cist uses video technology to monitor the process to ensure the right medication was labelled for the right patient. The pharmacist was then also available for video counseling with the patient.3 This telepharmacy practice could be instrumental in spreading pharmacy care as one pharmacist could provide services for a few different sites. In this manner, telepharmacy could also greatly assist rural institutions in decreasing their operating costs while still providing pharmacy services 24 hours a day.
er clinical service opportunities through telepharmacy include conducting medication reconciliation and medication therapy management services (MTMs).6,7 Medication reconciliation services are commonly conducted by a pharmacist onsite prior to patient discharge. However, one facility found they were able to provide more comprehensive service by supplementing their onsite staff with telepharmacy staff. This initiative helped ensure all patients received sufficient discharge instructions and helped pharmacy staff catch medication discrepancies and potential drug interactions.7 TelepharmaAnother possible benefit for institutions implecy has also been utilized to conduct MTMs and to menting telepharmacy services, in addition to remonitor patients remotely. One company that ofduced staffing pressures, is the opportunity for fers these services described their ability to monitor quicker, more efficient medication dispensing. For patients more frequently due to telepharmacy. example, in an integrated hospital system consistWith these services, pharmacists assisted patients ing of five institutions, centralized telepharmacy with adherence problems and potential adverse services were initiated for the hospital system. reactions. Upon identifying potential issues, pharPharmacists utilized a private network to access macists were able to intervene early to help optihospital data and had pharmacy phone calls routed mize the patient’s care.6 to them. This arrangement freed up some of the nursing staff and was found to reduce the average Though telepharmacy presents many unique opnightly order processing time for routine orders portunities for pharmacists and benefits for pafrom 26.8 minutes to 14 minutes.4 This study tients and institutions, there are also many potendemonstrated that not only can telepharmacy help tial obstacles that may arise when trying to initiate provide pharmacy services more efficiently, but a new telepharmacy service. To ensure the telethat it also can alleviate burdens on other hospital pharmacy service operates as smooth as possible, staff. these potential barriers must be considered ahead of time and properly managed throughout the proThough there are many possible advantages for incess of providing the service. stitutions that use telepharmacy, one may question the depth of services a virtual pharmacist could One of the most significant factors that must be provide. Though it may initially seem like telephar- considered in advance of providing service is reimmacy may limit the scope of a pharmacist, there are bursement. This factor may be especially difficult as actually a variety of clinical services that have been different states currently have different regulations successfully provided through telepharmacy. One regarding telehealth services. Further complicating opportunity is for enhanced complex disease state the matter, pharmacists are not currently officially management. For example, one facility developed recognized as healthcare providers by the Centers an asthma education program and delivered it to for Medicare and Medicaid Services (CMS). Consepatients via telehealth. Clinicians virtually met with quently, this lack of designation makes it difficult patients on a regular basis to help with adherence for pharmacists to be reimbursed under traditional and to assess asthma control and found an overall fee-for-service models. However, there has been a improvement in the majority of their patient’s asth- recent push to move towards more value-based ma control by the end of the year-long study.5 In care models which may provide the flexibility to algeneral, telepharmacy provides a unique way to low the realm of telepharmacy to expand.1 meet patients and its convenience may allow more Nonetheless, until there is a major shift in the frequent patient-clinician interactions with ample healthcare reimbursement structure in the United opportunity for thorough counseling. States, pharmacists or institutions considering initiation of telepharmacy services must carefully exIn addition to medication counseling sessions, oth|33| www.KPHANET.org
