Wednesday, November 28, 2007

The Facts about Telepharmacy

Photo: Scott Tague, AutoMed, gives a demo on Telepharmacy
Yesterday, Rep. Bob Herkes sponsored an all day demonstration at the State Capitol on "Remote Dispensing Technology for Medications" or Telepharmacy. The demo was provided by the Hawaii Pharmacists Association in partnership with AmerisourceBergen Technology Group.

The group was unsuccessful during the 2007 legislative session in getting their bills heard in committee. It seems like the bills got lost amidst the thousands that are introduced each year, and, according to Barbara Kashiwabara, Director of Pharmaceutical Services at Kaiser Permanente, there was a lack of information on what telepharmacy is (and is not), and how it would help folks in isolated and rural areas of Hawaii. I stopped by at the end of day, and they were kind enough to stay late and give me a quick review. This is my understanding on how it might work:
Say you are a patient on Lanai and your doctor is in Honolulu. There would be an independent pharmacy operator set up on Lanai, most likely at a clinic or doctor's office. This pharmacy operator would have a fully stocked cabinet filled with medications that are prepared, counted and sealed by a pharmacist. I was told that each cabinet would contain the most commonly prescribed medications, and that there would probably be a 75% chance that the prescription requested is already stocked in the cabinet.

Your doctor would call in your prescription at a main pharmacy. The pharmacist will then hold a teleconference with the technician and you on Lanai. That would include a consultation with you prior to dispensing the medication, and sending an electronic bar coding for the prescription. The barcoding system allows the pharmacy technician to manage the stocking of the cabinets, and tracks lot numbers and expiration dates. After getting authority from the main pharmacist, the pharmacy technician on Lanai would access the dispensing cabinet through a biometric, fingerprint protected access system. The technician would be able to process a pre-packed prescription for you.
This technology has been used since the mid-90's, primarily through the Veterans Administration. To date, over 20 states have developed or are in the process of evaluating and completing the necessary regulations that allow Telepharmacy. In the South Pacific, the Hawaii VA has used this technology for several years, with sites on Maui, Kauai, the Big Island, Guam and soon in American Samoa.

The promise for Hawaii lies in being able to service rural areas that have poor access to healthcare and pharmacies. Good idea? Concerns?

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