Telepharmacy at Texas Tech

Jon Phillips,

Associate Director of Telemedicine

Senate Bill 65—Legislation Enabling Telepharmacy

A “telepharmacy system” means a system that monitors the dispensing of prescription drugs and provides for related drug use review and patient counseling services by an electronic method, including the use of these technologies Audio and video Still image capture Store and forward

S.B. 65 continued

Telepharmacy services provided by a Class A or Class C pharmacy to a health facility at a distant location

Distant telepharmacy site may not be located in a community in which a Class A or Class C pharmacy exists

Required to be under the continuous supervision of a pharmacist (electronic supervision by audio and video communication)

S.B.65 continued

Directs the Texas State Board of Pharmacy to develop rules to govern the operation of telepharmacy services

TSBP Telepharmacy Rules

Remote pharmacy services—storage & dispensing of prescription drugs, drug regimen review, and patient counseling at a remote site

Sites eligible for remote pharmacy services Rural health care clinic Health care center Health care facility located in a medically underserved

area

TSBP Rules cont’d

Each pharmacist at the central pharmacy may supervise—electronically—no more than three remote sites that are simultaneously open (exceptions may be granted)

Texas Tech Telepharmacy Pilot Project

Collaborative project Texas Tech Sid Ontai – private physician Health Care Visions, Inc.

Texas Tech Telepharmacy

Pharmaceutical Care Center at Texas Tech Medical Center Southwest (TTMCSW) serves as the demonstration central pharmacy

Evaluating the project Health professional student education and

training in rural care Economic feasibility to provide services to

rural communities Evaluation of current law to determine if it

allows maximum potential of the system

Funding

USDA RUS grant to Dr. Ontai for equipment and operations

Texas Tech for research and monitoring

Texas Tech Telemedicine service area

Telepharmacy service area

Project Objectives

Field test telepharmacyPropose rule changes and improvementsEnhance access to medicationsTraining/education

• The Turkey Telepharmacy site site is staffed with an Emergency Medical Technician (EMT) from 8:00 AM to 12:00 noon Monday through Friday.

• Medications available for dispensing at the the Turkey Telepharmacy site were determined by a committee composed of Dr. Ontai and the Director of the Texas Tech Pharmaceutical care and Infusion Center.

• To conform to security standards, medications at the the Turkey Telepharmacy site are stored in approved, secured medication blister packs

Project information

Project information

• The central computer maintains separate sets of computerized data files. This allows each extended pharmacy to have its own NABP number, drug formulary, inventory, patient, doctor, and prescription files.

• Communications between the TTMCSW and the Turkey Telepharmacy site are conducted through an encrypted DSL connection.

Educational opportunities -Rural Clerkship-

One day with Dr. Ontai in his office in Plainview, Texas.

One day at central pharmacy at TTMC SW.

Three days with mid-level practitioner at Turkey Rural Health Clinic.

Progress Report

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5

10

15

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25

30

35

40

Sept Oct Nov Dec Jan Feb March

NewRefill

247 total prescription transactions completed as of March 31,2003

Telepharmacy Technology

• RX filled at a central location, RX label and monograph printed at remote location

• Thumbnail of medication and scanned NDC / quantity used for verification at Remote Site

• Final approval of RX completed by pharmacist utilizing Rendezviewer

• POS Transaction completes sale and records sale

Rendezvous and Rendezviewer

• Uses store and forward technology

• Review episodes from you home, office, airport or anywhere you have access to the Internet

• Proven reports for audits and compliance

• Allows episodes to be forwarded to multiple healthcare professionals for review and comments

Audit and Reporting Features

• Inventory Control for Central and Remote

• Centralized Drug Ordering

• Cash Register Audit Report

• Voided Prescription Report

• Pharmacist Review Time and Date TrackingPatient Compliance Reporting

First Telepharmacy Prescription in the State of Texas

Turkey Medical ClinicTurkey Medical ClinicTurkey, TexasTurkey, Texas

Texas Tech Texas Tech Medical Center SWMedical Center SW

Lubbock, TexasLubbock, Texas

September 18, 2002September 18, 2002

PATIENT SATISFACTION SURVEY QUESTIONS

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2

4

6

StronglydisagreeSomewhatdisagreeNo opinion

Somewhat agree

Strongly agree

Question # 1

I would rather see a pharmacist on the telepharmacy system than travel to see him or her

PATIENT SATISFACTION SURVEY QUESTIONS

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0.5

1

1.5

2

2.5

3

3.5

4

StronglydisagreeSomewhatdisagreeNo opinion

Somewhat agree

Strongly agree

QUESTION # 2

If the Telepharmacy system were not available, I would receive my medicine by mail or internet pharmacy

PATIENT SATISFACTION SURVEY QUESTIONS

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0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

Stronglydisagree SomewhatdisagreeNo Opinion

SomewhatagreeStronglyagree

QUESTION # 3

I felt the pharmacist counseling was not adequate because the pharmacist was not showing me my medicine in person

PATIENT SATISFACTION SURVEY QUESTIONS

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0.5

1

1.52

2.5

3

3.5

44.5

5Less than 20miles20 to 30 miles

30 to 40 miles

40 to 50 miles

over 50 miles

QUESTION # 4

If the Telepharmacy system were NOT available, how many miles would you have to have travel one way to get your prescription?

Project status

Project will continue Results very positive Sound science and technology Considering expansion/additional sites

Questions?