Top 11 Emerging Use Cases for Telepharmacy

Adam Chesler | October 5, 2018

Studies have shown that telepharmacy can be used to increase pharmacist access, improve patient outcomes, and decrease overall healthcare costs. As a result of advances in technology and a changing health care climate, we are seeing a surge in telepharmacy use cases across the US and the world. Health care providers value the addition of a pharmacist on the health care team. With the advent of telepharmacy, the question now in the health-care community isn’t HOW can we add a pharmacist to the patient care team, it’s WHEN can we add a pharmacist.

Here are the top 10 emerging use cases for telepharmacy:

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1. Behavioral health facilities 

These facilities face the challenge of patients not filling their prescription after they are released from treatment, which increases the risk of readmission. Patients with a behavioral health diagnosis are often susceptible to non-adherence to their medication for a variety of reasons including denial of illness, adverse side effects, barriers to obtaining the medication and so forth (read our article on overcoming barriers to medication adherence here). With telepharmacy, a pharmacy can be located within the behavioral health facility. This allows patients to develop a relationship with their pharmacist, receive a consultation on their medication, discuss any present side effects and have their medication in hand before walking out the door.

 

2. Homeless shelters

Imagine the stress of being homeless and without access to reliable transportation. How long would it take you to get to your pharmacy to fill your prescription? Would you need to take the bus? A cab? How often would you be able to make that trip and where would you store your medications? This is a problem over 1.5 million Americans face every day. Patients who are homeless are receiving 30 day prescriptions for necessary medications, yet they lack convenient access to the pharmacy to fill those prescription on a regular basis. Additionally, a study has shown that homelessness increases the risk of non-adherence to antipsychotic medications in patients diagnosed with schizophrenia. By adding a telepharmacy into a homeless shelter, patients can conveniently fill their prescriptions, which increases adherence and helps them manage their diagnosis. Additionally, access to a telepharmacy at a homeless shelter could decrease emergency room visits for lost medication or complications from non-adherence, which currently makes up nearly half of all US medical care and places a huge burden on health care costs. 

 

3. HIV clinics 

There is still a stigma that exists surrounding HIV and approximately one in eight people living with HIV have experienced a denial of health services as a result. Additionally, not all pharmacists are residency-trained on the complex medications used to treat this condition. In an illness where the number one indicator of outcomes for HIV therapy is adherence, it is of highest importance that patients have access to a trusted, knowledgeable source for their medications to ensure a positive therapeutic outcome. With the addition of telepharmacy in an HIV-clinic, a residency-trained pharmacist can be involved in the initial stages of the patient’s treatment to establish a relationship and provide specialized, on-site consultations. This ensures the patient learns about all potential side effects and interactions and can start their medication immediately. The telepharmacy can even be used for a partner’s PreP therapy, and lead to overall improved therapy for the patients.

 

4. Ophthalmology clinics

Patient’s of the ophthalmology clinic are presented with a tough decision - they just underwent eye surgery, but now they need to pick up their prescription from the pharmacy on the way home. Do we really want patients driving after eye surgery? As someone who drives often, I would prefer not! Also, the prescribed eye drops often require prior authorization from insurance for coverage. With the power of telepharmacy, patients can get their medications right there at the ophthalmology clinic and go home after surgery (no extra trip required!). It also allows the doctor to quickly change the prescribed medications if they are not covered by insurance and patients avoid unnecessary trips and complications due to inability to drive to a pharmacy after surgery. 

 

5. Urgent care centers

Imagine this: Your child has a fever so you take them to the nearest urgent care clinic. You’re finally discharged at midnight with a diagnosis of an ear infection and a prescription for an antibiotic. You check Google Maps. The closest 24-hour pharmacy is 30 minutes away and you are left with two choices: make the hour round-trip drive to fill the prescription, or wait until morning and delay your child’s treatment. Telepharmacy fixes this situation by allowing a pharmacist at 24-hour pharmacy to remotely supervise a telepharmacy within the urgent care facility. You can now leave the urgent care facility with your child’s prescription in hand and receive a face-to-face consultation from the drug expert: your pharmacist. No extra trips, no waiting until morning for therapy, and your child can start feeling better sooner. 

