The method, developed by Alaska Native Medical Center, began as a pilot project in April 2003, and it became operational in December, said Erika Wessel, a pharmacist at the medical center who oversees the program.

The hospital is contracting with PickPoint Corp., a Pleasanton, Calif.-based firm that designs and distributes automated pharmaceutical storage and dispensing systems.

Nurse practitioners and health aides in the communities diagnose the patients' maladies, and contact the pharmacy at ANMC to get the needed drugs released from a secure, onsite high-tech medicine cabinet.

"The cost of wasted medicines is expected to go way down. This will save thousands of dollars every year," she said.

"At first there was some resistance to the new technology, but now the input from people using it is positive. They understand that we are here to help them."

With this method, Wessel said, patients and health care providers know they are getting the same top-quality pharmacy service they would get if they were at the hospital in Anchorage.

The machines have three locking mechanisms, and access to the keys is strictly limited. "I've actually seen a case where someone tried to break into one, and they were unable to," she said. "And the cabinets are too heavy to just carry off. Theft of one in a small village would be very unlikely. I think someone would notice a six-foot tall vending cabinet."

Wessel and her staff review the inventories and requests for new medications every day, and mail the goods to the clinics.

She said the potential for errors in drug prescriptions and interactions is greatly reduced with the system, due to an integrated secure network that catalogs and stores patient information using bar-coding.

Dispensing machines are currently available in nine communities: King Salmon, Sand Point, False Pass, Iliamna, St. Paul, Cold Bay, McGrath, Seldovia and Whittier. ANMC will soon add Adak and Nelson Lagoon to the system, Wessel said.

"Hopefully, we will be able to eventually get all of our clinics on this system," she said. "I'm getting calls all the time from people interested in it."

The telepharmacy project is being funded through a grant from the federal Department of Health and Human Services, Wessel said, and the hospital will apply for additional funding through 2005.