Sullivan University starting new pharmacy school

LOUISVILLE, Ky. (AP) -- A private, for-profit college in Louisville is starting a pharmacy school. When it opens next July, Sullivan University’s pharmacy school will be the second in the state. The University of Kentucky also has one.

Kentucky has the second-largest pharmacists shortage in the country, said the Pharmacy Manpower Project, which tracks states’ pharmacist shortages.

The growing need for pharmacists is fueled by several factors including the aging of the baby-boom generation, more and better medications for chronic conditions, and the spread of 24-hour pharmacies.

The pharmacy school’s tuition is $32,000 a year for the three-year program. The school’s application is being reviewed by the Accreditation Council for Pharmacy Education.

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Sullivan Univ. to launch pharmacy school

Louisville hasn’t had a pharmacy school since 1947, when the old Louisville College of Pharmacy was moved to the University of Kentucky.

But that’s about to change. In response to a growing national demand for pharmacists, Sullivan University will break ground tomorrow for a pharmacy college in a renovated building on Gardiner Lane, across Bardstown Road from its existing campus.

It will be the first doctoral program for Sullivan, which calls itself “Kentucky’s Career University,” training students for a range of careers — from business managers to bakers, paralegals to professional nannies.

And it responds to a national demand that is acute in Kentucky, according to the Pharmacy Manpower Project, which maintains an index of states’ pharmacist shortages. Kentucky has the second-largest shortage, behind Alabama.

The growing need for pharmacists is fueled by several factors, including the aging of the baby boom-generation; more and better medications for chronic conditions; and the spread of 24-hour pharmacies, including those in food and discount stores.

“The number of prescriptions … has gone up dramatically,” said Peter Vlasses, executive director of the Accreditation Council for Pharmacy Education. “Pharmacies are opening everywhere.” The national council is currently reviewing Sullivan’s application for accreditation for its pharmacy school.

The number of pharmacy colleges nationally is also on the rise. Since 1999 their number has grown by nearly 25 percent, to 103, Vlasses said — and more are being planned.

Sullivan’s school will become Kentucky’s second when classes begin next July.

It will provide an in-state alternative to UK, whose highly rated but overcrowded pharmacy college accepts one in eight applicants.

Within a few years, Sullivan expects to turn out nearly 100 pharmacists a year — enough to fill roughly one-fourth of the current estimated shortage in Kentucky.

The college also could help business leaders recruit drug-related firms to town, and its faculty pharmacists could collaborate with medical and dental researchers at the University of Louisville, officials said.

But for Patrick Starowitz, 24, the school could provide something more basic — the chance to stay in his hometown while training for his career.

“I’ve grown up in Louisville my whole life and I love the city of Louisville.

Convenience-wise, my family’s here, my job’s here,” said Starowitz, a recent U of L graduate who is a pharmacy technician at a Kroger store in St. Matthews.

He hopes to be in Sullivan’s first pharmacy class, though he has also applied to other schools.

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Canadian e-health sector could use a booster shot

We don't have a trusted local brand, the size of the market is small and there's still a lot of cultural resistance. We check the vital signs of what should be a burgeoning industry

There's a host of opportunities for Canadian companies looking to serve the burgeoning electronic health record market, but insiders say serving the market is not going to be easy.

A number of hospitals have already set up electronic record systems with patient information, and a national agency, Canada Health Infoway, has a mandate to create a unified e-health record by 2009. Despite this momentum, as well as the handful of programs to help fund the automation of doctors' offices in Canada, however, resistance to the idea still runs high.

“The real challenge in health care is cultural,” said Ross Armstrong, senior research analyst at London, Ont.-based Info-Tech. Persuading doctors to invest thousands of dollars of their own money in a system that will benefit the health care system as a whole and change the way they work is a huge challenge.

To encourage doctor buy-in, vendors, he said, need to better craft their messages to show doctors how digitizing their offices will give them more time to dedicate to the most profitable parts of their practice.

