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`BAXTER INTERNATIONAL INC.
`
`EX. 1015
`
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`BAXTER INTERNATIONAL INC.
`EX. 1015
`
`

`

`Telepharmacy at
`Texas Tech
`
`Jon Phillips,
`Associate Director of Telemedicine
`
`001
`
`

`

`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
`
`002
`
`

`

`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)
`
`003
`
`

`

`S.B.65 continued
`
` Directs the Texas State Board of Pharmacy
`to develop rules to govern the operation of
`telepharmacy services
`
`004
`
`

`

`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
`
`005
`
`

`

`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)
`
`006
`
`

`

`Texas Tech Telepharmacy
`Pilot Project
`
`Collaborative project
` Texas Tech
` Sid Ontai – private physician
` Health Care Visions, Inc.
`
`007
`
`

`

`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
`
`008
`
`

`

`Funding
`
` USDA RUS grant to Dr. Ontai for
`equipment and operations
`
` Texas Tech for research and monitoring
`
`009
`
`

`

`Texas Tech Telemedicine
`service area
`
`010
`
`

`

`Telepharmacy service area
`
`011
`
`

`

`Project Objectives
`
`Field test telepharmacy
`Propose rule changes and improvements
`Enhance access to medications
`Training/education
`
`012
`
`

`

`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
`
`013
`
`

`

`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.
`
`014
`
`

`

`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.
`
`015
`
`

`

`Progress Report
`
`247 total prescription transactions completed as of March 31,2003
`
`New
`Refill
`
`Sept
`
`Oct
`
`Nov
`
`Dec
`
`Jan
`
`Feb March
`
`40
`35
`30
`25
`20
`15
`10
`
`05
`
`016
`
`

`

`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
`
`017
`
`

`

`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
`
`018
`
`

`

`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
`
`019
`
`

`

`First Telepharmacy Prescription
`in the State of Texas
`
`Texas Tech
`Medical Center SW
`Lubbock, Texas
`
`Turkey Medical Clinic
`Turkey, Texas
`
`September 18, 2002
`
`020
`
`

`

`PATIENT SATISFACTION
`SURVEY QUESTIONS
`
`Question # 1
`I would rather see a pharmacist on the telepharmacy system than travel
`to see him or her
`6
`
`4
`
`2
`
`0
`
`Strongly
`disagree
`Somewhat
`disagree
`No opinion
`
`Somewhat agree
`
`Strongly agree
`
`021
`
`

`

`PATIENT SATISFACTION
`SURVEY QUESTIONS
`
`QUESTION # 2
`If the Telepharmacy system were not available, I would receive my
`medicine by mail or internet pharmacy
`
`4
`3.5
`3
`2.5
`2
`1.5
`1
`0.5
`0
`
`Strongly
`disagree
`Somewhat
`disagree
`No opinion
`
`Somewhat agree
`
`Strongly agree
`
`022
`
`

`

`PATIENT SATISFACTION
`SURVEY QUESTIONS
`
`QUESTION # 3
`I felt the pharmacist counseling was not adequate because the pharmacist
`was not showing me my medicine in person
`
`5
`4.5
`4
`3.5
`3
`2.5
`2
`1.5
`1
`0.5
`0
`
`Strongly
`disagree
`Somewhat
`disagree
`No Opinion
`
`Somewhat
`agree
`Strongly
`agree
`
`023
`
`

`

`PATIENT SATISFACTION
`SURVEY QUESTIONS
`
`QUESTION # 4
`If the Telepharmacy system were NOT available, how many miles would
`you have to have travel one way to get your prescription?
`
`5
`4.5
`4
`3.5
`3
`2.5
`2
`1.5
`1
`0.5
`0
`
`Less than 20
`miles
`20 to 30 miles
`
`30 to 40 miles
`
`40 to 50 miles
`
`over 50 miles
`
`024
`
`

`

`Project status
`
` Project will continue
` Results very positive
` Sound science and technology
` Considering expansion/additional sites
`
`025
`
`

`

`Questions?
`
`Questions?
`
`026
`
`
`

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