Access to pharmacies is a real struggle in some areas, and it’s a problem that will require a mix of responses. Telepharmacy is one option already helping to stem the tide of pharmacy closures in low-population regions and giving independent pharmacists a way to expand their business model.
Deserts and Pandemics
So-called pharmacy deserts, communities located 10-plus miles from the nearest retail pharmacy, are not only rural; urban patients can also struggle to access a pharmacist, with research indicating that minority neighborhoods often do not gain new pharmacies at the rate of white communities.
And while telepharmacy originally emerged because of economic drivers, the COVID-19 pandemic illustrates other advantages. Telepharmacy technology can be used to serve patients who struggle with pharmacy access because of concerns about virus transmission. Telepharmacists can also help manage patients with chronic diseases who may be delaying medication advice-seeking during the pandemic. So, how does telepharmacy work?
The requirements largely mirror those of a traditional pharmacy: front-end space, a stock of medication, and a certified pharmacy technician. The major difference is that no pharmacist is physically present. Instead, technology helps the off-site pharmacist supervise dispensing and speak with patients. The remote location needs a pharmacy management system, point-of-sale, and a telepharmacy system.
Workflow for prescription processing:
1. Prescription adjudication happens in the pharmacy management system.
2. Pharmacy technician preps the medication for pharmacist review.
3. Technician captures images of the prescription, medication label, drug, medication bottle, etc. (Added bonus: these images provide an audit log/defense.)
4. Pharmacist, located at a traditional pharmacy or managing site, reviews the images, references the patient’s profile, and gives approval.
5. Pharmacist can conclude with interactive patient counseling. For this, telepharmacy software usually relies on a HIPAA-compliant, high-definition, live video feed.
Importance of Technicians
Successful telepharmacy needs pharmacy technicians who can use the technology, have great patient relationships, and be problem solvers. As the on-site face of the pharmacy, technicians should be screened for attention to detail, critical thinking, commitment to learning, initiative, and customer service skills.
Technicians in these roles are acting as an extension of the pharmacist, using technology to help pharmacists deliver services. They are not really responsible for installing or implementing the technology itself. But as a side note, the growth of telemedicine has raised calls for specially trained technicians to set up, run, troubleshoot, and maintain telehealth technology. This would free healthcare workers to focus on patient care.
Telepharmacy During COVID-19
The coronavirus pandemic has only accelerated the use of telemedicine in an effort to limit personal contact and virus spread. In waiving many of its usual regulations in response to the crisis, the Centers for Medicare & Medicaid Services temporarily expanded reimbursements for telehealth.
Similarly, telepharmacy also helps minimize the risk of virus exposure. It does not in itself remove the need for people to pick up their prescriptions, but it does allow for touchless processes. Patients can have private conversations with pharmacists without risking infection in either direction. Counseling can happen on devices located at the telepharmacy or via personal cell phones, which can allow patients to stay home when they are sick and send caregivers to pick up medications for them. An additional benefit is that video visits in patients’ homes make it easy for them to show pharmacists what medications they’re currently taking, which is sometimes difficult to figure out in the store.
Serving Patients in New Ways
Healthcare providers doing patient care via technology are finding that it can bring unexpected extras to the relationship. Pharmacists practicing telepharmacy indicate that they’re able to reach patients that they otherwise might not. Done right, telepharmacy doesn’t need to decrease the personal feel of independent and community pharmacies.
Telepharmacy may also be the answer to community pharmacists’ desire to expand business with a smaller initial investment than needed by a traditional store. Such sites may become profitable after only months of operation compared to the two or three years it can take a traditional store. And remember that the technology can also allow a hybrid telepharmacy model with a part-time pharmacist on site and full-time patient access.
State rules regarding telepharmacy vary in their requirements for setting, staffing, and record keeping, so pharmacists contemplating a telepharmacy must become familiar with their state’s language about specific practice. The National Association of Boards of Pharmacy® website contains a list of state links to begin learning more.
While regulatory and technology issues are part of it, a mindset of innovation is also important. Pharmacists and technicians need to be open to new ways of providing the care patients need, regardless of circumstances – just like they’ve already demonstrated during these unprecedented times.