Armstrong said the market for electronic health record services will take off once some hospitals start offering patients free access to their medical records online. “Once one hospital in one region offers this service for free, then all other hospitals or clinics will start doing so as well in order to maintain or gain competitive advantage,” said Armstrong. “If the health care enterprise dovetails the portal project with an existing electronic medical record or electronic health record project, then the costs of the portal could be reduced since that back end is now in place.”

Michael Martineau, director of the Branham Group, has similar predictions. Branham foresees a major increase in the automation of doctors' offices over the next 18 to 38 months. “It's the next frontier,” said Martineau. Alberta's physician office system program), for example, had 61 per cent of the province's physicians signed up as of July 2006, making it one of the leading jurisdictions in physician automation world-wide, it claims.

Martineau said to advance that uptake, companies in the electronic health record market in Canada will benefit by having their products certified by Canada Health Infoway's e-Health Collaboratory, an initiative designed to help vendors comply with CHI's e-health record standard.

“It shows the health care system that you are being part of the process, so it's a good corporate citizen thing to do,” he said.

But the biggest challenge Canadian companies face in cracking the e-health market is the lack of a Canadian “brand,” said Barry Gander, executive director of The Canadian Advanced Technology Alliance (CATA).

Canadian companies, he said, toil in obscurity not only within the country but on the global stage as well.

“If people are looking for a solution or a partner Canada doesn't come to mind,” he said. “We really have to adopt a co-ordinated strategy to become better known.”

That's what CATA hopes to change with the debut of its global webinars, described as “the founding step in the creation of a new healthcare community spanning the world's biggest block: the Commonwealth.”

Gander said the idea is to use the global webinars to present profiles of Canadian companies to build awareness of the capabilities that exist within Canada in an interactive way that can lead to Canadian partnerships and dealmaking.

“We need to fuse all these public sector needs with the knowledge of our private sector capabilities, and we're just on the beginning of that road now,” said Gander. “Our aim is to create a system where everybody knows what everybody else is doing.”

Another challenge Canadian companies face is the same one any Canadian company faces: Canada represents such a small market it's often not worth pursuing.

“The market (in Canada) is one-tenth of the size so when you're dealing with an organization in the U.S. with 600,000 members, the equivalent in Canada is 60,000,” said Jay Couse, senior vice-president of business development for Toronto-based Diversinet.

Diversinet, a vendor of mobile security products, for example, recently signed a deal with Blue Cross of Northeastern Pennsylvania (BCNEPA) to provide members access to their personal medical records through mobile phones, handheld wireless devices and personal computers using Diversinet's MobiSecure Wallet and Vault soft token technology.

Its business model is to make the technology available on an OEM basis to large health insurance providers.

Diversinet has built the back end but Blue Cross is responsible for the interface consumers will use, he said, as well as for negotiating the connections to the data.

The project will roll out to 100,000 users in the first half of this year, gradually scaling up to all 600,000 members.

“MobiSecure Vault is designed to give consumers the ability to access their personal information anywhere, anytime from a mobile device,” said Couse. “It acts like a remote control in that you don't have to store everything on the phone - the phone can be used as a pointer.”

The first phase of the project will allow consumers to access all the information warehoused by Blue Cross, such as insurance claims, as well as pharmacy-related and medical record information.

Americans, said Couse, are used to the idea of paying for health care, a concept that has not yet proved popular here at home.

‘In the U.S. market even if people have insurance they are paying US$250 a month on average,” he said. “They also pay a co-pay every time they visit the doctor … so their out-of-pocket costs can be very dramatic.”

That's not to say Diversinet is not interested in the Canadian market. Couse said the company is close to announcing a Canadian customer.

“They built the system to handle all the medial records at the physician level and we will then give our technology to them and they can give it to their patients.”

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Clinic goes high-tech, letting patients tell doctors what's ailing them via the Internet

AMARILLO - The health clinic in Turkey looks far from modern. It sits on a dirt road in an old school building and shares a wing with the justice of the peace.

But inside the clinic sits multi-million-dollar equipment that connects these rural residents to a Plainview doctor via the Internet and a video camera.

With other programs in Hart, Earth and Quitaque, Dr. Sidney Ontai's services provide a way for rural Panhandle residents to conveniently see a doctor rather than driving as far as 45 miles.

