The North Dakota Telepharmacy Project: Restoring and Retaining Pharmacy Services in Rural Communities

Abstract

Objective: To provide a detailed description of the North Dakota Telepharmacy Project including its overall purpose, goals, and how it works, and provide valuable information and guidelines for pharmacists and rural communities on how to successfully implement a telepharmacy program designed to serve small rural communities that have lost their pharmacy services, are about to lose their pharmacy services, or have had no pharmacy services. Discussion: Ten rural communities in western, northern, and central frontier counties of North Dakota including 4 central pharmacy hub sites serving 6 remote rural telepharmacy spoke sites are described. Through use of audio, video, and computer links, North Dakota has developed a successful statewide telepharmacy program to restore and retain pharmacy services to rural communities that have lost, are about to lose, or have no pharmacy services. North Dakota currently has full-service telepharmacy sites established in the communities of Beach, New England, Maddock, Rolette, and New Town. These remote telepharmacy sites are served by licensed pharmacists in central pharmacies located in Killdeer, Rugby, and Watford City. The distance from the central pharmacy site to the remote telepharmacy site ranges from 31 to 95 miles (average ∼57). The size of the remote telepharmacies ranges from 1,200 to 2,500 square feet (average ∼1,660). The remote telepharmacies are staffed by 2–3 personnel (1 pharmacy technician, 1–2 store clerks). The remote telepharmacy sites dispense 15–55 prescriptions per day (average ∼35). Hours of service of the remote telepharmacy sites are generally 9:00 am to 5:00 pm, Monday through Friday. The remote telepharmacy communities have populations ranging from 498 to 1,367 people (average ∼799). The remote communities have a medical clinic staffed 5 days a week by either a physician, physician's assistant, or nurse practitioner. Conclusions: Through use of telepharmacy technology, pharmacy services can be restored and retained in remote rural communities satisfying all rules and regulations of the state board of pharmacy using the same processes and procedures as traditional pharmacy practice including pharmacist drug utilization review, verification before dispensing, and patient counseling. Telepharmacy services produce the same quality of pharmacy services as the traditional mode of delivery and provide additional value-added features that are not found with traditional pharmacy practice.