Ontario Hospitals will Dispense Drugs via PharmaTrust Kiosks

The PharmaTrust dispensing machine is set to be deployed in Canadian hospitals in the province of Ontario, according to an Ontario Hospital Association press release:

The OHA and PharmaTrust will collaborate on the installation of telepharmacy prescription-dispensing kiosks in hospitals across the province.

PharmaTrust MedCentre kiosks offer live video pharmacist counseling and quick and safe 24/7 access to prescription and over-the-counter medications, dispensed under the complete control of a pharmacist. The PharmaTrust MedCentre allows patients to simply insert their prescription, pick up the handset and interact live with a pharmacist who provides counselling via two-way video conferencing. The pharmacist is supported by integrated safety features to ensure prescription authenticity, accuracy and patient safety.

If you've been reading this blog for a while, you know that the kiosk was developed by Patient Care Automation Services, Inc with a grant from the National Research Council of Canada, and was trialed in Toronto's Sunnybrook Hospital.

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!

New Mexico Allows Remote Supervision of Pharmacy Technicians, Prevents Closing of Local Pharmacy

In a newly published paper entitled Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease, researchers analyze a University of New Mexico Health Sciences Center project given the acronym "Health Extension Rural Offices" (aka HEROs) as "a vehicle for its model of health extension." According to the paper, some adjustments were made at the behest of Silver City, NM that allowed improved health services:

UNMHSC College of Pharmacy helped revise New Mexico State Board of Pharmacy regulations to permit pharmacists in larger towns to use a telepharmacy service to supervise local pharmacy technicians in rural and frontier counties. Initiated by the local HERO agent, telepharmacy will permit the local pharmacy to remain open, which is a health and economic benefit to the community.

This happened sometime probably in early 2009, as the paper was submitted in July, accepted in October and finally published now in the first Annals of Family Medicine of 2010.

Technology Allows Pharmacists to Deliver Services from Home

Tammy Worth writes a new article for the Health Care Reform Hub of the American Pharmacists Association's pharmacist.com called "Creating a virtual team: The future for medical homes?" In the article, Worth notes "working virtually" may be the answer to a lot of pharmacy's hurdles. She mentions the venerable North Dakota Telepharmacy Project as well as the lesser known project out of the University of Nebraska Medical Center, where pharmacists work from home to provide inpatient pharmacy services:

Lisa Moffett, PharmD, went to pharmacy school, completed her residency, and then decided to stay at home with her children. When she received a call from the University of Nebraska Medical Center offering her work from home, she jumped at the chance.

Moffett is one of 14 stay-at-home moms, “retired” pharmacists, and moonlighters working for the university’s telepharmacy program. The group provides services to six rural hospitals that either need after-hours pharmacy coverage or do not have a pharmacist on staff.

Their responsibilities are purely clinical. A tollfree number is available for hospital staff to ask their virtual pharmacists questions at any time. The group reviews patient profiles, provides dose adjustments, rounds with physicians via telephone, and even takes part in one hospital’s monthly pharmacy committee meetings—all remotely.

“There are so many different things that this job encompasses,” Moffett said. “We practice inpatient pharmacy in our houses through the computer.”

Worth also highlights how the University of Arizona and a few other College of Pharmacies who are developing programs to provide remote medication therapy management (MTM), involving remote consultations. A telepharmacy equipment company out of North Dakota called Custom Data, Inc. says, “We are trying to build systems and come up with methods for doing tele-MTM through similar systems to what we are using now.”

Minnesota Board of Pharmacy Grants Telepharmacy Variances

Back in September the Minnesota Board of Pharmacy granted and renewed a host of variances for pharmacies around the state:

New variances:
Abbot Northwestern Hospital in Minneapolis was permitted to have a pharmacist provide remote verification of pre-op and post-op orders for the Edina Surgery Center so long as the pharmacist-in-charge remains the same person.

Extension to current variances:
West Duluth Clinic Pharmacy in Duluth was allowed to provide telepharmacy services to the Duluth Clinic in Remer, MN for the duration of two years so long as they continue to make visits and monitor usage.

Re-approved variances:
Cub Pharmacy in Cottage Grove and Cub Pharmacy in Shorewood were permanently allowed pharmacist certification of the prescription medication with use of the digital image of the medication so long as the pharmacist-in-charge remains the same.

Finally, Mercy Hospital Pharmacy in Moose Lake was allowed remote "After Hours Order Entry" of the hospital's physician medication orders when pharmacy is closed from normal business hours of operation from St. Luke's Hospital in Duluth, until 4/1/2011.

Idaho Board of Pharmacy 2009 Year in Review: Telepharmacy eases pharmacist shortage, restores services

The Idaho Board of Pharmacy just released their 2009 Performance Measurement Report. A retail telepharmacy project makes the Performance Highlights list:

We extended a temporary rule that will bring pharmacy services to a remote location in Idaho by means of a telepharmacy. This was a joint effort by the board, the community, our Governor, legislators and Idaho Congressman. We are seeing more of our remote areas lose their community pharmacies and we hope this will be a means of providing our citizens [with a way] to continue to have access to pharmacy services and needed medications.

Click here for the rest of the report.

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.

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.

Minnesota Sees Need for Telepharmacy in Rural Areas Rising in 2010

The Minnesota Society of Health System Pharmacists just released a position statement assessing the changes they feel are required, called Pharmacy Technician Education, Training and Competency. In the statement, highlight many of the roles technicians are increasingly expected to take on, and use some trends research to speculate on the "Future of Healthcare" in the state:

There will be increasing needs for pharmacists in prescription and telepharmacy to improve services to rural areas of the state.

Kansas Mulls New Draft Rules for Hospital and Retail Telepharmacy

As you know if you've been reading the blog for a while, Kansas is proposing new telepharmacy rules. The Kansas State Board of Pharmacy's September meeting minutes fills us in on their concerns and how far along they are in the process:

Hospital Telepharmacy Update – Mr. Coast presented the update and stated the regulation title has been changed to “Electronic Supervision of Medical Care Facility Pharmacy Personnel”. The draft regulations were presented for the Board’s review. The Board discussed the potential hazard of unintended consequences of telepharmacy being used to reduce pharmacy staffing, which could lead to a decrease in patient safety and quality of care; and that this should be taken into consideration as the regulations are drafted. The Board will forward questions and issues for the task force to discuss and consider. The next task force meeting will be October 26, 2009 in Wichita.

Retail Telepharmacy Regulations and Update – Mr. Coast updated the Board on the retail telepharmacy regulations. Aaron McReynolds, the owner and PIC at Lincoln County Pharmacy in Lincoln, Kansas , connected by phone to tell the Board his issues concerning the current retail telepharmacy draft regulations. He sent his suggestions to the Board several months ago and has requested the Board consider the North Dakota regulations. He requested the telepharmacy regulations allow controlled substances and questioned the feasibility of unit of use packaging. Mr. Coast asked if the Board would be open to allowing controlled substances on a site by site basis. Mr. McReynolds will participate in the next task force meeting to assist in drafting regulations that will resolve his areas of concern. Mr. Forbes needed the Board’s input concerning questions posed by the Attorney General’s Office. The Board reviewed the questions. The task force may address those questions as well as Mr. McReynolds’ issues. The task force will schedule a meeting.

The October minutes haven't been released yet.