In the coming months and years, we expect you will be hearing a lot more about telepharmacy. While we believe that would have been the case before COVID-19, the health crisis has undoubtedly shined a bright spotlight on the value and benefits of virtual care services such as telepharmacy.
To help you gain a better understanding of the concept of telepharmacy, which will be important if your organization elects to pursue a telehealth strategy that includes pharmacy services, we'll use this blog to explore the question of "What is telepharmacy?" and then touch on a few of the ways the pandemic has accelerated the embracing of this emerging area of care.
What is Telepharmacy?
Let us begin by looking at some telepharmacy definitions.
- A widely cited definition comes from the "Model State Pharmacy Act and Model Rules of the National Association of Boards of Pharmacy" (Model Act). The Model Act defines the practice of telepharmacy as follows: "… the practice of pharmacy by registered pharmacies and pharmacists located within U.S. jurisdictions through the use of telepharmacy technologies between a licensee and patients or their agents at distances that are located within U.S. jurisdictions."
- In its statement on telepharmacy, the American Society of Health-System Pharmacists (ASHP) references the Model Act's definition but then goes on to provide its own definition for the purposes of the statement document: "… ASHP defines telepharmacy as a method used in pharmacy practice in which a pharmacist utilizes telecommunications technology to oversee aspects of pharmacy operations or provide patient care services."
- An article in the American Journal of Medical Research defines telepharmacy as "… the delivery of pharmaceutical care to outpatients at a distance through the use of telecommunication and other advanced technologies."
- North Dakota State University states the following: "Through the use of state-of-the-art telecommunications technology, pharmacists are able to provide pharmaceutical care to patients at a distance. Telepharmacy expands access to quality healthcare to communities nationwide, primarily in rural, medically underserved areas."
- Finally, an article in Pharmacy Times that defines telepharmacy includes an important caveat about broad definitions of telepharmacy when it states the following: "Practically speaking, telepharmacy can be defined as the provision of pharmacy services through telecommunication. However, state laws usually define telepharmacy more narrowly, based on pharmacy practice in the states."
Common Telepharmacy Services
To gain a better understanding of telepharmacy, it is worth taking a moment to identify the different types of telepharmacy services, of which there are many. In its statement on telepharmacy, ASHP highlights four applications. They are as follows:
- Medication selection, order review, and dispensing
- Intravenous (IV) admixture verification
- Patient counseling and monitoring
- Clinical services
Other telepharmacy services regularly referenced include drug review/monitoring, verification of oral and sterile compounding, patient assessment, and medication therapy management. We will be taking a deeper dive into these telepharmacy services — what they include and their benefits — in future blogs, but one can still envision the great value such services can deliver to patients and healthcare providers.
Impact of COVID-19 on Telepharmacy
Telepharmacy is not a new concept. In fact, as mHealthIntelligence notes, "Telepharmacy services date back to the early 2000s, when a rural hospital in North Dakota used a virtual care channel to provide on-demand specialists consults." While many states have since legislated its use, telepharmacy — like many telehealth services — has largely remained in the shadows. And then COVID-19 hit.
One of the few silver linings from the pandemic is the increased adoption and embracing of telehealth, including telepharmacy. The use of virtual care services was experiencing a gradual increase before the health crisis, but then lockdowns and stay-at-home orders, coupled with the rapid removal of regulatory hurdles, led to a surge in the number of telehealth visits.
OptumHealth, a subsidiary of UnitedHealth Group, reported that 29% of consumers said they used telehealth in May, which was up from just 8% in December. A survey of 1,000 patients by software company Kyruus found that 72% of respondents experienced their first virtual care visit during the pandemic, with more than three out of every four patients indicating they were very satisfied with their experience.
The broader concept of telehealth largely received the bulk of the attention during the initial weeks of the pandemic as healthcare providers, insurance companies, employers, vendors, the federal government, state governments, and others rushed to build an awareness and understanding of those virtual care services that would be necessary to safely keep consumers in their home. Now that the concept of telehealth is more widely known and appreciated, increased attention is being paid to specific types of telehealth, including telepharmacy.
For example, telepharmacy was highlighted by the Centers for Disease Control and Prevention in its guidance for pharmacists and pharmacy technicians in community pharmacies during the COVID-19 response: "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." In response to the pandemic, the Drug Enforcement Administration issued guidelines intended to make it easier for prescribers to gets patients controlled substances through telemedicine. Many states loosened rules concerning the delivery of telehealth services, including those provided by pharmacists.
The American Pharmacists Association noted, "Just like telemedicine has been essential during the COVID-19 crisis, the same can be said for telepharmacy." We recently highlighted how telepharmacy is making a difference during the health crisis.
Future for Telepharmacy
There is a high probability that telepharmacy will make a difference following the pandemic. In June, Centers for Medicare & Medicaid Services Administrator Seema Verma stated in an interview with STAT News that she favored keeping in place the expanded telehealth access following the pandemic: "People recognize the value of this, so it seems like it would not be a good thing to force our beneficiaries to go back to in-person visits." MedCity recently noted, "Whether healthcare organizations are ready or not, the era of virtual care has arrived, with telehealth spearheading the change." Results from the Kyruus survey noted earlier showed that close to 75% of patient respondents stated a desire for virtual care to be a standard part of their care moving forward, with about half stating they would switch providers for the offering.
While the future of telepharmacy looks very bright, there remain obstacles to maximizing the short- and long-term value of the virtual service, including the lack of provider status for pharmacists. Despite this and other challenges, it seems that telepharmacy's day is here — sooner than many expected. But that's great news for patients, healthcare providers, and our healthcare system as a whole.
For additional information, check out our white paper, “The Benefits of Telepharmacy on Improving Medication Management” here.