Telepharmacy takes pharmacists online off-site

Drug Store News, August 18, 2003

A new type of delivery system is emerging within pharmacy, and it has the potential to both enhance patient care and provide a new revenue stream for pharmacy operators.

In what are being described as advanced stages of pilots, pharmacy operators in retail and clinical-settings, as well as health care professionals working in urgent care facilities, emergency rooms and doctor's offices, are testing the automated delivery of prescription medications to patients.

In addition, some pharmacies are piloting telepharmacy systems that make it possible for registered pharmacy technicians working in stores in remote or rural locations to deliver medications to customers after the prescription has been processed and adjudicated by a pharmacist working from a home or central pharmacy location.

Thrifty-White currently has two telepharmacies in operation (see Drug Store News July 21); Jody Doe, an independent pharmacist who owns Killdeer Pharmacy has two telepharmacies in operation in North Dakota; and Larry Larsen, who operates a pharmacy in Watford City, N.D., is about to open a telepharmacy on the Fort Berthold Indian reservation in Newtown, N.D.

Howard Anderson, the executive director of the North Dakota Board of Pharmacy, said that under the definition the board has adopted for dispensing prescriptions a registered technician at a remote pharmacy can manually prepare the medications to deliver to the patient. The technician has to be, supervised by a pharmacist in a "home" pharmacy who monitors the filling process via an Internet connection and a video camera and only permits the medications to be dispensed after the patient has been counseled.

The remote location also must be linked to a pharmacy management software system.

Anderson said the North Dakota Pharmacy Board has a list of about 10 retailers who hope to offer additional telepharmacy services by September of next year.

"We have lots of requests from retailers to open telepharmacies," said Anderson, who said they meet the needs of consumers living in remote locations that are not able economically to support a full pharmacy. "Thrifty-White had the vision of opening telepharmacies three years ago."

Two companies that make automated prescription dispensing systems, Telepharmacy Solutions, a division of AmeriSource Bergen, and Mendota Healthcare say they have a system that would work within that model, and both are talking to chain and independent pharmacy retailers about putting the technology into stores.

According to Ken Rosenblum, the chief executive officer of Minnetonka, Minn.-based Mendota Healthcare, which makes an automated prescription dispensing system called InstyMeds, two chains with pharmacies, a mass merchandiser and a food store, both in the top five slots in their industries in terms of sales volume, are in discussions with Mendota to test InstyMeds in pilots that could start within the next six months.

And according to Carl Geberbauer, director of sales and marketing for North Billerica, Mass.-based Telepharmacy Solutions, an AmeriSourceBergen company that markets a proprietary automated prescription dispenser under the brand name ADDS, the company is talking with numerous independent pharmacy operators about installing ADDS units in clinics, physician offices and retail stores within the next three to four months.

Jody Doe, who opened his first telepharmacy in Beach, N.D., last September and his second in New England, N.D., last November, said his decision to try telepharmacy was promoted by the needs of the people living in rural communities.

"There hasn't been a pharmacy in Beach, N.D., for the past 10 years, and the business there is growing pretty fast," he noted.

"We're averaging 30 to 35 scripts a day. In New England, the pharmacist was retiring, and no one wanted to take it over."

Doe said that through telepharmacy, be can operate the two stores at what is now coming close to break even. "The cost is about one-third of what it would be if I had a pharmacist. If those stores needed a pharmacist to be there, they wouldn't be in operation."

Doe said that given the shortage of pharmacists and the economic difficulties of providing pharmacy services in remote area like Beach and New England, he believes telepharmacy as a health care service will continue to grow.

"I think it will take off. I know other states like South Dakota and Montana are looking at this, as well. If I can build the volume to where I can hire another pharmacist in Killdeer, I would certainly, think of opening more telepharmacies," Doe said.

David Holmstrom, executive director of the Minnesota Pharmacy Board, said that there are about five telepharmacies in operation in Minnesota right now, some open for several years and they seem to be serving a real need for patients in remote locations in the state.

"It seems to be working well. We've had no complaints of dispensing errors and we'll probably see it continue to grow, especially in rural areas."

Jennifer Livingston, a pharmacist supervising an automated telepharmacy in a franchised Medicap store in Exira, Iowa, said that they have had a telepharmacy since December 1999 and that it has been both a service to the community and a source of incremental revenues for Kimwood, the company that owns the franchise.