Is telepharmacy coming to a town near you?

"Telepharmacy has had a positive impact by serving communities that have not had access to a pharmacy for years," said Carmen Catizone, executive director of the National Association of Boards of Pharmacy.

With the dawn of the Internet and easy-to-use videoconferencing technology, telepharmacy has become more than just science fiction. In less than a decade, 16 states have enacted rules that allow telepharmacy; no state prohibits the practice. And more states are considering new regulations.

The technology first took off in North Dakota, where there were no pharmacies to be found. Today, it's no longer limited to isolated communities. Telepharmacy has expanded into urban medical clinics that serve low-income patients. The VA is using the technology as it expands its community-based clinics around the country, and even one pharmacy school-Texas Tech University in Amarillo-requires fourth-year students to complete a rural pharmacy experience using telepharmacy.

"There's definitely a need in rural areas to provide immediate pharmacy services to people who do not have access to pharmacists," said Justin Sherman, Pharm.D., associate professor of pharmacy practice at the University of Louisiana at Monroe College of Pharmacy. "It can be used in the retail and hospital settings, but it seems to be more common in hospital settings where they are facing shortages of pharmacists."

For more than two years, there was an opening for a pharmacist at a VA clinic in Monroe, La., where Sherman works part time. Before the position was filled, the clinic decided to install a telepharmacy system that was supervised by a pharmacist in a much larger VA clinic. "It worked really well because we had trained nurses on site and then our pharmacist provided counseling," said Sherman.

Pros and cons

The live video consultations that telepharmacy offers is one of its major benefits, added Sherman. A televised face-to-face visit with a pharmacist is better than merely receiving the medication in the mail, he believes.

In addition to the video consultation, another advantage is that prescriptions are filled immediately so patients are going home with their drugs, explained Scott Tague with AmerisourceBergen Technology Group, which makes the ADDS telepharmacy system.

"Receiving prescriptions at the point of care helps patients comply with their medications," he said.

In some VA centers, the ADDS system is directly linked to the VA mail-order system. When the initial prescription is filled, an electronic order for three additional months of drugs is processed and mailed to the patient's home within 10 days.

In addition to the cabinetry and software, there are additional costs including computers, phone lines/DSL, firewalls, and videoconferencing equipment, not to mention the cost of a technician and drug inventory. The North Dakota Telepharmacy Project has outlined many of the factors to consider for adopting telepharmacy for both retail and hospital settings.

Despite the long list of expenses, investing in tele-pharmacy is more cost effective than opening a brick and mortar pharmacy. One study found that the cost of a technician and equipment is about 15% compared with opening a new store.