Developing a mobile pharmacist-conducted wellness clinic for rural Montana communities

Objective: To describe pharmacist-conducted disease screening services in remote communities. Setting: Frontier, rural, and nonrural counties throughout western Montana. Practice Description: Using federal telehealth funds, a motor home was converted into a mobile office and equipped with a satellite transmitting/receiving dish to provide wireless Internet access. The pharmacist uses an ultrasound unit to test heel bone density, a spirometer to test lung function, and appropriate analyzers to measure A1C and serum lipid levels. Screening clinics are held in conjunction with county health departments, tribal health authorities, community pharmacies, county agricultural extension agents, and Federally Qualified Health Centers. Employee wellness clinics are also conducted. Student pharmacists assist with screenings. Practice Innovation: Mobile pharmacist-conducted disease screening clinics in remote communities. Main Outcome Measures: Number of communities served, number of patients screened, percentage of test results out-of-range/patients referred to their primary health care providers for follow-up, number of student pharmacists participating, and total revenues generated. Results: During the first 2 years of the project, IPHARM pharmacists traveled approximately 14,000 miles, conducted 72 clinics in 17 counties and performed 5,100 screening tests for more than 3,100 people. Approximately 36% of all screening test results were outside of expected range. More than 80 student pharmacists, most of whom were on clinical rotations, participated in the clinics and 11 community pharmacists have been trained to conduct screenings. In excess of $70,000 was generated by the project in operating revenue and donations. At the conclusion of IPHARM's first year of operations, the motor home was taken out of service because of the cost of gasoline, difficulties of winter travel with such a large vehicle, and the realization that virtually all host organizations were able to provide space in which the screening clinics could be conducted. Conclusion: Pharmacists and student pharmacists are capable of providing disease screening services in remote frontier and rural communities. Obtaining sufficient payment for these services in rural communities to cover costs remains a challenge.