Telepharmacy will celebrate its 20th birthday next year, and yet the concept was still considered a relatively new and largely untapped method for pharmacists to deliver patient care coming into 2020. But the COVID-19 pandemic has significantly increased the awareness of telepharmacy and other associated disciplines of telehealth. Specifically, the health crisis has demonstrated the value of virtual care in supporting and helping patients, including those with reduced access to services because of where they live and those who want to reduce their risk of exposure to COVID-19 by limiting in-person contact. Another factor for the increasing adoption of virtual pharmacy services is the development of telepharmacy software that is helping pharmacists not only communicate effectively with patients but also improving the ability for pharmacists to provide essential care services.
In this blog, we'll provide a brief background on telepharmacy and some of the common services available to patients via this discipline and then more closely examine how telepharmacy software is helping pharmacists better tackle one of the most significant medication management challenges.
What is Telepharmacy?
For a simple definition of telepharmacy, we at Cureatr like to describe it as follows: "Telepharmacy is the use of technology to deliver pharmacy services to patients located at a distance."
The concept of telepharmacy came out of North Dakota. In 2000, the state was struggling with the loss of community pharmacies in more than two dozen of its communities. Another dozen communities were facing the prospects of losing pharmacies. In the hopes of reducing the negative effects of these losses, the North Dakota State Board of Pharmacy established pilot telepharmacy rules in 2001. The objective, according to North Dakota State University (NDSU): "… explore the feasibility of using telepharmacy to restore and retain pharmacy services in medically underserved remote rural communities of North Dakota."
One year later, the NDSU College of Pharmacy received a federal grant to implement a statewide telepharmacy program to test these pilot rules and help save rural pharmacies. The pilot project proved successful. In 2003, the state's board of pharmacy established permanent rules that permitted the practice of telepharmacy on a broader scale in North Dakota. By 2016, a little less than half of all states had authorized telepharmacy in some capacity. By 2019, the number of states allowing telepharmacy reached 45. You can learn more about the history and future of telepharmacy here.
While we don't have figures for 2020 yet, we know that the mode of practice has increased substantially. The federal government relaxed its rules and most states have issued waivers concerning telehealth, enabling pharmacists to deliver more services, many of which can be provided virtually.
Services Provided Via Telepharmacy
One of the reasons that telepharmacy is such a valuable care delivery model is that pharmacists can provide a wide range of services virtually that can significantly enhance care for patients. These services also support efforts to deliver comprehensive medication management (CMM).
Typical services provided via telepharmacy include the following:
- Medication selection
- Remote order entry
- Medication therapy management
- Drug review and monitoring
- Patient counseling and assessment
- Compounding medication verification
Telepharmacy Software and Medication Reconciliation Post-Discharge
Now let's talk about telepharmacy software. On a basic level, the delivery of telepharmacy services requires access to an interactive communication platform that enables the use of audio and/or video to connect pharmacists and patients in real time. Some commonly used HIPAA-compliant communication products include Microsoft Teams, Updox, VSee, Zoom for Healthcare, Doxy.me, and Spruce Health Care Messenger.
The good news for organizations interested in starting to provide tech-enabled clinical pharmacy services or strengthening an existing telepharmacy program is that there is a growing number of solutions available. To help you better understand how such telepharmacy software is helping pharmacists better support patients, let's focus specifically on one particular telepharmacy service: medication reconciliation post-discharge (MRP).
Medication reconciliation post-discharge "assesses whether adults 18 years and older who were discharged from an inpatient facility had their medications reconciled within 30 days," according to the National Committee for Quality Assurance. Performing MRP is critical for catching potentially harmful omissions or changes in prescribed medications. Its importance is elevated for elderly patients who are typically prescribed a greater quantity and variety of medications. A frequently referenced, peer-reviewed study published in the Drug Safety medical journal revealed that approximately 53% of adults have at least one medication error in their record, 027% of patients suffer an adverse drug reaction post discharge, and 20% of patients are readmitted due to ADEs. Despite these alarming statistics, the study goes on to reveal that only 50-60% of discharged patients receive an MRP, meaning that close to half of all patients are at an elevated risk of experiencing an adverse drug event (ADE) and preventable readmission.
Three of the reasons why MRP is not being performed for all patients are as follows:
- Providers are often unaware that a discharge occurred.
- Current methods of identifying non-adherence and other medication-related risks are error-prone and inefficient.
- Organizations lack the clinical resources to perform MRPs on all discharged patients.
Pharmacists, leveraging telepharmacy software, can play a significant role in better ensuring medication reconciliation post-discharge is performed consistently and correctly. One platform that supports these efforts is Cureatr's Meds 360°.
Here's how Meds 360° helps our team of telepharmacists improve medication reconciliation post-discharge for our clients' patients:
- When a patient is discharged from a hospital, Meds 360°'s real-time national discharge alerting notifies the telepharmacists. The assigned telepharmacist initiates the MRP process, with the goal of completing it within 72 hours.
- Meds 360° provides the telepharmacist with the patient's demographic and contact information, complete discharge summary, and historical clinical data from every available clinical encounter. The telepharmacist has access to the discharge eRx medications, hospital discharge instructions, plan of care, problem lists, ICD-10 codes, procedures, allergies, lab results, vital signs, and more.
- The platform integrates this real-time clinical data with real-time prescription fill data. This provides the telepharmacist with the most current and comprehensive medication lists across all prescribers — regardless of their location and EMR system(s) used. Included in the medication lists are electronic prescriptions, real-time pharmacy claims, and retail point-of-sale data, including cash transactions.
- Meds 360° merges the real-time data sets to identify primary and secondary non-adherence. One common example: patients failing to pick up one or more discharge medications.
- With this rich dataset at their fingertips, the assigned telepharmacist initiates the telepharmacy visit with the patient, performing the medication reconciliation and driving adherence.
- As a final step, the telepharmacist will document the medication reconciliation post-discharge encounter so the client receives credit towards Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare Star ratings.
The results: fewer harmful adverse drug events, lower readmission rates, and increased quality and patient satisfaction scores.
As we like to say at Cureatr, quality care doesn't end when the patient leaves the hospital. Telepharmacy software like Meds 360° permits providers to extend their support of patients following discharge, ultimately improving clinical outcomes, optimizing patient safety and reducing total cost of care. To schedule a demo and learn more, click here.