Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55414, USA.
Am J Health Syst Pharm. 2010 Jul 1;67(13):1085-92. doi: 10.2146/ajhp090531.
Telepharmacy practices in rural hospitals in several states were examined, and relevant policies and state laws and regulations were analyzed, along with issues to be addressed as the use of telepharmacy expands.
Telepharmacy initiatives in rural hospitals were identified through a survey of the 50 state offices of rural health. Telephone interviews were conducted with board of pharmacy directors in selected states with successful telepharmacy programs. Interviews were also conducted with the individual hospitals regarding the type of telepharmacy activities, funding, and impact on medication safety. The information was analyzed to identify themes and to assess whether state laws and regulations followed recommendations by the National Association of Boards of Pharmacy (NABP) and the American Society of Health-System Pharmacists.
Although telepharmacy is addressed in NABP's model pharmacy practice act, many state boards are just beginning to address it. The model act addresses the practice of pharmacy across state lines, and the state board directors interviewed generally agreed that pharmacists should be licensed in the state where they are providing the service. States differed on whether a pharmacist should be required to be physically located in a licensed pharmacy and how much time the pharmacist should have to spend onsite. Telepharmacy models being implemented in hospitals in several states incorporate long-distance supervision of pharmacy technicians by pharmacists. The models being implemented vary according to area, state regulations, hospital ownership, and hospital size and medication order volume. Most hospitals reported that they track medication error rates, and some said error rates have improved since telepharmacy implementation.
The application of telepharmacy in rural hospitals varies across the United States but is not widespread, and many states have not defined regulations for telepharmacy in hospitals.
研究了几个州农村医院的远程药学实践，并分析了相关政策和州法律法规，以及随着远程药学的使用扩大而需要解决的问题。
通过对 50 个农村卫生州办公室的调查，确定了农村医院的远程药学计划。在有成功远程药学计划的选定州，与药剂委员会主任进行了电话访谈。还与个别医院就远程药学活动的类型、资金和对药物安全的影响进行了访谈。对这些信息进行了分析，以确定主题，并评估州法律和法规是否遵循了国家药剂师协会（NABP）和美国卫生系统药剂师协会的建议。
尽管 NABP 的模范药房实践法案中提到了远程药学，但许多州委员会才刚刚开始处理这个问题。该示范法案涉及跨州的药学实践，接受采访的州药剂委员会主任普遍认为，药剂师应在提供服务的州获得许可。各州对药剂师是否应在有执照的药房所在地和药剂师应在现场工作的时间长短存在分歧。几个州的医院正在实施的远程药学模式包括由药剂师对药剂技术员进行远程监督。正在实施的模式根据地区、州法规、医院所有权以及医院规模和药物订单量而有所不同。大多数医院报告说，他们跟踪药物错误率，有些医院表示，自实施远程药学以来，错误率有所降低。
美国农村医院远程药学的应用情况各不相同，但并不广泛，许多州尚未为医院远程药学制定法规。
