“One of our patients just tested positive for COVID-19”
“Our technician called in sick because she has a fever and sore throat”
These are legitimate conversations I had this weekend with some of my pharmacist colleagues. Ask any practicing pharmacist: each day they become more stressed that one of their patients who is asymptomatic may actually be a COVID-19 carrier and unknowingly infect them or anyone else they have been in contact with. If someone is feeling sick, they usually go to the pharmacist first, and all it takes is one sick patient to transmit COVID-19 to the pharmacist, who during the 5-11 day incubation period could transfer it to every patient they talk to.
In order to protect our pharmacists and their patients, the need for telepharmacy is greater than ever. If action is not taken, pharmacies will close and patients will lose access.
The Centers for Disease Control (CDC) recommends pharmacists utilize the same Personal Protective Equipment (PPE) as nurses or doctors, yet due to a nationwide shortage, almost no pharmacists are wearing ANY PPE, even in IV rooms where this is a normal practice. In other words, all pharmacists seeing patients right now should be wearing respirators, face masks, gloves, and gowns, but pharmacists don’t have the tools to follow this protocol. Supplies are in short demand and the physicians and nurses treating patients in hospitals are, and should remain, the main recipients of PPE. This does not mean pharmacists should be without PPE especially when they have the ability to utilize telepharmacy: the virtual face mask.
Virtual Face Mask:
Coughing and sneezing can travel quite a long distance. The CDC recommends people put a minimum of 6 feet between themselves and other people. Based on the images from this video, you could assume every private on-the-premises consultation is conducted at a closer distance than the recommendation and has the potential to further spread COVID-19. Pharmacists are resorting to desperate measures; placing masking tape lines on the floor to mark the 6-foot distance, requesting patients to use drive-thrus when available, and some are attempting to make their own face masks out of household supplies. Again, with N95 respirators in short supply, the answer is simple: use telepharmacy as your virtual face mask.
Instead of tape, telepharmacy creates separation between the patient and pharmacist, all while preserving the face to face interaction. The benefits of being able to observe non-verbal communication are still available, but there is zero risk of transmission. If needed, technology even allows the audio portion of the consultation to occur through the patient’s cell phone. This is the virtual face mask we need for our pharmacists and our communities to ensure maximum safety. The technology has been in use for almost 20 years (North Dakota since 2001) and is proven to be safe. In fact APhA, ASHP, NCPA, and all other major pharmacy associations agree, telepharmacy should be implemented immediately in pharmacies to protect our pharmacists and patients.
In addition to a virtual face mask, telepharmacy can also be used as virtual gloves. The CDC states while there is a “risk of transmission from contaminated surfaces of objects, this is not thought to be the primary method of transmission.” Even with this warning, it is still recommended that pharmacists and technicians wear gloves along with a respirator and face mask. Virtual gloves occur in telepharmacy allow patients to use a touchless workflow on a tablet to confirm their purchase and consult face-to-face with the pharmacist who is remote, with virtual PPE protection. No touching means no gloves needed for pharmacy technicians. The technician can place the filled prescription on the counter, the patient can pick it up, and that’s the extent of the interaction.
Virtual Quarantine (Social Distancing):
Let’s say your pharmacist gets sick and can’t come into work, or comes in contact with a patient who has tested positive for COVID-19 and needs to quarantine. Without a pharmacist available to be on-site the pharmacy must close. This leaves patients without access to pharmacy care, and no one to consult with for common medication or general health questions, and nowhere to obtain their potentially life-saving daily medications.
This can be solved by using telepharmacy to promote virtual quarantine or social distancing. We are seeing this work across various industries as millions of people working from home are utilizing technology to operate virtually. The same concept holds true with telepharmacy: pharmacists can supervise the pharmacy from a remote location. Through full HIPAA-compliant, audio and visual technology pharmacists can still hear and see everything going on at the pharmacy remotely. The scope of practice is not changed with remote supervision, the pharmacist just performs their duties remotely. Telepharmacy as virtual quarantine has now kept that pharmacy open and retained patient’s access to vital care.
Think about all the locations during this crisis which could benefit from the expertise of a pharmacist. Telepharmacy provides access to a virtual pharmacist anywhere needed. Every physician could have access to a pharmacist’s knowledge during this time of crisis in locations such as 24-hour clinics, urgent care facilities, and even critical care hospitals, potentially avoiding the risk of prescribing medications that interact, such as azithromycin and hydroxychloroquine. It’s been proven that patient outcomes are better anytime a pharmacist is involved, so why aren’t we utilizing proven technology to enable this?
As a profession, it is time we stop risking our health and the health of our patients due to fear of technology. Every other healthcare professional has stood up and made the right choice for their patients and their communities. It’s time pharmacists embrace telepharmacy and utilize the virtual face mask. It’s been proven safe, it’s been proven effective, and we need to use it in order to protect our pharmacists and patients.
The best way to advocate for telepharmacy regulations in your state is to contact your governing pharmacy boards and legislators. In order to help with that, we've created templates you can use to reach out to them and advocate in your state: