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.

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.

North Dakota Telepharmacy Project Continues to Expand

Candie Helseth wrote an article in Prairie Business Magazine about Kathy Nelson, a North Dakota pharmacy owner who remotely supervises technicians dispensing medications in a retail setting. The NDTP's stats were highlighted a bit as well:

The use of telepharmacy technology is growing in North Dakota, which in 2001 became the first state to approve legislation allowing retail pharmacies to operate in remote areas without requiring a pharmacist to be physically present.

In the decade preceding the creation of the North Dakota Telepharmacy Project, the state had lost 26 pharmacies. As a result of the state’s telepharmacy project, 40,000 rural residents in North Dakota have had pharmacy services restored, retained or established, according to Ann Rathke, the coordinator of the state’s telepharmacy project.

Recent Telepharmacy Study Round-Up

Jayashri Sankaranarayanan published a Viewpoint in Medscape today, about a study in the Journal of the American Pharmacists Association from August 2009 called "Exploring the formation of patient satisfaction in rural community telepharmacies" that attempted to assess patient satisfaction with outpatient telepharmacies in rural communities. The study concluded:

A previous application of this instrument in a traditional community pharmacy setting yielded two interrelated latent constructs ("friendly explanation" and "managing therapy"). Our analysis suggests that the formation of patient satisfaction in rural community telepharmacies is much simpler in that patients form a single construct exhibiting high mean and median values. Anecdotal evidence from the literature suggests that the formation of a single construct reflects patients' desire to retain a point of access to health care in their communities.

Jayashri's analysis of the study is a little more straightforward:

Low response rate (24%) may have biased the study findings because highly satisfied patients may have responded to the survey and dissatisfied patients may not have responded. Study results are limited to telepharmacies in the Midwest. Because some patients may want to keep a point of access to healthcare in their communities as opposed to driving outside of the community to receive it, they may have reported high satisfaction with telepharmacies.

This is one of the first studies to evaluate patient satisfaction with telepharmacy. If patient behaviors are consistent with patient values, telepharmacy may complement the rural community pharmacy and have the potential to remain profitable while improving quality of care.

Sounds like in any case, patients were able to get the drugs they needed, which might not have been possible locally, without a telepharmacy.

Upon realizing I missed this study back Fall 2009, I looked back through PubMed for more interesting stuff I might have missed and found a couple more.

Implementing after-hours pharmacy coverage for critical access hospitals in northeast Minnesota (Sept. 2008)

CONCLUSION: Using Internet-based health IT, pharmacists from a metropolitan (hub) hospital with round-the-clock pharmacist coverage participated in the care of patients at a number of small, rural hospitals and helped ensure that those patients received safe and effective medication therapy. The coverage provided by pharmacists at the hub hospital improved nursing satisfaction with the overall quality of pharmacy services provided by both the hub hospital and the local onsite pharmacists.

Implementation of home-based medication order entry at a community hospital (Nov. 2009)

CONCLUSION: A community-based hospital successfully implemented a home-based medication order-entry program. The program alleviated the shortage of pharmacists during spontaneous surges of medication orders.

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.

Telepharmacy reaches out to the underserved

Not so long ago, medically underserved rural communities had only limited options, if any, when need arose for healthcare services and pharmaceutical support. That situation is finally changing, as necessity and technology converge in emerging applications of telepharmacy, the delivery of pharmaceutical care by means of telecommunications and information technologies to patients at a distance from large, usually urban tertiary healthcare centers.

Telepharmacy also provides nighttime pharmaceutical services to community hospitals. A few years ago, Sibley Memorial Hospital in Washington, DC, could not support a pharmacist to review medication orders for high-risk drugs (such as antibiotics, anticoagulants, antiplatelet agents, narrow therapeutic index drugs, and drugs with many potential interactions) during the night shift, so the hospital turned to telepharmacy. Once the service was implemented, nurses faxed new inpatient orders to clinical pharmacists and technicians, who reviewed these orders much as the hospital’s own pharmacy staff would have done during the day; the difference was that the nighttime pharmacy professionals were located at a remote site. Before administering medications, nurses waited for the pharmacists to review and confirm the orders. Pharmacy consultations and requests for drug information were also handled by telepharmacy during the night shift.

More recently, the Veterans Administration adopted telepharmacy practices in order to reduce costs and to remotely link patients as needed to centrally located pharmacies.

Another initiative, the North Dakota Telepharmacy Project, is a collaborative effort between the North Dakota Board of Pharmacy, the North Dakota Pharmacists Association, and the College of Pharmacy, Nursing, and Allied Sciences at North Dakota State University. In rural southeastern North Dakota, where initial testing of telepharmacy took place, seniors had been resorting to mail-order pharmacy. Now they have a community pharmacy, staffed by a pharmacy technician, and they use an internet connection to speak with a pharmacist located at a remote site. Under this model, a licensed pharmacist is located at a central pharmacy. Video conferencing enables the pharmacist to supervise a registered pharmacy technician at a remote pharmacy site. After preparing the prescription, the technician shows the pharmacist the original signed prescription, the computer-generated label, the stock bottle where the medication is stored, and the bottle the patient will take home. The drug is then dispensed and the patient has mandatory “face-to-face” counseling with the pharmacist by means of real-time audio and video.

To ensure the delivery of safe, high-quality pharmaceutical service and care, pharmacists provide drug utilization review, prescription verification/validation, and patient counseling. The latter 2 services are often omitted when a patient uses a mail-order or internet pharmacy. In 2001, North Dakota was the first state to pass administrative rules allowing retail pharmacies to operate remotely without requiring a pharmacist to be present. As of September 2008, North Dakota had 67 pharmacies, of which 44 were retail pharmacies and 23 were hospital pharmacies. Of these, at least 22 were central pharmacies and 36 were remote sites served by telepharmacy, according to Charles D. Peterson, PharmD, dean, professor, and principal investigator/director of the North Dakota Telepharmacy Project. The telepharmacy sites are full-service, with drug inventories that include over-the-counter drugs and other merchandise.

“Over 40,000 rural citizens have had pharmacy services restored, retained, or established through the North Dakota telepharmacy project,” said Dr. Peterson. “It has also added more than $12.5 million annually in economic development.” In addition, this project has created at least 40 to 50 new jobs.

In Anchorage, the Alaska Native Medical Center (ANMC) uses telepharmacy to improve prescription drug access and pharmacy services for rural patients whose villages are spread over 2,000 miles. The program employs an electronic medical record and prepackaged, bar-coded medication and prescription labels, as well as innovative software, videophones, and automated dispensing machines. The network began with 12 remote clinics and has since expanded. In 2006, the ANMC telepharmacy received an award for excellence in medication-use safety from the ASHP Research and Education Foundation.

As of September 2008, the states of Alaska, Idaho, Illinois, Montana, South Dakota, Texas, Utah, Vermont, and Wyoming, as well as Washington, DC, had changed their laws to permit establishment of remote pharmacies.

Source

New Tribal Pharmacies

The people of White Shield and Mandaree now have a way to get their medications without travelling far from home. Telepharmacies have opened at clinics in White Shield and Mandaree. Before they opened, people living in White Shield were forced to travel to the main clinic near New Town 60 miles away. The Twin Buttes Satellite Clinic, which opened in October, serves as the headquarters for the telepharmacy program on the Fort Berthold Indian Reservation.

Source

Pharmacies open in White Shield, Mandaree

WHITE SHIELD, N.D. (AP) Telepharmacies have opened at clinics in White Shield and Mandaree.

Tribal officials say residents from White Shield traveled to the main clinic near New Town for their medical appointments, prescriptions and medication refills despite the 120-miles round-trip drive.

Council representative Frank Whitecalfe says some heart patients in White Shield had to wait days for critical medication.

Twin Buttes Satellite Clinic serves as the headquarters for the telepharmacy program on the Fort Berthold Indian Reservation. It began operating in October.

Source

Open for business

White Shield Satellite Clinic telepharmacy opens

Article Photos

Submitted Photo
Pharmacist Donna Bieri, left, explains the telepharmacy process Wednesday to Three Affiliated Tribes member Matt Marsette, right, while Brenda Allard, White Shield pharmacy technician, looks on. The telepharmacy branch of the White Shield Satellite Clinic opened Wednesday in White Shield and will provide faster delivery of medications to patients in White Shield.