The telemedicine program is like seeing a doctor in person - except 150 miles separate the patient and physician.

"I don't understand why more doctors aren't using it," said Don Turner, a trained emergency medical technician who helps staff the clinic.

Clinicians enter a patient's vital signs, history, lab results, even an audio recording of a person's heart and lungs, into a computer. Workers in Turkey can even scan X-rays and other pictures.

Ontai, who practices family medicine in Plainview, reviews the information, talks to the patient and treats them from miles away.

He said if he ever needs to physically examine a patient, he tells them to come see him. If the patient is in dire emergency, he tells the EMT to get the patient in an ambulance and go to the emergency room.

"Telemedicine technology is no different than a scalpel or a stethoscope or any other tool," Ontai said. "Its safety and efficacy depends on the skill of the physician using it."

The Turkey telemedicine programs sees an average of eight people a month.

"It's not a full-time job because there's not a lot of people in Turkey," Turner said.

Turkey also is home to the state's first telepharmacy program, a separate but similar program run by Texas Tech Health Sciences Center.

It's a full pharmacy staffed without a pharmacist and started in November 2002.

The same workers at the Turkey clinic can fill any prescription.

Pharmacists at Texas Tech in Lubbock verify through a bar-code system that Turkey workers are dispensing the correct pills to patients. A pharmacist in Lubbock talks to the patient over the phone about safety and proper instructions.

Lawmakers changed state law in September 2001 to allow telepharmacies. Turkey was an immediate candidate for telepharmacy because it had health care with its telemedicine but no pharmacy.

"To my knowledge, there's probably been less than 10 telepharmacies set up in Texas," said Don McBeth, director of special projects at TTHSC.

Rush Pierce, interim regional dean of the Texas Tech School of Medicine in Amarillo, said the university should work harder to have more telemedicine programs in Panhandle cities. Most programs are in the South Plains, closer to Lubbock.

Texas Tech did 636 telepharmacy and telemedicine rural consultations in 2006.

Ontai said money is the main reason why telemedicine hasn't spread in popularity.

"Most doctors do things that make them money," Ontai said. "Telemedicine doesn't make money, so it is usually only done with grant support."

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McKesson aims to spread healthcare efficiency

McKesson, the largest US pharmaceuticals distributor and healthcare information technology provider, will probably ring up more than $100bn in sales this fiscal year.

The eye-popping figure puts the group in elite company, but it is McKesson's expertise in squeezing out efficiencies that allows it to make profits from the razor-thin margins of drug distribution, reflected in last year's net income of $913m out of $93bn of sales.

McKesson is one of the large cogs in the immense machinery of private market healthcare in the US, where annual health spending exceeds $1,000bn and continues to rise. It is one of the three dominant pharmaceutical distributors, along with Cardinal Health and AmerisourceBergen, acting as middlemen and service providers for thousands of pharmacies, doctors, clinics, hospitals, health insurers and sometimes patients.

One of the US's oldest healthcare companies, McKesson started in 1833 in New York importing and distributing therapeutic products and chemicals. Using covered wagons, it laid the groundwork for the country's first national drug distribution network.

Less well-known than the pharmaceutical groups it serves, McKesson seeks to move beyond being a middleman to using its central position to help connect the fragmented US healthcare system and make it more efficient.

It also is looking for more business overseas, where it is a contractor for work on the UK National Health Service's ambitious project to build a national electronic medical records system. It also has IT business in France, and disease management operations in Australia and New Zealand.

Marc Owen, head of McKesson corporate strategy, said: "What we're trying to do in effect is be the back office and help to industrialise healthcare . . . Part of our role being at the centre of all this, being in the middle, is to see the opportunities to bring it all together and help broker it and make the system work better."

But what McKesson does most is sell drugs, and lots of them. It is the largest North American drug distributor, with a big presence in Canada, and owns a stake in Nadro, a distributor in Mexico. In the fiscal year ended March 31, the pharmaceutical business generated 95 per cent of McKesson's sales and 85 per cent of its operating profits.

