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The purpose of the study is to utilize health information technology to provide geographically-remote Critical Access Hospitals (CAHs) with around-the-clock access to pharmacist expertise when each CAH's local pharmacist is unavailable. Eight CAHs in rural northern Minnesota communities and a tertiary-care hospital in Duluth, MN with around-the clock pharmacy operations participated. The Internet linked the MEDITECH patient information management system at each CAH to the urban hospital pharmacy. When the local pharmacist was unavailable, the CAHs faxed new medication orders to the urban hospital for pharmacist review. The urban hospital pharmacist downloaded the CAH patient's EMR via the Internet, reviewing the new medication orders against the patient's record for appropriateness of indication, formulary availability, dose, frequency, duplicative therapy, etc. The urban hospital pharmacist would verify the order, releasing the medication from an automated dispensing cabinet located at the rural CAH.