Telepharmacy is a relative newcomer to the family of telemedicine. First adopted in North Dakota in 2001, telepharmacy has taken off since 2010 and is now permitted in one form or another in two-thirds of the states.
Defined by the National Association of Boards of Pharmacy as “the provision of pharmaceutical care through the use of telecommunications and information technologies to patients at a distance,” telepharmacy allows pharmacies to expand without having to add new pharmacists—and can expand medical care in underserved communities.
“Telepharmacy can be used wherever there is not a pharmacist physically present to help provide the quality of care that’s needed,” said Allie Woods, PharmD, ASHP. In the retail setting, telepharmacy brings the skills and knowledge of an experienced pharmacist to smaller communities and gives patients at community clinics quicker access to prescribed drugs and medication-counseling services.
Essentially, telepharmacy leverages technology to allow one pharmacist to provide supervision and review prescriptions at multiple locations. Patients pick up medications from a nearby licensed location staffed by pharmacy technicians and have access to the same counseling with a pharmacist at the remote location as they would at the home pharmacy, only it is done via a screen rather than in person.
The setup requires slight changes from the usual workflow:
• Prescriptions arrive at the telepharmacy location through its pharmacy-management system or by drop-off of a hard copy. Remote-dispensing software automatically integrates electronically submitted prescriptions from the pharmacy-management system. Paper prescriptions are entered as usual.
• A pharmacy technician fills the prescription. The technician sends images of the prescription, label, medication, and bottle through the remote-dispensing software for the pharmacist to review.
• The pharmacist reviews the images and checks the medication against the patient profile to identify any contraindications, potential interactions, or other issues. If a problem arises, the pharmacist contacts the prescriber as usual. If everything there is fine, the pharmacist approves dispensation and the technician puts the medication in will-call or gives it to the waiting patient.
• When the patient picks up the medication, she receives counseling from the remote pharmacist through interactive, HIPAA-compliant video.
States vary in their approach to telepharmacy. While 16 states have not authorized telepharmacy, most of the western states have passed legislation or regulations that enable it with few restrictions. Some states offer waivers to existing regulations to enable telepharmacy, and several have pilot programs to test the concept. Other states have a mix of restrictions on the kind of facilities considered suitable for remote-pharmacy locations, staffing, distance from other pharmacies, and interstate provision of pharmacy services. Check your state’s rules for more information.
If your state does not currently permit telepharmacy, the NABP Task Force on Regulation of Telepharmacy Practice has developed recommendations for changes to regulations governing pharmacy and produced reports that may be helpful.
« Click here to return to Community Connection.
Published November 30, 2018