The drug distribution industry has recently undergone a transition in its business model following a drug manufacturers' inventory and accounting scandal. In the past, distributors would arbitrage pricing changes by drugmakers by buying large quantities prior to price increases and making money from the difference. McKesson and its rivals have now moved to a service-oriented model, charging drugmakers a fee to help manage wholesale drug inventory.

Changing to a service model has made the distribution business more predictable, which allows McKesson to focus harder on squeezing more efficiency and profits out of it. Last year, it improved its margin 8 basis points to 1.53 per cent.

Robert Willoughby, analyst at Bank of America, rates McKesson stock as a "buy" and says the group is growing, cash-rich, and pushing to improve efficiency and market share.

The other side of McKesson is its healthcare IT and software business. Although much smaller than drug distribution, McKesson's healthcare IT business is the largest in the world.

It ranges from patient records, hospital systems - including automated processes for drug dispensing - and pharmacy systems to back-office and claims processing for payers, and internet portals and remote monitoring for patients.

IT sales increased 24 per cent last year to $1.9bn, with profits up 11 per cent to $159m, representing 10 per cent of McKesson's total operating profits.

Improving US healthcare computer network systems has increasing, broad political and business support.

However, the immense and fragmented US healthcare business poses challenges. Lack of funds and interoperability between healthcare IT systems are significant obstacles.

But the hope remains that eventually a more widespread, if not national, electronic medical records system could bring more efficiency to US healthcare.

McKesson sees itself at the nexus of several key pushes in healthcare: IT infrastructure, disease management services for patients, and improving the efficiency and costs of its distribution.

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United Kingdom: Ripe For The Picking? Technology Futures In Local Government

Excerpt from this article:

The Ohio Board of Pharmacy uses fingerprinting for authorising prescription orders. It has installed 800 workstations that can check that the prescriber is allowed to issue an order for a prescription. Biometric technology is used in the UK‘s asylum system.

Slew of articles about pharmacist shortage

There have recently been quite a few articles about pharmacist shortages, not only in the US, but all around the world. This growing trend (the shortage) gives rise to innovative pharmacy practicies, such as the use of telepharmacy.

From "University of Pittsburgh School of Health and Rehabilitation Sciences Student Wins American Telemedicine Association 2007 Student Paper Award":

Remote areas often experience shortages of professionals and technical resources crucialto the delivery of services related to specialized medical fields.

From "From refugee to aspiring pharmacist, humanitarian":

There is a shortage of doctors and pharmacists in Kenya and Ethiopia.

From "Hospitals desperate for nurses using prized bait":

Hospitals have been contending with a nurse shortage for years, but the problem is expected to worsen. In California, the shortfall is magnified by state rules that require one nurse on duty for every five patients in a hospital and by population growth.
In many cases, the efforts also have targeted other hospital jobs difficult to fill, such as pharmacist, radiology technologist and physical therapist.

From "Health Care Officials Urge Youth to 'Make it in Scrubs'":

Currently, California has nearly 230,000 Registered nurses (RN) working full or part-time, according to the latest Legislative Analyst’s Office
(LAO) May 2007 report, “Ensuring an Adequate Health Workforce: Improving State Nursing Programs.” California ranks 49th in nurses per capita and 43rd in pharmacist per capita. By the year 2015, health experts estimate California will suffer a shortage of 17,000 doctors.

From "Customer Choice Plays More Significant Role in Prescription Drug Selection, Opinion Research Corporation Survey Finds":

With the rapid growth in the number of prescription transactions and a shortage of pharmacists, the role of the pharmacist had to become more operational," says Shea. "As technology evolves, I believe pharmacists will see their role becoming more influential and returning to a more advisory position. As a result, pharmacists may end up being one of the greatest influencers in the drug selection process.

University of Pittsburgh School of Health and Rehabilitation Sciences Student Wins American Telemedicine Association 2007 Student Paper Award

Award first ever given to student paper

PITTSBURGH, June 19, 2007 — University of Pittsburgh School of Health and Rehabilitation Sciences (SHRS) graduate student and doctoral candidate, Richard M. Schein, of Clifton, N.J., was recently awarded the American Telemedicine Association (ATA) 2007 Student Paper Award for his research in telemedicine.

