telepharmacy: an e-solution for rural hospitals telepharmacy: an e-solution for rural hospitals jac...
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Telepharmacy: an e-Solution for Rural Hospitals
Telepharmacy: an e-Solution for Rural Hospitals
Jac DaviesNovember 17, 2005
Inland Northwest Health Services
Inland Northwest Health ServicesInland Northwest Health Services
32 hospitals, with over 2500 beds, participating in an integrated information system and utilizing a common Master Patient Index
More than 20 clinics receiving hospital, laboratory and imaging data via standard electronic messages
More than 200 offices able to view hospital, laboratory and imaging data via a virtual private network.
More than 500 physicians accessing patient records wirelessly in hospitals via personal digital assistants
67 hospitals, clinics and public health agencies connected to the region’s telemedicine network
Clinical System Usage and StrategyClinical System Usage and Strategy
Clinical Docu-mentation
EMR Usage
Mobile Chart
CPOE Readiness
Telehealth Rural
Access
EMR Usage
Mobile Chart
CPOE Readiness
Telehealth Rural
Access
ED/ Medication
History
Imaging Systems – Rad, Card, Path/Other
INHS/IRM Community Foundation Meditech
HIS System
Text & Speech
Systems
Physicians Mercury MD
“Mobile” PCI Expert
Systems CPOE – Rules
and Alerts
Regional Telehealth Network
Physician Office
Systems – Billing and
EMR
The integrated information system and common MPI gives the region a foundation for innovative tools, including:
• Computerized Physician Order Entry (CPOE)
• Clinical Documentation Systems for Nursing Notes
• Decision-Support Tools
• Anywhere, Anytime Physician Access to Images
• Remote Consultations and Support for Rural Residents
INHS Telehealth SystemINHS Telehealth SystemNursing education with universities and community colleges addressing Nursing Shortages
Rural hospital TelePharmacy program providing remote Pharmacist services
TeleER program remotely assisting rural trauma doctors with ER cases
Physicians provide remote Clinical Consults in Neurology, Pathology and many other areas
Prison Health Services receive specialist care
Statewide Diabetes Education Program Including Native American Tribes
TelePharmacyTelePharmacy
The provision of pharmaceutical care through the use of Telemedicine technology, automated
dispensing technology, scanning technology and integrated computer systems
Goals of Telepharmacy ProgramGoals of Telepharmacy Program
Enhance Patient Safety
Compliance with State Board of Pharmacy regulations
Efficient use of Pharmacist resources
Alleviate Health Care Personnel shortage
Improve Patient Outcomes
Improve Financial Outcomes
Linking Technology to Improve Linking Technology to Improve Rural Health CareRural Health Care
Video
conf
eren
cing
Elect
roni
c M
edic
al
Rec
ords
Autom
ated
Dis
pens
ing
Dev
ices
TelePharmacy
Orders are sent to main pharmacy Orders are sent to main pharmacy utilizing scanning devicesutilizing scanning devices
Scanned ImageScanned Image
Pharmacist reviews orders receivedPharmacist reviews orders received
• Accuracy of order Accuracy of order entryentry
• AppropriatenessAppropriateness• DosingDosing• AllergiesAllergies• InteractionsInteractions• Disease stateDisease state
Consultations can be done via Consultations can be done via telehealth video linktelehealth video link
Medication dispensing by Medication dispensing by automatic dispensing devicesautomatic dispensing devices
ADD* RestockingADD* Restocking
• The utilization of a The utilization of a remote camera and remote camera and telehealth technology telehealth technology to oversee automated to oversee automated dispensing device* dispensing device* (ADD) restocking(ADD) restocking
Fill ListsFill Lists
Technician will print Technician will print ADD fill list & scan ADD fill list & scan copy to remote copy to remote pharmacistpharmacist
Technician will pull Technician will pull needed medication needed medication from inventory in the from inventory in the pharmacypharmacy
RestockingRestocking
Pharmacist visually insures with the technician that the medication is placed in the proper location in the automated dispensing device
Medication VerificationMedication Verification
• Pharmacist will Pharmacist will visually observe visually observe and verify name, and verify name, strength, dosage strength, dosage form and quantity form and quantity restocked in restocked in automated automated dispensing device.dispensing device.
AccomplishmentsAccomplishmentsFive rural hospitals now have experienced hospital pharmacists providing 24/7 coverage.
Two more hospitals are joining the program in the next three months.
Telepharmacists have intervened in 3% of each rural hospital’s 60,000 to 100,000 annual medication orders to avoid errors.
Participating hospitals have seen improved charge capture of $50,000-100,000 / yr / facility.
All facilities are now in full compliance with Pharmacy Board regulations.
Urban/Rural Technology Value ModelUrban/Rural Technology Value ModelUrban/Rural Technology Value ModelUrban/Rural Technology Value Model
Electronic Record Availability
Telehealth Video Connection to Urban Hospital
Remote ClinicalExpertise
Rural Patient
