Title: The North Dakota Telepharmacy Project Restoring and Retaining Pharmacy Services in Rural Communities
1The North Dakota Telepharmacy ProjectRestoring
and Retaining Pharmacy Services in Rural
Communities
- Charles D. Peterson, Pharm.D.
- Dean and Professor
- College of Pharmacy
- North Dakota State University
- Fargo, North Dakota
- Funded by the Office for the Advancement of
Telehealth, HRSA, of Health and Human Services
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3North Dakota Demographics2000 Census Highlights
- 642,200 population, ranks 47th in nation
- population growth 0.5 (1990-2000)
- population shift from rural to urban
- only 6 of 53 counties gained population
- 50 of ND counties lost at least 10
- 36 of 53 counties classified as frontier
- 14.7 over 65, vs 12.4 nationally
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7Access to Pharmacy Services in North Dakota
- Of the 373 cities, 73 have pharmacies
- Of the 53 counties, 9 do not have a pharmacy and
11 have only one Rx - North Dakota 51 ownership law
8ND Rural Health Care CrisisCommunity Pharmacy
Closings
- 26 rural community pharmacy closings
- 12 additional pharmacies at risk of closing
- pharmacist retirements - no replacement
- national pharmacist shortage
- negative impact on rural health
9Exploring SolutionsTelepharmacy Rules
- required changes in pharmacy practice act
- telepharmacy rules established by NDBDPh
- pilot project in 2001 ? permanent rules
established in June 2003 - allow pharmacists to supervise a technician at
remote site - dispense prescriptions
- pharmacist - patient consultation
-
10Boards of PharmacyTelepharmacy Regulations
- Approximately 25 states currently either have
telepharmacy regulations or are very close to
adopting regulations. There is a good chance by
the end of the year, there could be 30 pharmacy
boards with regulations in place. - Carl Geberbauer, V.P.
- AutoMed Technologies, Inc
11Telepharmacy Grant Awarded NDSU College of
Pharmacy
- Congressionally mandated federal grant via the
support of Senator Byron Dorgan - Office for Advancement of TeleHealth, Health
Resources and Services Administration of HHS - First Initiated September 1, 2002
- Approximately 2.5 million federal support to
date
12Goals of Telepharmacy Grant
- RESTORATION - restore pharmacy services in rural
communities which have lost their services - RETENTION - retain pharmacy services in rural
communities which are at risk of losing their
services - ESTABLISH establish pharmacy services in rural
communities which have previously not had
services -
-
13North Dakota Telepharmacy ProjectA Historical
Look
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15Telepharmacy Project Partners
- NDSU College of Pharmacy
- North Dakota State Board of Pharmacy
- ND State Pharmaceutical Association
- Licensed rural community pharmacies
- Targeted rural communities
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-
16Telepharmacy Grant Budget
- Assist in the telepharmacy start-up costs
- 50 OAT Grant/50 North Dakota
- Technology Hardware, Software, Connectivity
- Registered Pharmacy Technician
- Pharmacy Fixtures
- Drug Inventory
- Travel
-
-
17Pharmacy Technician Responsibilities Remote
Telepharmacy Site
- Maintains drug inventory at remote site
- Processes all prescriptions orders including
controlled substances - Computer order entry, filling, billing, labeling
- Takes original prescription orders by phone
- Prepares prescription for dispensing by
pharmacist - Connects patient to the pharmacist for private
consultation via audio and video link
18Pharmacy Technician Training Requirements
Telepharmacy Sites
- Registered with Board of Pharmacy
- ASHP accredited program or equivalent
- Minimum of one year experience in dispensing
prescriptions - Salaries are 15/hour or more
- Reciprocity from other states requires PTCB
certification
19Pharmacist Responsibilities
- Final check of technician Rx preparation
- Dispenses drug to the patient
- Drug utilization review
- Patient education counseling
- Remote site visits
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26DemographicsRemote Telepharmacy Sites
27DemographicsRemote Telepharmacy Sites
28DemographicsRemote Telepharmacy Sites
29DemographicsRemote Telepharmacy Sites
30Telepharmacy Technology
- Standard PCs with Pharmacy Software
- Polycom VSX 7000
- Sonic Wall TZ170 or Tele 3, Cisco Firewall
- AVerMedia - AVerVision 110 Document Camera
- DSL over the Internet or dedicated T-1 line
- Rx Software and audio video link run in parallel
31Benefits to North Dakota from Telepharmacy
- Improved access to health care for rural citizens
- Rural economic development
- Improved quality of care/pharmacist consults
- Increased patient pharmacist satisfaction
- Increase financial viability of rural pharmacies
- Provide relief for pharmacists for vacations,
etc. - Increased educational opportunities for students
- Increased retention of pharmacy graduates
-
32Economic Impact of Telepharmacy
- Has added a 500,000 per year business to the
rural community - Thus far, has added an estimated total of 12.0
million annually to the North Dakota rural
economy - Has added an estimated 40-50 new jobs to the
North Dakota rural marketplace - Has added 50 increase in prescription sales to
combined pharmacy operation
33Addl Economic Development Benefits of
Telepharmacy
- Helps build the local community economy
- Helps attract other businesses and families to
community because basic health care
infrastructure is present - Pharmacy can be used for other business retailing
not currently available within the community
34Student Involvement
- Incorporate telepharmacy technology in NDSUs new
Concept Pharmacy Lab - Trains students on the latest advances in
pharmacy technology - Teaches students how to deliver pharmacy services
in a unique and innovative way to smaller rural
communities - Helps attract graduates to rural practices
35Student Activities
- Provide pharmacists at the Central Pharmacy with
drug information and disease state management
assistance - Provide patient education counseling to remote
telepharmacy sites
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37Future Goals of the ND Telepharmacy Project
- 50 telepharmacy sites in five years
- develop a model for serving rural hospitals
- assist other states in implementing telepharmacy
services in rural areas - establish a state-wide data video network
- establish equipment standards
- conduct a formal medication error study
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39Telemedicine Technical Assistance Document A
Guide to Getting Started in TelemedicineIncludes
14 Telemedicine Areas
- http//muhealth.org/telehealth/geninfo/TAD.html
- 35 page chapter providing guidelines for how
- to implement telepharmacy services
40For more information visit our website at
http//telepharmacy.ndsu.nodak.edu/