The award was given in recognition of Schein’s presentation, “Telerehabilitation: Expanding Access to Wheelchair Provision and Service Delivery,” which was presented at the ATA Annual Conference in Nashville last month. This award is the first of its kind for the ATA.

“Richard's abstract was originally peer-reviewed by the ATA 2007 Peer Review Committee and was accepted for presentation at the annual conference,” said Jordana Bernard, senior director of ATA. “The award was based on the quality of both his written paper and oral presentation. We are very excited for him and the award is well deserved.”

The award-winning paper covered the following points about the importance telerehabilitation in rural areas:

Telerehabilitation offers many new opportunities to provide rehabilitation services in alternative ways and in different clinical settings. Remote areas often experience shortages of professionals and technical resources crucialto the delivery of services related to specialized medical fields.

Rural providers are often isolated from advancements and technologies used in larger metropolitan centers. As a result, when an individual in a rural area needs an assessment, a specific treatment, or both, patients may have to travel long distances to receive the specialized health care necessary to address their needs. This impacts both the health care providers and the patients. There are more people in need of the services of assistive technology specialists than there are regional clinics to serve them. The durable medical equipment industry has seen new coverage guidelines implemented by Centers for Medicare and Medicaid Services recently for wheelchairs (i.e. mobility assistive equipment)of who can perform these assessments.

The assessment of the user’s needs and matching the user with an appropriate wheeled mobility and seating intervention as well as fitting and training isessential for successful outcomes.

The rapid improvements in telecommunications technology also have the potential to improve the delivery of services to people with disabilities and those who are elderly. Transmission of voice, image, and data could provide a means for experts in wheeled mobility and in other rehabilitation aspects to provideconsultation to other health care professionals and consumers.

“This award is a testament to Rich's hard work and dedication to the project as well as recognition to the field of rehabilitation,” said Mark Schmeler, Ph.D., instructor at the University of Pittsburgh in the department of rehabilitation science and technology and principal investigator on Schein’s project. “People are living longer and surviving diseases and injuries more than in the past. Therefore needs are growing especially in rural areas. Telerehabilitation is emerging as a mechanism that warrants more consideration in the health care community to serve more people in an appropriate and cost-effective manner.”

Schein received a B.S. in rehabilitation and disability studies with a concentration in medical rehabilitation from Springfield College. Upon graduation, he came to the University of Pittsburgh to pursue a Master’s of science degree in rehabilitation science and technology as well as a certificate in assistive technology. He is currently a doctoral candidate in the SHRS within the department of rehabilitation science and technology. He has been working for the Rehabilitation Engineering Research Center on Telerehabilitation, where his research has focused on remote wheelchair prescription and consultation via telerehabilitation. Schein has been involved in clinical research for the past four years in areas such as seating and wheeled mobility, telerehabilitation, as well as funding and policy as it relates to assistive technology. He is also a member of the Rehabilitation Engineering and Assistive Technology Society of North America and the ATA.

The University of Pittsburgh Schools of the Health Sciences include the schools of Medicine, Nursing, Dental Medicine, Pharmacy, Health and Rehabilitation Sciences and the Graduate School of Public Health. The schools serve as the academic partner to the University of Pittsburgh Medical Center. Together, their combined mission is to train tomorrow’s health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care. For fiscal year 2005, Pitt and its institutional affiliates ranked seventh nationally among educational institutions in grant support from the National Institutes of Health (NIH).

For more information about this award or the Schools of the Health Sciences, please visit www.health.pitt.edu

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Automated dispensing units ready for American homes

A couple of articles came out a while ago about some new hardware with web controls that you can remotely administer.

FDA Grants Clearance To INRange System's Electronic Medication Management Assistant - EMMA™

EMMA the Magic Medicine Cabinet Approved by FDA to Deliver Medicine with Pharmacy Web Commands

Coincidentally, a vulnerability was found in another Pharmacy program around the same time. This is the first time I've really heard of such a thing. I guess healthcare applications just aren't abundant enough out there accessible on the internet to cause it to be a big deal -- until these automated dispensing units hit American homes, that is. It's going to be interesting to see how long it takes these things to be hacked.