 

6. Translation / American Sign Language services

Traditionally, if a patient entered the pharmacy and did not speak English the only available solution was a phone-a-pharmacist service, which provides access to pharmacists who speak other languages. While this solution is sufficient for the pharmacist to communicate the basics about the prescription to the patient, 55% of communication is non-verbal and, therefore, an opportunity exists to provide non-English speaking patients with a better service. Telepharmacy can be used to help overcome these language barriers. Through telepharmacy, patients can connect to a pharmacist who can speak any language through audio and video technology. This service can also be extended to better assist deaf and hard of hearing patients by connecting them with pharmacists who use American Sign Language. 

 

7. Physician dispensing

According to IMS Health Data, only 50-70% of all prescriptions arrive at the pharmacy and a mere 48-66% of prescriptions are actually picked up by the patient. This statistic creates a problem for not only patient outcomes, but physicians whose performance is based on patient outcomes. A Kaiser study showed that patients who didn’t fill their new prescriptions dropped to 5% if the service was offered at the point of care. As a result, there is an increasing sense of urgency for physicians to provide access to pharmacy services at the point of care in order to increase the number of new prescriptions filled. Critics of physician dispensing argue that it does not require the same checks and balances as a pharmacy and physicians do not possess the same expertise in the drug’s therapeutic index. Opening a telepharmacy within a physician’s office eliminates those concerns because it allows a pharmacist, the drug expert, to be involved in the dispensing process. Telepharmacy access at the point of care can increase convenience and the likelihood that the prescription will be filled, resulting in improved patient outcomes. 

 

8. Load balancing

Pharmacist’s time is limited and, in a traditional retail store, pharmacists become masters at juggling their time between verifying prescriptions, providing patient counseling and administering other clinical services such as flu shots. While pharmacists are spending valuable time with patients, the work behind the counter doesn’t stop (not even for lunch). Telepharmacy can help to balance the workload by allowing a pharmacist at another location to assist in verifying prescriptions and counseling patients. This frees up the pharmacist’s time and allows them to turn their focus back to patient care. Now, the patient that comes in for a flu shot can receive dedicated face to face time with the pharmacist to learn about other preventative care options available to them.

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9. Bedside delivery

Telepharmacy helps patients with the transition home from the hospital by allowing a technician to deliver the patient’s prescriptions directly to their bedside prior to discharge. The patient also receives a face-to-face consultation with the pharmacist through a computer tablet. As a result, adherence increases, first-fill rates increase, readmissions decrease, and the pharmacist who performed the consultation has a chance for a new customer. Everyone wins!

 

10. IV clean room

In a hospital setting, pharmacists must garb up and down each time they need to check the work of the technician in an IV-clean room. This results in wasted time, material and cost in a time when health care costs are already astronomical. Through telepharmacy, the pharmacist is able to oversee the technician from outside the clean room to verify the IV admixture and they can also retain a record of that fill for future reference. This can all be done without having to garb up and down! The benefit? Improved efficiencies and less wasted time, material and cost - all while providing the same quality of care. 

I know we said 10, but it’s your lucky day. We have a bonus use case scenario!

 

11. Disaster Relief

With the recent hurricanes and fires ravaging our country, there have been cases in which access to pharmacies has been limited or cut off altogether for days or weeks in the devastated areas. A telepharmacy solution should be included in every state’s disaster relief planning because it ensures that patients can still receive their medications in the event the pharmacy is destroyed or a pharmacist is unable to be present on site. Additionally, the telepharmacy software can be set up in minutes to eliminate any gap in care during these devastating times.  

 

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