Do remote community telepharmacies have higher medication error rates than traditional community pharmacies? Evidence from the North Dakota Telepharmacy Project.

OBJECTIVE To evaluate the differences in medication dispensing errors between remote telepharmacy sites (pharmacist not physically present) and standard community pharmacy sites (pharmacist physically present and no telepharmacy technology; comparison group). DESIGN Pilot, cross-sectional, comparison study. SETTING North Dakota from January 2005 to September 2008. PARTICIPANTS Pharmacy staff at 14 remote telepharmacy sites and 8 comparison community pharmacies. INTERVENTION The Pharmacy Quality Commitment (PQC) reporting system was incorporated into the North Dakota Telepharmacy Project. A session was conducted to train pharmacists and technicians on use of the PQC system. A quality-related event (QRE) was defined as either a near miss (i.e., mistake caught before reaching patient; pharmacy discovery), or an error (i.e., mistake discovered after patient received medication; patient discovery). MAIN OUTCOME MEASURE QREs for prescriptions. RESULTS During a 45-month period, the remote telepharmacy group reported 47,078 prescriptions and 631 QREs compared with 123,346 prescriptions and 1,002 QREs in the standard pharmacy group. Results for near misses (pharmacy discovery) and errors (patient discovery) for the remote and comparison sites were 553 and 887 and 78 and 125, respectively. Percentage of "where the mistake was caught" (i.e., pharmacist check) for the remote and comparison sites were 58% and 69%, respectively. CONCLUSION This study reported a lower overall rate (1.0%) and a slight difference in medication dispensing error rates between remote telepharmacy sites (1.3%) and comparison sites (0.8%). Both rates are comparable with nationally reported levels (1.7% error rate for 50 pharmacies).