Pine Bluffs finally has a pharmacy ... sort of

A video link and drug vending machine make the Telepharmacy possible.

By Jennifer Frazer
jfrazer@wyomingnews.com

CHEYENNE - No matter what it looks like, the drugs in a new Pine Bluffs machine aren't snacks. They're just dispensed that way.

With a prescription in hand, Pine Bluffs patients can now watch the amoxicillin for their strep throat be pushed out by a turning piece of coiled metal behind glass just as they would their daily sugar fix.

There are a few differences, however. There's no coin slot or button pad. Instead, a pharmacy technician in Pine Bluffs and pharmacist in Cheyenne - connected by video link - handle the dispensing of the drug.

After lacking a pharmacy for more than six years, the Hoy's Drug Pine Bluffs Telepharmacy opened for business on Feb. 21. It has only been inoperable one day since then, said Dr. Douglas Parks, a physician at the UW TriCounty Clinic whose lobby holds the telepharmacy, because the phone lines between Cheyenne and Pine Bluffs were down.

"People coming in with illness are just thrilled to be able to fill their prescription before they go home without having to travel somewhere," Parks said.

The machine is filling about 10 prescriptions a day, resulting in a savings of 600 to 900 miles of travel time and gasoline per day.

That means a lot to people, Parks said, particularly at current fuel prices.

"If you're driving an old Ford truck, it's a $30 trip to get your $12 prescription filled," he said.

And it's a great help to senior citizens who can't drive and formerly had to depend on getting their medicine through the mail.

The installation of the machine paves the way for other communities in Wyoming to take advantage of the technology, Parks said.

"Off the top of my head, I can think of eight to nine communities in similar situations," he said, "They have (doctors) but no pharmacy services. So I'd anticipate we'll be seeing this technology used in other communities in the state in short order."

Pine Bluffs resident Wendy Rohde has been very appreciative of the telepharmacy - she's been using it since the day it opened for her four foster children, she said. It has saved her at least one trip a week to Cheyenne to fill prescriptions, a savings of about $15 per trip - and an hour and a half in the van.

"I don't know if you've ever driven 45 minutes with a 4- or 5-year-old, but let me tell you, it can be something," she said. "And that's one way."

What the machine cannot offer, by law, is controlled substances like many prescription painkillers. That poses a problem, Parks said, for patients who break an arm or have teeth extracted in Pine Bluffs. They must still make the trek to Cheyenne to get their prescriptions filled.

Back in 2004, Parks' medical group approached several Cheyenne pharmacies about telepharmacy, but only Hoy's expressed interest in it.

"We're interested in helping out the community," said Jim Massengill, president of Hoy's Drug, of the reason they decided to pursue the telepharmacy in Pine Bluffs.

Though Hoy's knew there was potential for a drug store in Pine Bluffs, after the eye-opening cash layout they had to make to place a branch of their pharmacy in Cheyenne Regional Medical Center - more than $500,000 - they weren't prepared to lay out that sum of money again soon.

The telepharmacy seemed the ideal compromise.

But the organizers soon realized it was not yet legal to install one.

Working with Sen. Wayne Johnson, R-Cheyenne, and Rep. Rodney "Pete" Anderson, R-Pine Bluffs, they got a bill passed to legalize the machines in 2005. The state Board of Pharmacy approved rules the following year.

Though at 10 prescriptions per day the branch is not yet profitable, Massengill hopes with time it will be.

"It's totally a community service so far," he said, "but it has a lot of potential, it's growing each week, it's getting a little bit better, but it's going to take quite a bit of time before it gets there."

When a prescription is brought to the pharmacy, a pharmacy technician faxes it to the Hoy's in Cheyenne, where a pharmacist enters the information into the computer, which dispenses the drug back in Pine Bluffs. A label also is printed, and the Cheyenne-based pharmacist checks the appearance of the pills, the label and other information via video link.

Though the telepharmacy currently carries only about 100 drugs, any other drug stocked by Hoy's main branches can be delivered by the next business day.

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