Rex W. Force, PharmD,
Jessica N Vickers, PharmD,
Autumn Hayes, PharmD.
Department of Pharmacy Practice, College of Pharmacy, Idaho State University
Telepharmacy is a viable option for rural communities lacking traditional community pharmacy (TCP) service. Error rates in telepharmacy may differ from TCP. To evaluate this, we developed a reporting system to document error rates in telepharmacy and compared them with literature-based rates in TCP and established telepharmacies.
A single telepharmacy operated by pharmacy technicians located approximately 85 miles from the coordinating pharmacy
A data collection system was created to identify types and workflow locations of quality-related events (QRE) and true errors. QRE included errors that occurred at any point up to the patientâ€™s receipt of the prescription. True errors were defined as those discovered after patient receipt of the medication. Data collection was based on non-punitive self-report; pharmacy staff were educated on the process. Errors were categorized based on harm potential. Statistical process control charts were developed to track error rates and QRE over time. Comparisons will be made with literature-based estimates of error rates in TCP and telepharmacy settings.
The data collection period was 10/13/14-3/20/15. During this period, 175 QRE were recorded in 15,690 prescriptions (1.12%); 11 true errors occurred (0.070%). Published error rates in telepharmacies for QRE and true errors were 1.34% and 0.17%, respectively. In TCP, true error rates reported in the literature range from about 0.5 – 4%. Of the QRE and true errors in this project, 52.0% were unlikely to cause harm, 13.71% were possibly harmful, and 34.29% were likely to cause harm. Statistical process control charts have indicated a stable process over the study period.
Based on these data, the QRE and true error rates observed in this telepharmacy setting are comparable to those reported in the literature in other telepharmacy projects and are lower than many studies evaluating true errors in TCP.