1. Telepharmacy at Texas Tech
Jon Phillips,
Associate Director of Telemedicine

2. 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

3. 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)
Bullet 2—If the telepharmacy system is in the community first, and a Class A or C pharmacy locates there, then the telepharmacy system may continue to operate in that community.

4. S.B.65 continued
Directs the Texas State Board of Pharmacy to develop rules to govern the operation of telepharmacy services

5. 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

6. 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)

7. Texas Tech Telepharmacy Pilot Project
Collaborative project
Texas Tech
Sid Ontai – private physician
Health Care Visions, Inc.

8. 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

9. Funding USDA RUS grant to Dr. Ontai for equipment and operations
Texas Tech for research and monitoring

10. Texas Tech Telemedicine service area

11. Telepharmacy service area

12. Project Objectives Field test telepharmacy
Propose rule changes and improvements
Enhance access to medications
Training/education

13. Project information
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

14. 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.

15. 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.

16. Progress Report
247 total prescription transactions completed as of March 31,2003

17. 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

18. 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

19. 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 Tracking
Patient Compliance Reporting

20. First Telepharmacy Prescription in the State of Texas
Texas Tech Medical Center SW
Lubbock, Texas
Turkey Medical Clinic
Turkey, Texas
September 18, 2002

21. PATIENT SATISFACTION SURVEY QUESTIONS
I would rather see a pharmacist on the telepharmacy system than travel to see him or her

22. PATIENT SATISFACTION SURVEY QUESTIONS
If the Telepharmacy system were not available, I would receive my medicine by mail or internet pharmacy

23. PATIENT SATISFACTION SURVEY QUESTIONS
I felt the pharmacist counseling was not adequate because the pharmacist was not showing me my medicine in person

24. PATIENT SATISFACTION SURVEY QUESTIONS
If the Telepharmacy system were NOT available, how many miles would you have to have travel one way to get your prescription?

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

26. Questions?