Thinking about launching a telepharmacy program but are unsure what you need to do? In this blog, we share six important steps to help you evaluate your current environment and identify what to do to develop a telepharmacy system that can support a successful program.
1. Research telepharmacy rules and regulations
An essential first step is to determine the rules and regulations you will need to follow when developing your telepharmacy system and program. While most states permit some form of telepharmacy, requirements can vary significantly from one location to another. COVID-19 has further complicated matters as "… many states have taken action to remove policy barriers to telehealth utilization to address the pandemic on a temporary basis," notes the Center for Connected Health Policy, which provides a helpful resource that lists state actions taken by each state's governor, Medicaid program, medical board and/or department of insurance and their current status.
It is advisable to reach out to your state's board of pharmacy and state pharmacy association for information on current regulations. If you hope to deliver telepharmacy services across state lines and/or intend to establish telepharmacy operations in multiple states, you will want to determine the rules for all of these states.
2. Research telepharmacy services
Once you have completed the research required to identify the rules that will govern your telepharmacy program, you should have knowledge about the types of telepharmacy services you are permitted to deliver in your state(s). Now it's time to research those services and begin to develop the process, policies, and procedures your telepharmacy team will need to follow to best ensure safe and effective delivery. Common telepharmacy services include the following:
- Comprehensive medication management (CMM)
- Medication therapy management (MTM)
- Medication reconciliation post-discharge (MRP)
- Drug information, review, and monitoring
- Patient assessment and counseling
- Compounding medication verification
- Annual Wellness Visits
- Remote Patient Monitoring
- Medication Synchronization
3. Evaluate current components and resources
With an understanding of the services you can deliver, you will be in a better position to identify the components and resources available within your organization to determine what will be required for you to create a telepharmacy system that supports effective care service delivery.
Components and resources you will want to evaluate include the following:
- Physical space: Do you have existing space that you can house your telepharmacy team or do you need to acquire that space? What will you need to appropriately furnish the space to deliver services?
- Personnel: Do you have pharmacists and pharmacy technicians available to staff the program? As your research into rules may have indicated, some state boards of pharmacy identify specific training, certification, and/or experience pharmacy technicians must possess to legally engage in telepharmacy services. You will also need to identify who will oversee and coordinate the program, handle scheduling, perform billing, etc.
- Education and training: Do you have the means to provide and document the education and/or training that will be necessary to get your pharmacists and pharmacy technicians comfortable with delivering telepharmacy services?
- Licensing: Do you meet the licensing requirements to deliver telepharmacy? If not, do you know who can research and secure that licensing for you? Related, if you plan to stock controlled substances, you will need to complete the Drug Enforcement Administration registration process.
4. Assess existing IT infrastructure
Critical to a successful telepharmacy system is the information technology (IT) infrastructure that powers operations. You will want to evaluate your organization's existing infrastructure to determine the types of IT systems and solutions that you will need to implement. These may include the following:
- HIPAA-compliant telecommunications platform(s) to interact with patients, from a simple telephone to solutions such as Microsoft Teams and Zoom for Healthcare. You’ll also need tools in place for your telepharmacy administration team to properly route patient calls and requests to available telepharmacists.
- HIPAA-compliant platform(s) to collaborate with other members of patient care teams
- Computerized provider order entry system
- Pharmacy information system
- Telepharmacy software that specifically supports the delivery of telepharmacy services, such as a solution that helps with medication reconciliation post-discharge
- Data exchange architecture
An essential consideration when evaluating your IT infrastructure and making any investments to build it out further in support of your telepharmacy program is security. As the American Pharmacists Association notes, "The same HIPAA requirements exist for healthcare providers whether they are administering patient care in person or via telehealth. Electronic files need to be stored securely and extra precaution needs to be taken to ensure that … both sides of the telehealth consultation (i.e., both the pharmacist's and the patient's environments) are private. … All technology utilized is required to be encrypted and HIPAA compliant."
5. Make a "build vs. buy" decision
Considering we've only scratched the surface of what is required to develop a telepharmacy system, it's likely evident that establishing a telepharmacy program is no small feat. The good news is that organizations interested in adding telepharmacy have options.
If the evaluation of components, resources, and IT infrastructure demonstrate that most of the nuts and bolts for a program are available and/or already in place, then proceeding with an in-house offering may be feasible and worthwhile.
If the evaluation reveals that your organization lacks most components, resources, the IT infrastructure, and, most importantly, the time required to develop a strong telepharmacy system but you still recognize the significant value and ever-growing need for a telepharmacy program, you can now offload the services to a third party. For example, Cureatr offers a telepharmacy service. We supply health systems and provider organizations with board-certified clinical pharmacists who deliver medication management support services, including patient assessments, medication therapy evaluation, medication care plan development, and follow-up and monitoring. Our telepharmacists use the Meds 360° platform and essentially become an extension of the care team, with care coordinated across providers and settings.
If the evaluation reveals that your organization is missing some the key components, resources, and/or IT needed for a telepharmacy program, the way to proceed may become a bit murkier. Fully outsourcing the service remains an option, as does working to fill in those holes and running an in-house program. If you choose to proceed with the latter, it is paramount that you provide your pharmacists and pharmacy technicians with the software they need to efficiently, effectively, and safely deliver your telepharmacy services.
6. Understand what to look for in a telepharmacy vendor
If you choose to go the route of outsourcing your telepharmacy services, here are some of the recommended qualities to look for in a vendor:
- All clinical pharmacists are board certified and licensed
- Pharmacists have access to software that supports their efforts in delivering comprehensive medication therapy management
- You receive detailed reports on services rendered
- Scheduling flexibility to meet your organization's needs (e.g., 24/7, weekends, nights, peak hours, leaves of absence, emergency support)
- Service flexibility to meet your and patients' needs
- You receive information on how the vendor will be best ensuring HIPAA security
- Vendor places a high priority on quality assurance and performs regular audits on clinical team performance and outcomes
If you're interested in learning more about how Cureatr can assist your organization in launching or supporting a telepharmacy program, please contact us!