Using Technology to Expand Services: IMPLEMENTATION OF THE SYSTEM

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29 Apr 2010

IMPLEMENTATION OF THE SYSTEMThundermist began to implement the satellite distribution system by seeking the state’s approval for remote dispensing of pharmaceuticals. One major challenge was the licensure of the remote dispensing system through the Department of Health’s Board of Pharmacy. The Board members were concerned about the newness of the technology and the security of the system, wondering who would be releasing the medication at the remote facility. Because of a lack of experience withthis technology, few statutes and regulations applied to remote dispensing. This impediment resulted in a five-month delay. The Board of Pharmacy eventually granted approval with a one-year probationary period.

Another problem involved staffing. As a result of the regulations imposed by the Board of Pharmacy, an employee releasing medication at a remote site had to become a “licensed pharmacy technician in training” under the direct supervision of the pharmacist in charge—in this case, the Director of Pharmacy. Although the system itself is user-friendly, finding the opportunity to properly train these employees as technicians was difficult and time-consuming, because many of them had no previous pharmacy experience.

Adhering to the requirement to repackage medications was challenging. The manufacturer of the dispensing units recommended that the drugs be prepackaged before their insertion. The pharmaceuticals were ordered and shipped to the pharmacy, where the pharmacist verified and repacked all medications. The medications were then shipped for repacking in the dispensing units, creating an additional three-week turnaround time.

Table 2   Satellite Distribution System Dispensing









June 2004





July 2004





August 2004





September 2004





October 2004





November 2004





December 2004










Equipment was installed in the state’s southern sector at the end of May 2004, and operations began during the first week of June. Equipment was installed in the central site of the state during the second week of June and in the northern location of the state in the first week ofJuly. Table 2 describes customer usage of the satellite distribution system. kamagra jelly uk

Limited promotion accompanied the introduction of the remote dispensing units at the satellite locations. Internal memos were distributed to the medical staff members who were responsible for writing prescriptions, and other personnel were informed of the expanded services. After the new system was implemented, several local newspapers featured articles based on news releases that described the technology.


After reviewing the performance of the satellite dispensing system, the CEO and the Director of Pharmacy Operations became concerned that penetration into the market was not as extensive as they had initially hoped. To increase penetration, particularly among low-income, uninsured clients, they are considering adopting an aggressive promotional campaign. Instrumental to this campaign is the need to address concerns about which promotional outlets would be most appropriate to reach the underserved market they are targeting. However, some staff members are concerned about the ethics of medical advertising and they have questioned spending what is perceived as scarce resources on advertising and other promotional activities. These personnel have pointed out that their patients are primarily undereducated, live in low-income housing, and are not readers of many traditional advertising media, including major newspapers.
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Another more immediate concern is the imminent loss of the temporary license granted by the Licensing Board. A condition of the temporary license was documentation of the security and safety of the dispensing system. In particular, the Licensing Board wanted to ensure that patients received the proper medication. The CEO and the Director of Pharmacy Operations were uncertain as to what information they could give the
Licensing Board that would address their security concerns.

To date, no patients have complained about not receiving their medications, and the system has indicated that no prescriptions are missing. The executives do not wish to conduct an entire system audit, because this would require the system to be shut down for two to three days—a step that would possibly cost thousands of dollars. They are sure, however, that the Licensing Board will question the use of “licensed pharmacy technicians in training.”

Thundermist is also considering the option of expanding the network into other underserved areas of Rhode Island and into neighboring states. However, before any resources can be allocated to either program, the Board of Directors must grant approval. The CEO and the Director of Pharmacy Operations are contemplating how to assure the Board of Directors that the current program is working; however, they hope to learn why more patients are not using the satellite system. buy levitra uk

During the last two quarters of 2004, more than 9,500 prescriptions were filled in the health center’s pharmacy, yet only 778 prescriptions were filled in the satellite system. Was this just a case of slow adoption, or were there more fundamental issues surrounding patients’ acceptance of remote dispensing units? Before the Thundermist executives go back to the Board of Directors, these questions must be answered.

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