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BRIAN C. O’NEAL, M.S., PHARMD., is Assistant Director of Pharmacy,. University of Kansas Hospital (UKH), Kansas City. JOHN C. WORDEN, M.S., PHARM.D., is Director of Pharmacy, Memorial Hospital, McPherson, KS; at the time of this study he was Pharmacy Practice Management Resident, UKH. RICK J. COULDRY, M.S., B.S., is Director of Pharmacy, UKH.

Address correspondence to Dr. O’Neal at the Department of Pharmacy, University of Kansas Hospital, 3901 Rainbow Boulevard, Kansas City, KS 66160.

Purpose. A program using telepharmacy and bar-code technology to increase the presence of the pharmacist at a critical risk point during chemotherapy preparation is described. Summary. Telepharmacy hardware and software were acquired, and an inspection camera was placed in a biological safety cabinet to allow the pharmacy technician to take digital photographs at various stages of the chemotherapy preparation process. Once the pharmacist checks the medication vials’ agreement with the work label, the technician takes the product into the biological safety cabinet, where the appropriate patient is selected from the pending work list, a queue of patient orders sent from the pharmacy information system. The technician then scans the bar code on the vial. Assuming the bar code matches, the technician photographs the work label, vials, diluents and fluids to be used, and the syringe (before injecting the contents into the bag) along with the vial. The pharmacist views all images as a part of the final product-checking process. This process allows the pharmacist to verify that the correct quantity of medication was transferred from the primary source to a secondary container without being physically present at the time of transfer. Conclusion. Telepharmacy and bar coding provide a means to improve the accuracy of chemotherapy preparation by decreasing the likelihood of using the incorrect product or quantity of drug. The system facilitates the reading of small product labels and removes the need for a pharmacist to handle contaminated syringes and vials when checking the final product. Index terms: Antineoplastic agents; Codes; Compounding; Computers; Personnel, pharmacy; Pharmacists; Pharmacy, institutional, hospital; Quality assurance; Technology; Telepharmacy