The Difference Between Outpatient and Inpatient Telepharmacy

Mitch Larson | March 12, 2020

We’ve talked before about how the term “telepharmacy” tends to get confused with other terms, such as kiosk pharmacy and internet pharmacy, which are entirely different practices altogether. Well, it doesn’t stop there, because even within the world of telepharmacy, there can still be confusion over the vocabulary.

Today we’re going to clear up some confusion around Inpatient Telepharmacy, also known as Remote Order Entry (ROE).

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The term “telepharmacy” is sometimes used interchangeably to refer to “remote order entry” in the inpatient setting. However, this word usage is not entirely correct or incorrect, because as you can see from this article, ROE is one of the four types that fall under the umbrella of telepharmacy.

Uh oh. You’re confused. We get it. But we’ll do our best to clear this up.

The four types of telepharmacy are:
  1. Remote dispensing (AKA Outpatient Telepharmacy - most commonly associated with the word “telepharmacy”)
  2. Remote order entry (AKA Inpatient Telepharmacy)
  3. Remote verification of IV admixtures
  4. Remote counseling

Numbers 3 and 4 on the list are relatively self-explanatory, but remote dispensing and ROE get mixed up often. In an effort to clarify, we’ll go into more detail on outpatient telepharmacy (remote dispensing) and inpatient telepharmacy (remote order entry).

Let’s start by unpacking outpatient telepharmacy, or remote dispensing:

In general, when the term “telepharmacy” is used, it is referring to outpatient telepharmacy. A remote dispensing site, or retail telepharmacy, is a licensed brick-and-mortar pharmacy staffed by one or more pharmacy technicians. A pharmacist supervises the technician, reviews prescriptions and counsels patients from a host location via two-way, HIPAA-compliant, audio-visual connection. Imagine a traditional pharmacy, except the pharmacist is located off-site.

Remote dispensing sites (or “telepharmacies”) are used in both retail community pharmacy and outpatient/discharge pharmacy settings, and these telepharmacies provide patients with convenient access to a pharmacist and prescription medication. Remote dispensing allows pharmacies and healthcare organizations to open retail telepharmacy sites in areas where a traditional pharmacy would not be feasible by sharing the cost of a pharmacist across multiple locations.

In the remote dispensing process, the pharmacist is performing PV1 (data verification) and PV2 (product verification), along with the various other roles and responsibilities they would typically have in a traditional pharmacy setting.

Now let’s take a closer look at inpatient telepharmacy, or remote order entry:

Remote order entry is much more specific than remote dispensing in terms of the responsibilities it requires of the pharmacist. ROE in the inpatient setting refers to the process of a pharmacist performing order-entry services remotely for the on-site inpatient pharmacy. The remote pharmacist only performs PV1 data verification, reviewing medication orders at prescheduled intervals or on-demand, allowing the pharmacist to review orders in closer proximity to hospital staff administration of drugs.

Hospitals and health systems benefit from inpatient telepharmacy as it allows for medication order review closer to administration time. Remote order entry in a health system serves as an extension of the in-house pharmacy and allows them to provide 24/7 coverage or fill-in during peak hours to supplement and strengthen the inpatient pharmacy.

Conclusion

Ultimately, the term “telepharmacy” has several meanings, but its primary usage is to describe the practice of remote dispensing where a pharmacist remotely performs all the duties of a traditional outpatient pharmacy, including PV1 and PV2.

Remote order entry is inpatient telepharmacy, but it is not referred to as “telepharmacy.” Ultimately what this boils down to is a matter of semantics. If you refer to ROE as “telepharmacy,” you’re not entirely wrong, but the lack of specificity can cause confusion.

It’s like telling the valet that your car is the black sedan. That is definitely not wrong, but telling them your car is the black Toyota Camry is much more specific and more helpful for them to understand which one is yours.

*This article is not sponsored by Toyota.

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