El Rio Health Center (El Rio) was established in 1969 and incorporated as a private, non-profit health center in 1973. El Rio provides community-based primary health care services to all residents of Pima County with a special emphasis on the underserved, and is the largest provider of medical services to the uninsured and Medicaid populations in Pima County. The pharmacy department provides patients with five in-house pharmacy locations. Our pharmacy practice software system allows patients to visit any El Rio pharmacy location to fill their eligible prescriptions. The pharmacy department provides service to over 72,000 patients, filling approximately 380,000 pre­­­­scrip­tions per year. In addition, we offer various drug discount and compassionate care programs.

Finding the Best System for Our Patients
The majority of our patients are women, children, young families, and the elderly. For these special population groups, transportation to and from a community pharmacy often presents a significant challenge. Since we wanted to be able to reach these patients more efficiently, we decided to review the available telepharmacy systems with the aim of making our prescription medications available at our El Pueblo satellite clinic site. We determined that a telepharmacy system would improve prescription pickup adherence, patient safety, and ultimately, disease outcomes.

We performed due diligence on three possible telepharmacy systems, and our pharmacy and IT director ultimately decided on ScriptPro’s system. The ScriptPro system robot prepacks tablets and capsules into bar coded containers, which are then sent to the El Pueblo clinic for filling prescriptions. The clinic electronically transmits prescription orders to El Rio pharmacists who screen, approve, and release them back to the clinic for filling. Pharmacy technicians at the clinic use ScriptPro telepharmacy scanning stations to select prefilled containers and packaged items (e.g., inhalers and creams) and label them with instructions for patient use. As a safety check, the technicians capture electronic images of the tablets, capsules, container, and label and send them to El Rio pharmacists for approval. Every El Pueblo telepharmacy patient is counseled by a pharmacist through a video link integrated into the telepharmacy system.

Adopting the Telepharmacy System
After putting the system in place, our staffing model did require some adjustment. For every shift, specific pharmacists and technicians were assigned to the telepharmacy responsibility. While the telepharmacy process did not change our practice, per say, it did improve our ability to serve patients who have access-to-care challenges. We can now provide pharmacy services remotely to our patients, whereas prior to implementing the ScriptPro system, we could not provide traditional pharmacy services at the El Pueblo clinic.

Using the Telepharmacy System
The ScriptPro telepharmacy service did not change our process of drug preparation and verification, nor did it particularly affect any other pharmacy workflow, so it was fairly easy to implement from a practice standpoint. In order to use the system, we did need to perform some remodeling to the remote site to be in compliance with the Arizona Board of Pharmacy rules and regulations.

Since its inception, we have been using the system to train our technician staff on proper telepharmacy practices. Thus far, the system has been received positively by staff including pharmacists, technicians, and nursing. Most important, we have received positive feedback from our patients and are realizing an increase in prescription pickup compliance.

Financial Impact
While purchasing and implementing the ScriptPro system has resulted in a greater monthly expense for telepharmacy services, we anticipate a break-even point being obtained as use of the service continues to increase.

Tony Felix, RPh, is the pharmacy director of El Rio Health Center in Tucson, Arizona.

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