Appalachian College
of Pharmacy

A Model for Pharmacy-Based Virtual Clinics to Improve Access to Care in Rural Southwest Virginia

The Project

The Appalachian College of Pharmacy (ACP) established two virtual telehealth access points within grocery store pharmacies to improve chronic disease management for patients with diabetes. This project aimed to enhance access to care by utilizing conveniently located virtual clinics, where medical providers, pharmacists, and pharmacy staff worked together to coordinate diabetes treatment and management. These telehealth clinics were housed in the Food City Pharmacies in Vansant and Big Stone Gap, leveraging technology to provide remote chronic care services.

Work Conducted:

Launched two virtual telehealth clinics at Food City Pharmacies in Vansant and Big Stone Gap, enhancing access to chronic disease care.
Expanded telehealth capabilities by upgrading equipment, marketing services, and increasing patient engagement.
Improved diabetes management by enrolling patients in a remote chronic care program and serving telehealth patients.
Offered essential screening and treatment for COVID-19, Flu A/B, and Group A Strep at telehealth access points.

Goals Achieved:

Reported on patient health outcomes, highlighting the impact of telehealth interventions.
Analyzed clinical services provided, detailing the number and types of patients supported.
Assessed program success, including goals set and achieved.
Tracked patient referrals for follow-up care and additional medical services.

Evidence from Across Appalachia

Telehealth for Diabetes Management in Rural Appalachia

A study published in the Journal of the American Medical Association evaluated a telehealth program designed to support individuals with type 1 or type 2 diabetes in rural Appalachia. The program utilized virtual specialty clinics to provide diabetes care, resulting in improved glycemic outcomes for participants.

Increasing Access to Diabetic Self-Management Education Using Telehealth

Research conducted in Appalachian Kentucky explored the use of telehealth to deliver diabetes self-management education (DSME). The study found that telehealth interventions effectively increased access to DSME, addressing the shortage of healthcare providers in the region and improving diabetes care.

Evaluation Summary Report

ACP’s pharmacy-based virtual clinic project expanded rural access to care through two project sites in underserved communities. The Vansant Food City site, operated with Appalachian Family Clinic, launched earlier and generated the majority of patient enrollment and service delivery through consistent on-site medical care, telehealth access, and digital navigation. The Big Stone Gap Food City site launched later and offered a more limited model centered on the distribution of remote patient monitoring equipment with intermittent on-site staffing support for telehealth. The project provided general telehealth services to 101 patients, diabetes management telehealth services to 140 patients, and tested and treated 29 patients for infectious diseases. Clinical outcome data were incomplete for several of the proposed measures. Available findings suggested modest improvement in hemoglobin A1C, blood glucose, medication adherence, and blood pressure among non-random patient subsamples.

Despite evidence of community need and some measurable benefit, enrollment remained below target, and service delivery varied considerably by clinic location. This limited the ability to compare the two models or fully assess intended outcomes. Sustainability remained uncertain due to the closure of the Appalachian Family Clinic in Vansant and the need for additional funding to support ongoing clinical services in Big Stone Gap. Telehealth infrastructure provided by the project, however, may still provide value if paired with more stable on-site staffing and digital navigation.