What is Telepharmacy?

Defined simply, telepharmacy is the provision of pharmacy services at a distance. While used in countless ways across various pharmacy practice settings, the most relevant example to NuCara is telepharmacy in a community pharmacy practice.

As a leader in rural health care, telepharmacy is a natural fit to NuCara. We currently own and operate three telepharmacy sites and are providing the verification and counseling services for an additional four sites in Illinois. A telepharmacy operates just like a traditional community pharmacy, however the pharmacist verifies the prescriptions and counsels the patient through the use of technology. Patients will receive the same level of service at a NuCara telepharmacy as they do at any other NuCara Pharmacy.


Zearing, home to NuCara’s first pilot telepharmacy location in Iowa.

NuCara first entered the world of telepharmacy in 2013 with the opening of the second telepharmacy pilot in the state of Iowa in Zearing. Since then, we have welcomed Enderlin, North Dakota, to the NuCara family as well as a second Iowa pilot site in State Center.

With the recent legislation signed by Iowa Governor Branstad, we expect more telepharmacy services to be in our future. We have gathered excellent patient safety and have been working to provide additional pharmacist-provided clinical services such as immunizations and MTM into our telepharmacy sites.

Additionally, we are very excited about the “hybrid” telepharmacy model, which we define as having a pharmacist on site at least one day each week. This allows the efficiency of a telepharmacy, while providing regular access to an on-site pharmacist. NuCara has also used the same technology to provide quick and easy assess to other specialists, like respiratory therapists, to our patients in rural areas. As technology evolves, NuCara continues to be a pioneer in how to best serve our patients through innovation.


Current Issues in Health Care: Diabetic Shoe fitting

womensshoeAs our healthcare system continues to evolve, pharmacy as it is practiced today is changing, and hopefully for the better. Here is the last of four topics hat are in the “hot seat” as we round up the first half of 2014:


Pharmacies around the state of Iowa pride themselves as being able to provide more than just prescription and over-the-counter medications. One of these services is the fitting and selling of therapeutic shoes. These are most often for diabetic patients suffering from neuropathy (continual loss of sensation) in their feet. Approximately three months ago, Iowa pharmacies were informed that, starting on July 1st of 2014, it was no longer within their legal means to help patients find the right shoe and minimize their discomfort 7.

Current Standing

After receiving this news, the Iowa Pharmacy Association immediately went to work to resolve this issue. To allow pharmacists to keep providing useful assistance to their patients, IPA met with the Iowa Board of Pharmacy and Attorney General’s Office, other accrediting organizations, and even shoe manufacturers. The IPA’s proactive response led to the Iowa Board of Podiatry and Board of Pharmacy writing a total of eight letters to accrediting organizations and the Centers for Medicare and Medicaid Services (CMS). Within the three months of lobbying, it was determined Iowa pharmacies will be able to continue therapeutic shoe fitting 7.

How are YOU, the patient, affected?

Continuing this service will allow pharmacists to help patients achieve these four objectives in shoe fitting as laid out by the American Orthopedic Foot and Ankle Society: (1) relieve areas of excessive pressure, (2) reduce shock and shear, (3) accommodate, stabilize, and support deformities, and (4) limit the motion of joints to decrease inflammation 8. If you have questions or concerns about diabetic neuropathy, ask your local pharmacist today. Therapeutic shoe fitting is also provided at the majority of NuCara stores.

References for all four topics:

1. http://www.ashp.org/DocLibrary/Advocacy/HR-4190.pdf
2. As of June 20th, 2014 on https://beta.congress.gov/bill/113th-congress/house-bill/4190
3. http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror
4. https://beta.congress.gov/bill/113th-congress/house-bill/4577?q=%7B%22search%22%3A%5B%22hr4577%22%5D%7D
5. http://thehill.com/opinion/letters/191831-preferred-pharmacy-networks-limit-choices
6. http://www.iarx.org/documents/Jun%2013_NPM%20Press%20Release%20June%202014.pdf).
7. Letter from CEO of IPA Kate Gainer on June 19th, 2014. Further questions or requests for information can be emailed to ipa@iarx.org.
8. http://www.aofas.org/footcaremd/conditions/diabetic-foot/Pages/Shoes-and-Orthotics-for-Diabetics.aspx


Current Issues in Health Care: Ensuring Seniors Access to Local Pharmacies

Couple Enjoying A Game Of GolfAs our healthcare system continues to evolve, pharmacy as it is practiced today is changing, and hopefully for the better. Here is the second of four topics (the first two being current legislation) that are in the “hot seat” as we round up the first half of 2014:

H.R. – 4577: Ensuring Seniors Access to Local Pharmacies


Similar to HR 4190, this legislation would amend the Social Security Act. It also focuses on the same Medicare beneficiary groups as follows: Medically Under-served Areas, Medically Under-served Populations, and Health Professional Shortage Areas. However, the bill is written to affect Part D of Medicare, or the part that is most often used in the pharmacy. Under the law, insurance plans would be required to offer preferred network benefits to pharmacies in the previously defined regions.

Current Standing

Although only introduced in last month, this legislation is also picking up steam and already has bipartisan support from 31 congressional representatives 4. Community pharmacies not in a preferred network currently have to either charge patients more for medications and/or net a loss from providing expected, quality care. An article from late 2013 suggested that there are approximately 1,800 pharmacies that are the only provider in their community. Also astounding is the fact that 91% of all community pharmacy owners and operators were non-preferred; on average, these patients then have to travel 20 miles to a pharmacy that can provide savings promised by their insurance plans 5.

How are YOU, the patient, affected?

Similar to H.R. 4190, patients across the country, including all five states where NuCara practices pharmacy, would benefit from increased access to affordable health care. The choice of where to pick up medications or seek health services should be left up to YOU, the patient, not an insurance plan! The restrictions this legislation absorbs directly improve the chances that your local pharmacy and trusted pharmacist will continue to provide exceptional health services and keep their doors open.

Current Issues in Health Care: Change to Benefit Patients and Pharmacists – A Four Part Series

US Constitution And Scales Of JusticeAs our healthcare system continues to evolve, pharmacy as it is practiced today is changing, and hopefully for the better. Here is the first of four topics (the first two being current legislation) that are in the “hot seat” as we round up the first half of 2014:

H.R. – 4190: The Push for Provider Status


This legislation would amend a portion of the Social Security Act to give pharmacists what is known as “Provider Status.” Specifically, this amends Medicare Part B to include pharmacists in the group of professionals that are reimbursed for professional services. The legislation focuses on Medicare beneficiaries in three separate regions as defined by the US Dept. of Health and Human Services’ Health Resources and Service Administration (HRSA): Medically Under-served Areas, Medically Under-served Populations, and Health Professional Shortage Areas 1.

Current Standing

Originally introduced in March of 2014 by a Republican congressman from Kentucky, this legislation now has 56 bipartisan co-sponsors 2. It is gaining support by the day as representatives of congress recognize the benefits this bill would provide. Along with having the most expensive health care system in the world, a recent study also finds that, compared to ten other industrialized and powerful countries, the United States has the worst health outcomes 3.

How are YOU, the patient, affected?

Pharmacists are often considered the most accessible healthcare providers. This legislation manages to further increase that patient access. Additionally, it will assist pharmacists in the provision of high quality and cost-effective services that are within the scope of their education. Both individual households and our government are looking for ways to decrease their healthcare expenditure; this amendment could be a starting point! Check and see at https://beta.congress.gov/bill/113th-congress/house-bill/4190/cosponsors if your district’s congressman is a co-sponsor.