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Rural Inpatient Telepharmacy Consultation Demonstration for After-Hours Medication Review

Stacey L. Cole, John H. Grubbs, Cathy Din, and Thomas S. Nesbitt

A pilot project shows that medication order review by remote pharmacists — dubbed "telepharmacy" — offers a viable solution for rural hospitals that lack night and weekend coverage.

A national shortage of pharmacists, low patient volumes, and limited resources hinder rural hospitals' ability to maintain even full-time pharmacy staffing, let alone during extended hours. At the same time, recent studies have begun to identify the clinical, financial, and demographic constraints that predispose rural facilities to higher rates of medication errors.

Computer-based prescribing systems that address staffing shortages and help reduce medication errors in large urban hospitals are beyond the reach of most rural hospitals. Telepharmacy has been proposed as a practical, cost-effective alternative. To test the utility of remote verification by telepharmacy of medication orders and dispensing, UC Davis Health System conducted a one-year demonstration project with six independent rural hospitals in Northern California.

This unique pilot, focused exclusively on after-hours pharmacy services, resulted in fewer medication errors:

  • The study reviewed 2,378 medication orders and identified 97 errors.
  • Over 19% of patients enrolled in the pilot were saved from a medication error.

The project, sponsored by CHCF, shows that telepharmacy is an effective means of providing pharmacy support to rural hospitals despite implementation challenges related to staffing, technological sophistication, and system compatibility. Furthermore, telepharmacy may be especially useful from 5:00 PM to 7:00 AM and on weekends.

The complete article is available free of charge from the Telemedicine and e-Health site through the External Link below.

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