title: Rural inpatient telepharmacy consultation demonstration for after-hours medication review.
abstract: OBJECTIVE
  Medication errors contribute to a significant number of fatal and nonfatal adverse medical events each year. Many actions, from both a policy and innovation standpoint, have been taken to reduce medication errors in the inpatient setting; yet, these actions often target larger urban hospitals. Rural hospitals face many more challenges in implementing these changes due to fewer resources and lower patient volumes. Our article discusses the implementation and results of a telepharmacy demonstration implemented between the University of California Davis Health System and six rural hospitals.
  
  
  METHODS
  A retrospective chart review obtained baseline medication errors for comparison with the prospective review of medication orders through telepharmacy. Medication orders from rural hospitals were transmitted via fax to the University of California Davis Pharmacy for after-hours review. If a medication required after-hours removal from the pharmacy, it was requested that video verification by a telepharmacist be used to verify that the correct medication was removed from the pharmacy.
  
  
  RESULTS
  Baseline findings from the retrospective chart review indicated that 30.0% of patients had one or more medication errors and that these errors occurred in 7.2% of the medication orders. None of these errors were found to have resulted in harm to the patients. During the telepharmacy demonstration, 2,378 medication orders were screened from 504 independent order review requests. In total, 58 (19.2%) patients had one or more medication errors. The errors from the telepharmacy demonstration represented potential errors that were identified through telepharmacy medication review.
  
  
  CONCLUSIONS
  Telepharmacy represents a potential alternative to around-the-clock on-site pharmacist medication review for rural hospitals.
authors: University of Utah School of Medicine, Salt Lake City, Utah 84132-2101, USA. slcole@ucdavis.edu
authors: Stacey L
authors: SL
authors: Cole
authors: John H
authors: JH
authors: Grubbs
authors: Cathy
authors: C
authors: Din
authors: Thomas S
authors: TS
authors: Nesbitt
mesh_terms: D039602:After-Hours Care; D002140:California; D003157:Community Pharmacy Services; D006801:Humans; D008485:Medical Audit; D008508:Medication Errors / Q000517:prevention & control; D059065:Medication Reconciliation / Q000379:methods*; D019114:Remote Consultation; D012189:Retrospective Studies; D019035:Rural Health Services