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An ATM for Pills 

by Pia K. Hansen


An innovative program that makes it easier to distribute medication to underserved areas is running smoothly in the Inland Northwest and may be extended if funding can be secured.


The Community Health Association of Spokane (CHAS) operates four medical clinics in Spokane and one in Ione, Wash. Together with Dennis Clifton, professor of pharmacy practice at Washington State University, CHAS has developed a Telepharmacy that makes it possible for pharmacy technicians to fill prescriptions from a remote location.


Here's how it works: a client shows up at one of the clinics with a prescription, which is then faxed to the central CHAS pharmacy in the Valley. There, the prescription is entered into a computer, a label is generated and the pharmacists there verify its accuracy. Once everything is checked, the message is transferred via the Internet to the remote pharmacy, where the medication is dispensed from a machine. At this point, the label and prescription is verified one more time, and the personnel at the remote site sets up a video conference with the pharmacist at the Valley location. Via the video camera, the pharmacist checks that the seal on the bottle isn't broken and that the right label has gone on the correct medication. The patient receiving the medication is also given any necessary directions and counseling at this point, by the pharmacist.


"Since we began doing this, we have processed more than 23,000 prescriptions," says Clifton. He adds that from his perspective the program has been so hugely successful because of the cooperation between CHAS and WSU.


"It was my idea, and Deborah Haberman who worked here in the college of pharmacy, was in on the idea, too," says Clifton. "I had seen the equipment at a meeting, and we started thinking about what we could do with it here." He took the proposal to the Office of Pharmacy Affairs -- which is part of the Department of Health and Human Services -- in Bethesda, Mary.


"They were already looking for innovative things, with the primary purpose to promote access to the low-cost medication that's made available to the government via what's called the 340B program," says Clifton. "We were one of very few projects that got the necessary grants."


Not only does the Telepharmacy program make it easier to distribute the most widely used medications, it also serves a social purpose.


"Many of the clients we serve at the clinics are low-income people who have a hard time getting their prescriptions filled," says Clifton. "Even if it's not totally free medication we distribute, we are still helping people who really need it to gain access to medication it can be hard for them to get otherwise."


Two surveys conducted in February and April of this year show that 65 percent of all the clients served said they likely would not have been able to get their prescription filled if it wasn't for the CHAS Telepharmacy. About 87 percent said they would have a hard time affording the medication altogether if it wasn't for CHAS, and the clients surveyed indicated a very high satisfaction with the pharmacy services.


"From my perspective, in the college of pharmacy, the Telepharmacy has been a great partnership between us and CHAS," says Clifton. Pharmacy students have also been able to gain on-the-job training at the clinic sites.


Is it going to continue?


"Well, we have funding for this year, but that is the last year," says Clifton. "The program is designed to be self-sufficient with the first grant we got mainly going to help us get started and purchase equipment and such. I'm not sure about all the inside things that go into establishing the ongoing funding, but I know CHAS is working on it."


There are a few challenges to keep the funding together, but Clifton is optimistic: "We are serving a higher number of uninsured patients than we expected. It's definitely one of those programs where everyone who's worked with it has been really excited about it."
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