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`Internet Archive
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`AFFIDAVIT OF CHRISTOPHER BUTLER
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`may be_setsuch.thata pr_intout._fr-om-_it-will
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`DATE: (cid:9)
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`[ i
`
`Christopher Butler
`
`001
`
`

`

`CALIFORNIA JURAT
`
`See Attached Document.
`
`State of California
`County of San Francisco
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`6 Y day of !h a r cl1 (cid:9)
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`, (cid:9)
`
`, by
`
`Christopher Butler,
`
`proved to me on the basis of satisfactory
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`See (cid:9)
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`a c.". A
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`002
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`

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`A notary public or other officer completing this
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`State of California
`County of San Francisco
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`Subscribed and sworn to (or affirmed) before me on this
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`day of
`r..r
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`(cid:9)
`

`

`Exhibit A
`Exhibit A
`
`004
`
`004
`
`

`

`https://web.archive.org/web/20040509162423/http:/www.ttuhsc.edu/telemedici
`ne/Powerpoint/Telepharmacy%2Opresentation%2042503.ppt
`
`005
`
`

`

`Telepharmacy at
`Texas Tech
`
`Jon Phillips,
`Associate Director of Telem ~dicine
`
`006
`
`

`

`Senate Bill 65—Legislation
`Enabling Telepharmacy
`• A "telepharmacy system" means a
`system that monitors the dispensing
`prescription drugs and provides for
`related drug use review and patient
`counseling services by an electronic
`method, including the use bf these
`technologies
`Audio and video
`Still image capture
`Store and forward
`
`of
`
`007
`
`

`

`• y~
`
`ll-
`
`n 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)
`
`008
`
`

`

`+feR!{FTC ~
`
`Directs the Texas State Board of Pharmacy
`to develop rules to govern the operation of
`telepharmacy services
`
`009
`
`

`

`Remote pharmacy services storage &
`dispensing of prescription dregs, drug regimen
`review, and patient counseling at a remote site
`n Sites eligible for remote pharmacy services
`Rural health care clinic
`Health care center
`Health care facility located in a medically underserved
`area
`
`010
`
`

`

`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)
`
`011
`
`

`

`Collaborative project
`• Texas Tech
`• Sid Ontai —private physician
`• Health Care Visions, Inc.
`
`012
`
`

`

`m
`
`• Pharmaceutical Care Center at Texas Tech
`Medical Center Southwest (T1TMCSW) 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
`
`013
`
`

`

`Funding
`
`USDA RUS grant to Dr. Ontai for
`equipment and operations
`
`• Texas Tech for research and monitoring
`
`014
`
`

`

`Texas Tech Telemedicine
`service area
`
`Texas Tech Telemedicine !
`Service Area
`
`i a
`
`•
`
`(cid:9) Tech
`
`Health
`Health ~~ Go
`Lubbock, Texas
`
`7
`
`rte _.•./` ~ ` i ...4- • ~ . .uy.. ~ n
`
`J
`
`• e . ~ (cid:9)
`777 (cid:9)
`
`~ l tT
`Y (cid:9)
`
`l~'~..r=w (cid:9)
`~ c c (cid:9)
`
`a
`
`^ (cid:9)
`
`.uvw
`
`015
`
`(cid:9)
`(cid:9)
`

`

`iii.
`
`il ! Telepharmacy service are]
`
`016
`
`

`

`1Zil
`
`~~
`
`n Field test telepharmacy
`.Propose rule changes and improvements
`•Enhance access to medications
`n Training/education
`
`017
`
`

`

`Project information
`
`• The Turkey Telepharmacy site site i 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 Infuslion Center.
`• To conform to security standards, medications at the
`the Turkey Telepharmacy site are sthred in approved,
`secured medication blister packs
`
`018
`
`

`

`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.
`
`019
`
`

`

`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.'
`
`020
`
`

`

`Progress Report
`
`247 total prescription transactions completed as of March 31,2003
`
`40
`
`35
`
`30
`
`25
`
`20
`
`15
`
`10
`
`5
`
`0
`
`n New
`0 Refill
`
`Sept (cid:9)
`
`Oct (cid:9)
`
`Nov (cid:9)
`
`Dec (cid:9)
`
`Jan (cid:9)
`
`Feb March
`
`021
`
`

`

`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
`
`022
`
`

`

`iiiiti;
`
`Uses store and forward technology
`
`Review episodes from you home, offi e, 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
`
`023
`
`

`

`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
`
`024
`
`

`

`A
`
`.,
`
`Texas
`Medical Center SW
`Lubbock. Texas
`
`Turkey Medical Clinic
`Turkey, Texas
`
`025
`
`

`

`PATIENT SATISFACTION
`SURVEY QUESTIONS
`
`Question # 1
`I would rather see a pharmacist on the telepharmacy system than travel
`to see him or her
`
`• Strongly
`disagree
`• Somewhat
`disagree
`• No opinion
`
`• Somewhat agree
`
`• Strongly agree
`
`026
`
`

`

`PATIENT SATISFACTION
`SURVEY QUESTIONS
`
`QUESTION # 2
`If the Telepharmacy system were not available, I would receive my
`medicine by mail or internet pharmacy
`
`• Strongly
`disagree
`• Somewhat
`disagree
`• No opinion
`
`• Somewhat agree
`
`• Strongly agree
`
`027
`
`

`

`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
`
`• Strongly
`disagree
`• Somewhat
`disagree
`No Opinion
`
`• Somewhat
`agree
`• Strongly
`agree
`
`028
`
`

`

`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?
`
`• Less than 20
`miles
`• 20 to 30 miles
`
`• 30 to 40 miles
`
`• 40 to 50 miles
`
`• over 50 miles
`
`029
`
`

`

`n Project will continue
`• Results very positive
`• Sound science and technology
`• Considering expansion/additional sites
`
`030
`
`

`

`
`
`
`
`Questions?
`
`031
`
`031
`
`