmacy as a valid alternative when on-site pharmacists are not available:

Hospitals that we visit that are under 100 beds have pharmacists onsite on a daily basis and often have pharmacist review of medications orders via telepharmacy during off hours. It is becoming more common to have pharmacists available on a daily or 5 days a week schedule in hospitals below 50 beds with on call coverage and remote medication order review via telepharmacy. Medications commonly used in today’s hospitals, regardless of size are highly effective but have great potential for toxicity if prescribed in error and available for use without pharmacist review. A revised standard would clearly be discriminatory as it would establish two levels of care for patients in hospitals in Texas and fail to assure patients in “rural” hospitals the basic safety standards considered essential in all other hospital patients.

There you have it, directly from the head of ISMP, "the nation’s only 501c (3) nonprofit organization devoted entirely to medication error prevention and safe medication use": Prospective drug regimen reviews by qualified pharmacists are what is safe, and using Telepharmacy to increase their availability is becoming more viable and is far better from a safety standpoint than the alternative.

UPDATE from TSHP (Texas Society of Health-System Pharmacists)'s newsletter on the matter today:

TSHP is calling upon its members to help defeat a bill that could spell the end of pharmacy practice in small and rural hospitals in Texas.

HB 1924, filed at the request of the Texas Organization of Rural and Community Hospitals (TORCH) was originally written in reaction to discussions of the Texas State Board of Pharmacy’s Task Force on Class C Regulations that indicated that some changes might be recommended in hospital pharmacy practice.

The bill would put into law TSBP regulations that are 30 years old, limiting the role of pharmacists to consultant drug use review 7 days after administration, and essentially allowing nurses to practice pharmacy in rural hospitals. It is estimated that this would have affected nearly 200 hospitals in the State.

TSHP has tried to meet with TORCH and the Texas Hospital Association to find a reasonable, middle ground for compromise. Our efforts have been rejected, and, in fact, TORCH has been successful in passing the bill out of the House of Representatives and it is now in the Senate Health and Human Services Committee, awaiting a hearing.

To make matters worse, TORCH has proposed a Senate Committee Substitute that would specifically prohibit TSBP from adopting ANY regulations that would require prospective drug use review by pharmacists in any hospital less than 100 beds, would allow a nurse and an unsupervised pharmacy technician to operate a hospital pharmacy WHENEVER A PHARMACIST IS NOT PRESENT and mandate that a pharmacist only retrospectively review drug dispensing every 7 days.

TORCH and some of its members believe that the cost of having a pharmacist prospectively review new, non-emergency medication orders outweighs the benefits to patient safety and health, even though they have been shown that such review can occur electronically and inexpensively.

Besides creating sub-standard care for patients in rural areas, the bill is a bad precedent for pharmacy and patient care in any hospital. Could this lead to our largest facilities operating with just a consultant coming by once a week, while nurses dispense and monitor patients’ drug therapy?

...

The matter is so critical that the Institute for Safe Medication Practices (ISMP) and ASHP have contacted the Senate to voice their concern over what will happen to patient care if this bill passes. For copies of their letters, see the TSHP website:

ASHP – http://www.tshp.org/ASHP1924.pdf

ISMP – http://www.tshp.org/ISMP1924.pdf

We don’t often have to ask for your help. We have a great legislative team. But against the combined lobby forces of rural hospitals and their county politicos, health-system pharmacy stands to be outgunned in this important battle.

Notice in ASHP's letter they also hint at the telepharmacy alternatives:

It is important, and in the best interest of patients, to ensure that the pharmacy practice act and its implementing regulations continue to evolve and reflect modern advances in medication therapy, technology, and the needs of the patient population.

More from the Telepharmacy Blog on Texas HB1924 as it develops.

"Telepharmacies are good medicine for small towns"

Jo Dee Black writes about a local telepharmacy operation in Great Falls/Three Forks, Montana:

The VanCampens purchased Liberty Drug. Justin is a pharmacist.

They also own Railway Drug in Three Forks, which is operated as a telepharmacy, a relatively new program in Montana that allows a pharmacist to oversee a registered pharmacy technician at another site using real time video and audio technology.

"Justin steps in front of a monitor and talks to our technician in Three Forks all day long," said Keri VanCampen.

Montana's telepharmacy program was authorized by the 2005 Legislature and modeled after the one established in North Dakota in 2002. It's a tool to preserve pharmacy services in small towns, said Ann Rathke of North Dakota State University College of Pharmacy.

Fred of CPhTLink.com also shares his commentary on the story.

University research group compiles rural Telepharmacy policy brief for Federal Government

The Upper Midwest Rural Health Research Center, a group from the University of Minnesota Rural Health Research Center and the University of North Dakota Center for Rural Health who focus on the quality of rural health care, prepared a policy brief for the US federal government (available here), who will likely use it to set national policy regarding telepharmacy.

The full report's summary:

Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety - Findings from this new report and policy brief describe successful telepharmacy activities being implemented in rural hospitals and analyze policy issues related to the implementation of telepharmacy projects in rural hospitals.

The following pharmacies participated in the data collection:

Arkansas State Board of Pharmacy
Cross Ridge Community Hospital, Wynne, Arkansas
St. Bernard’s Medical Center, Jonesboro, Arkansas
Idaho State Board of Pharmacy
St. Luke’s Wood River Medical Center, Ketchum, Idaho
St. Luke’s Meridian Medical Center, Meridian, Idaho
Minnesota State Board of Pharmacy
Ely-Bloomenson Hospital, Ely, Minnesota
St. Luke’s Hospital, Duluth, Minnesota
Wheatland Memorial Hospital, Harlowton, Montana
St. Vincent’s Hospital, Billings, Montana
North Dakota State Board of Pharmacy
North Dakota State University College of Pharmacy
Heart of America Medical Center, Rugby, North Dakota
Lisbon Area Health Services, Lisbon, North Dakota
Oklahoma State Board of Pharmacy
Atoka Memorial Hospital, Atoka, Oklahoma
South Dakota State Board of Pharmacy
Lead-Deadwood Regional Hospital, Deadwood, South Dakota
Texas State Board of Pharmacy
Envision Telepharmacy, Alpine, Texas
Utah Division of Occupational and Professional Licensing
Allen Memorial Hospital, Moab, Utah
San Juan Hospital, Monticello, Utah
University of Utah
Washington State Board of Pharmacy
Sacred Heart Medical Center, Spokane, Washington
Coulee Community Hospital, Grand Coulee, Washington

Support for this report was provided by the Office of Rural Health Policy, Health Resources and Services Administration, PHS Grant No. 5U1CRH03717-02-00.