WHITE SHIELD Community members gathered at the Satellite Clinic in White Shield Wednesday to participate in the grand opening and ribbon-cutting ceremony of the clinic's new telepharmacy branch.

The White Shield Satellite Clinic is a sub-clinic of the Three Affiliated Tribes' Minne-Tohe Health Center west of New Town. Patients from the White Shield community have health care available to them primarily on Tuesday and Thursday each week, and their medications were usually filled in New Town and delivered to them later in the day or sometimes the following day by tribal Community Health representatives.

White Shield council representative Frank Whitecalfe cut the ribbon to officially open the telepharmacy operations at the field clinic with Stella Berquist, Minne-Tohe Health Center chief executive officer. Whitecalfe said the telepharmacy will alleviate the long waits and that in some instances, heart patients in White Shield had to wait days for critical medication.

Many residents from White Shield have traveled to the main clinic near New Town for their medical appointments, prescriptions and medication refills despite the 120-miles round-trip drive.

Donna Bieri, lead pharmacist for the Minne-Tohe Pharmacy Program, and Brenda Allard, a certified pharmacy technician, demonstrated the telepharmacy process following the ribbon-cutting ceremony. Allard will be the permanent pharmacy technician at White Shield.

"I am happy because we don't have to make the long trip to New Town for our medication it saves a lot of time for us here at White Shield," said Matt Marsette, a tribal elder who was the first community member to view the prescription process.

In addition to addressing the medical needs of the community, Whitecalfe said he has requested a full-time physician for the White Shield Satellite Clinic. With a full-time physician, the clinic will operate five days a week, contrast the two days a week when a doctor travels from the main clinic in New Town to attend to patient needs in White Shield. A physician is expected to start at the White Shield clinic in the near future.

Lovette Veach, with the Minne-Tohe Health Center, commended the tribal business council and all of the team members involved with the telepharmacy project for making it happen.

The next telepharmacy on Fort Berthold Reservation will open today at the Mandaree Satellite Clinic. Twin Buttes Satellite Clinic serves as the headquarters for the overall telepharmacy program on Fort Berthold and officially began operating in October.

Source

Telepharmacy is a first for reservation

TWIN BUTTES A ribbon-cutting ceremony for the opening of the Three Affiliated Tribes telepharmacy will be held Wednesday at 10 a.m. in the Minne-Tohe Health Center's satellite clinic in Twin Buttes.

The opening of the telepharmacy is a first for the Fort Berthold Reservation.

There will be a prayer offered by tribal elder Edwin Benson and an open house at the telepharmacy from 10 a.m. to 2 p.m.

A traditional meal will be served at noon in the Twin Buttes Memorial Building followed by a health fair.

"This is a historic day for the people of the Mandan, Hidatsa and Arikara Nation. The telepharmacy project is a major step toward improving the quality of patient care across the Fort Berthold Reservation," said Stella Berquist, chief executive officer of the Three Affiliated Tribes Minne-Tohe Health Center at New Town. "Health care professional of the Three Affiliated Tribes have been working diligently over the past few months to make this dream a reality."

Here's how telepharmacy works:

Through the use of state-of-the-art telecommunications technology, pharmacists are able to provide pharmaceutical care to patients at a distance. A licensed pharmacist at a central pharmacy site supervises a pharmacy technician at a remote telepharmacy site through the use of video conferencing technology. The technician then prepares the prescription drug for dispensing by the pharmacist.

The Twin Buttes clinic is the main office of the telepharmacy project on Fort Berthold. Other pharmacies will be opening in Mandaree, White Shield and Parshall.

Donna Bieri, a pharmacist from Dodge who has nearly five years of experience working with telepharmacy, will be working on a permanent basis at the Twin Buttes telepharmacy. She will travel to each of the other sites at least once a month.

The pharmacies in Mandaree, White Shield and Parshall are expected to open in about four to six weeks.

The telepharmacy project is a project of the Minne-Tohe Health Center, tribal business council and Twin Buttes Segment.

Source
This seems to have been summarized and distributed to limited AP press outlets: here & here