VA to do Remote Order Entry from smartphones?

At the Washington DC VA Medical Center, chief of staff for informatics, Dr. Divya Shroff has been ushering in the use of smartphones for a few functions around the hospital normally performed by people at computers. One thing she sees in their future is Remote Order Entry via smartphones like BlackBerrys or the iPhone. From the ComputerWorld article:

Dr. Shroff sees many of the tasks currently being performed on laptops in medical settings making their ways to smartphone platforms as well. Possible future uses for mobile applications for physician's include remote order entry, remote chart changes, and the ability to read and make notes in real-time on medical materials from anywhere, to name a few, Dr. Shroff says.
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DCVAMC is already working on an iPhone application for patients, though Dr. Shroff didn't share specifics.

This would be an absolutely amazing and revolutionary use of mobile phone technology for use in the healthcare setting. Here's to hoping they develop the application.

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.

Remote Review of Chemo Orders Saves Time and Money

Pharmacy Practice News highlights a new and interesting application of remote electronic supervision of pharmacy technicians via live video at Exempla Lutherin Medical Center in Denver, Colorado in their article, ASHP Coverage: Remote Camera To Check Chemotherapy Orders Saves Time and Money (free login required, or use bugmenot):

Prior to implementation of the camera, decentralized pharmacists had to go to the compounding area in the central pharmacy to verify the accuracy of the order. The new process improves efficiency by eliminating the time it takes for the pharmacists to travel to the central pharmacy. The process of traveling to the central pharmacy, waiting for other personnel and completing the check took an average of 346 seconds before the camera was put in place; that was reduced to five seconds with implementation of the camera.

Additionally, after implementing the new system, the Denver pharmacists were able to more than double the number of chemotherapy doses prepared each day, from four to nine.

Great article, it highlights all the points, including that it saves them time, money ($15,000 anually!), and helps them comply with Federal regulations (797).

More info on Adrian's telepharmacy grant

As reported here a while back, the City of Adrian, MN received partial funding for its telepharmacy project, which restored pharmacy services to the area, in the form of a grant from the Blandin Foundation. The Nobles County Review fills us in again:

The Blandin Foundation notified the city of Adrian on March 13, 2009 that Adrian had been selected for the $50,000 grant through the Sterling Drug, Inc. telepharmacy project. The city received the funds from the Blandin Foundation and forwarded the funds to Sterling Drug, Inc. for the purchase of the telepharmacy equipment.

It is good to know that grants are available for hi-tech medical projects such as retail telepharmacies. If you are having trouble initiating or restoring pharmacy services to your area, you might borrow from Kevin Norskog's example and research available grants.

US Army seeks bids for Telepharmacy maintenance in Missouri

The Office of US Army Medical Command is soliciting bids for maintaining Telepharmacy equipment for a Robotic dispensing system for the General Leonard Wood Army Hospital in Fort Leonard Wood, Missouri:

PERFORMANCE WORK STATEMENT

1. SCOPE OF WORK: Contractor shall provide all labor, supplies, tools, material, transportation, parts, and equipment to perform Preventive Maintenance (PM), Calibration/Verification/ Certification (CVC), to maintain the Telepharmacy Robotics. This includes unlimited telephonic assistance and unlimited on-site maintenance repairs. The equipment is located in the Pharmacy, General Leonard Wood Army Community Hospital (GLWACH), 126 Missouri Avenue, Fort Leonard Wood, Missouri, 65473.

They will use the lowest cost provider that meets the technical specifications. Bids are due by July 16^th.

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 system for remote supervision of pharmacy technicians in hospital decreases likelihood of medication errors, increases safety of process

The culmination of some telepharmacy work out of Kansas, finally published, highlighted earlier by this blog! An article in the newest AJHP details an interesting usage of telepharmacy:

Summary. Telepharmacy hardware and software were acquired, and an inspection camera was placed in a biological safety cabinet to allow the pharmacy technician to take digital photographs at various stages of the chemotherapy preparation process. Once the pharmacist checks the medication vials’ agreement with the work label, the technician takes the product into the biological safety cabinet, where the appropriate patient is selected from the pending work list, a queue of patient orders sent from the pharmacy information system. The technician then scans the bar code on the vial. Assuming the bar code matches, the technician photographs the work label, vials, diluents and fluids to be used, and the syringe (before injecting the contents into the bag) along with the vial. The pharmacist views all images as a part of the final product-checking process. This process allows the pharmacist to verify that the correct quantity of medication was transferred from the primary source to a secondary container without being physically present at the time of transfer.

Conclusion. Telepharmacy and bar coding provide a means to improve the accuracy of chemotherapy preparation by decreasing the likelihood of using the incorrect product or quantity of drug. The system facilitates the reading of small product labels and removes the need for a pharmacist to handle contaminated syringes and vials when checking the final product.

Sounds promising -- and a great new method of lowering medication errors in the absence of a pharmacist, as well as costs in pharmacies, though if you've been reading this blog for a while, you know remote verification of pharmacy technician work in hospitals via telecommunications isn't entirely new.

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.

Retail Minnesota Telepharmacy up and running

An update on the Minnesota town, Adrian who got their retail pharmacy back in the form of a Telepharmacy, serviced from another town's pharmacy:

After over a year of planning and paperwork Adrian will once again have a pharmacy on Maine Street. Sterling Drug will be opening its telepharmacy in the Government Building on Tuesday, June 2.

This comes from Krisine Kern out of the Nobles County Review. According to a PDF on their website, it looks like telepharmacy equipment provider ScriptPro supplied the equipment (pdf).