Telehealth and telemedicine are in the spotlight as the country works to "flatten the curve" on the novel coronavirus through a variety of strategies that include social distancing and stay-at-home orders. In a recent blog, we identified some of the services providers are delivering via telehealth, including COVID-19 screenings, mental health, dentistry, and physical therapy. We also called attention to the work of one provider that's offering medication management services using telehealth. Such an offering could be considered a form of telepharmacy.
Telepharmacy is defined by the Medicina journal as "… a form of pharmaceutical care in which pharmacists and patients are not in the same place and can interact using information and communication technology facilities. Telepharmacy has been adopted to provide pharmaceutical services to underserved areas and to address the problem of pharmacist shortage." Like most other telehealth services, telepharmacy is receiving greater attention during COVID-19.
How Telepharmacy is Making a Difference During the Pandemic
Here are six noteworthy telepharmacy developments and announcements pertaining to the coronavirus pandemic.
1. Telepharmacy can provide significant benefits
The potential value of leveraging telepharmacy during this viral outbreak was summed up well by Eric Maroyka, PharmD, BCPS, director of the American Society of Health-System Pharmacists' Center on Pharmacy Practice Advancement.
According to a Drug Topics article from mid-March, he stated, "Appropriately trained and equipped pharmacists can use telepharmacy to remotely oversee pharmacy operations and provide distributive, clinical, and supervisory services … A large part of a pharmacist's role in patient care is education and counseling. With the use of telepharmacy, pharmacists can improve patient access to care, provide credible information and awareness, enable successful comprehensive medication management, provide recommendations for symptom management, and help triage and refer patients to higher levels of care when diagnostic testing is warranted. Telepharmacy has demonstrated value in medication selection, order review, and dispensing; sterile admixture verification; patient counseling and monitoring; and the provision of clinical services."
Essential to maximize such benefits is relaxing restrictions on telepharmacy, writes James Broughel, a senior research fellow at the Mercatus Center at George Mason University. "Currently, most tests for COVID-19 have a relatively long turnaround time, often requiring patients to wait at home for results. When results become available, tested individuals could have a consultation with the pharmacist on the phone or via video conferencing platforms such as Skype or Zoom. … Currently, there is a debate taking place about take-at-home COVID-19 tests. If these tests become common, relaxing telepharmacy rules could enable pharmacists to provide remote instructions to patients administering their own tests. Telepharmacy reforms have also been known to increase access to pharmacies among underserved populations, such as rural populations."
2. CDC is encouraging the use of telepharmacy
Earlier this month, the Centers for Disease Control and Prevention (CDC) issued "Considerations for Pharmacies during the COVID-19 Pandemic," which provides guidance for pharmacists and pharmacy staff as they navigate the COVID-19 pandemic, reports the American Pharmacists Association (APhA). Among the key takeaways from the guidance: "Pharmacists who are providing patients with chronic disease management services, medication management services, and other services that do not require face-to-face encounters should make every effort to use telephone, telehealth, or telepharmacy strategies."
3. Many states are embracing telepharmacy
As U.S. Pharmacist notes, a growing number of states have issued waivers or otherwise amended regulations to permit the use of telepharmacy for management of a wide range of pharmacy operations. Highlights include the following:
- California is permitting pharmacists to remotely conduct order entry and drug-utilization reviews, interpret clinical data, process insurance claims, and perform therapeutic interventions.
- Minnesota and Nevada are permitting pharmacy staff to process prescriptions and medication orders remotely. Most functions related to prescriptions, besides dispensing, may be conducted remotely.
- Ohio is allowing pharmacies to remotely receive, interpret, evaluate, clarify, and approve medication orders and prescriptions. Pharmacists or technicians may perform remote order entry, data entry, drug-utilization review, insurance processing, clinical interpretation, therapeutic interventions, and author release of medication.
4. Pharmacy organizations include telepharmacy in policy recommendations
In March, a dozen pharmacy organizations representing the interests of pharmacists in the United States released a joint set of policy recommendations concerning the COVID-19 pandemic. One of the four main policy areas addressed in the recommendations concerned the need to "ease operational barriers to address workforce and workflow issues," notes the American Association of Colleges of Pharmacy (AACP), which is one of the participating organizations. The way to do so, according to the recommendations: "Allow pharmacists and pharmacy technicians with valid licenses to operate across state lines, including via telehealth. … Authorize pharmacists and pharmacy staff to conduct routine pharmacy tasks remotely as necessary (i.e., prescription data entry and script verification), including those licensed outside the state."
5. Chain drug stores are lobbying for telepharmacy
In a March 17 letter to U.S. Congressional leadership and the Administration by the head of the National Association of Chain Drug Stores (NACDS), the association pushed for "Immediate federal policymaking [that] would empower pharmacies and pharmacists to help enhance the nation's COVID-19 response right now, and as vaccines and other resources are developed and deployed." Among the recommendations from NACDS: "enabling telepharmacy."
6. Telepharmacy can play a role in "jump starting" the economy
In late March, the Mercatus Center issued a series of policy proposals it believed could contribute to a "quick, entrepreneur-led rebound" of the U.S. economy. One such policy concerns expanding pharmacist practice authority to improve healthcare efficiency.
Mercatus Center Executive Director Daniel Rothschild writes, "To tap into pharmacists' expertise and routine access to patients, states can allow online prescribing, remove restrictions to Clinical Laboratory Improvement Amendments waivers, accept out-of-state pharmacist licenses, or enter into reciprocity agreements with other states, relax restrictions on telepharmacy, and reduce restrictions on pharmacy technicians."