June 2009

ePharmacist Direct Provides 24-Hour Service to North Dakota Hospitals


In rural areas of North Dakota, there is an acute need for pharmacy services. The state's 39 rural acute care hospitals typically do not have a registered pharmacist onsite 24 hours a day. In some cases, coverage is provided by retail pharmacists who are not always trained in the demands of acute care.

CHI's ePharmacist Direct program gives these hospitals 24-hour access to the services of licensed clinical pharmacists. Three hospitals are already using the new service.

ePharmacist Direct helps hospitals expand pharmacy coverage while easing the on-call burden on their own pharmacists. A dedicated workstation and camera installed in each hospital lets physicians, nurses, pharmacy technicians and patients to connect and consult with a licensed clinical pharmacist any time of day or night. This enhances the availability and safety of the medications patients need. "Like physicians and nurses, pharmacists provide a unique perspective and another 'safety check' on the medication administration process," said Tricia Killingsworth, director of pharmacy clinical services.

ePharmacist Direct is an extension of the North Dakota Telepharmacy Project, which first linked hospitals and remote pharmacists by computer in 2004. ePharmacist Direct has taken the concept further by establishing a central hub in Fargo, ND; standardizing the technology used to connect the hub with hospital sites; planned expansion to 24-hour service; and staffing the service with clinically trained pharmacists. The initiative is partially funded by a grant that the Department of Health and Human Services awarded to North Dakota State University, which is partnering with CHI in developing the telepharmacy service.

Currently, three CHI hospitals and one additional hospital in North Dakota are connected to ePharmacist Direct: Lisbon Area Health Services, Lisbon; Mercy Hospital, Devils Lake; St. Joseph Hospital and Health Center, Dickinson; and Cavalier Memorial Hospital, Langdon. All of CHI's North Dakota and Minnesota hospitals will be connected to the service within the next two years.

This is how ePharmacist Direct works:

  1. Patient sees physician
  2. Physician writes a medication order
  3. Nurse or pharmacy technician takes the order to the ePharmacist Direct workstation, scans it and sends it electronically to the central pharmacy
  4. Pharmacist reviews and verifies the order, including a review of the "5 Rights" (right patient, drug, dose, route and time)
  5. Pharmacist consults with the nurse, pharmacy technician and physician as needed
  6. Nurse or pharmacy technician obtains the medication from hospital supply and prepares it under the observation of the pharmacist
  7. Pharmacist visually confirms that the medication is prepared according to the medication order and safe practices
  8. Nurse administers medication to patient
  9. Pharmacist counsels patient as needed


The ePharmacist Direct program provides training for hospital pharmacy technicians and nurses who will use the system to fulfill some pharmacy technician functions. For more information, contact Shelley Johnsen, director of ePharmacist Direct, shelleyjohnsen@catholichealth.net.