INSIGHT - Summer 2020

Summer 2020 | 26 Telehealth/Pharmacy Emily Smith, Sr. Marketing Coordinator What happens when a state realizes that its population is losing pharmacy services because owning stores in rural communities isn’t financially attractive? Almost 20 years ago, North Dakota responded by pioneering telepharmacy, or the dispensing of prescription medicines from a location with no pharmacist physically present. Telepharmacy has not only helped stem the tide of pharmacy closures in low-population regions, it’s also given independent pharmacists a way to expand their business model and reach underserved patients. 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 Caucasian communities. Other healthcare settings have also recognized telepharmacy’s benefits. Integrated Delivery Networks (IDNs), realizing that quick, convenient refills improve medication adherence, are using telepharmacy to even out the prescription-filling demand between their various facilities and free up pharmacists’ time for improving patient outcomes. And while telepharmacy originally emerged because of economic drivers, recent events with the COVID-19 pandemic illustrate 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 crisis. So, how does telepharmacy work? Telepharmacy Logistics The requirements for a telepharmacy operation 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 enables an off-site pharmacist to supervise dispensing and speak with patients as requested or required. In terms of technology, the remote location needs a pharmacy management system, point-of-sale, and a telepharmacy system – which these days is usually software- based (including cloud options) rather than a piece of hardware. Workflow is similar: prescription adjudication happens in the pharmacy management system, and then a technician prepares the medication for review by the pharmacist. To facilitate approval, the technician captures images of the prescription, medication label, drug, medication bottle, and whatever else is requested by the pharmacist. The pharmacist (located at a traditional pharmacy or managing site) then reviews the images and references the patient’s full medication profile. The image-based workflow of today’s telepharmacy software has significantly improved efficiency compared to older live- video workflow, which required the pharmacist and technician to be on the same screen at the same time. Images also provide a complete audit log and audit defense. The pharmacist can conclude the prescription fill by conducting an interactive patient counseling session through a live video connection. For patient counseling, telepharmacy systems usually rely on a HIPAA-compliant, high-definition, live video feed. The Importance of Technicians Given the centrality of technology to telepharmacy, successful practice requires a pharmacy technician that can use the technology, have great patient relationships, and