Telepharmacy at a glance
As a transformative force in the recent telehealth frontier, pharmacists have contributed significantly to patient and public health outcomes using telecommunication technology.1
Pharmacist adoption of telehealth models has greatly extended the impact of their services and has been associated with improved readmission rates, cost-savings, and medication safety.2-4 Specifically, integration of telehealth into medication therapy management (MTM) care, and recently into new models of enhanced MTM, has further enabled pharmacists to identify and address access, cost, health literacy, and transportation barriers that affect medication adherence.1,5-7
Impact of Pharmacists on Patient Outcomes
As pharmacists have become more involved with telehealth models for chronic care management, more opportunities for improving medication safety and cost savings have been observed.3,7 Such results have been observed in rural patients who received telehealth pharmacist services for interprofessional epilepsy management.4 Longitudinal improvements to clinical outcomes, such as blood pressure management, were also observed in patients who received pharmacist store-and-forward telehealth services.8
Telehealth is often used to provide patient and provider education. One study found that use of the Pharmacist-Guided Education and Monitoring (PGEM) model, in tandem with synchronous telehealth pharmacist services, facilitated discussions between patients and pharmacists regarding medication beliefs and perceptions of condition progress.9 Another study demonstrated the ability of a synchronous telehealth pharmacist service to improve anxiety, depression, and physical health through remote pharmacist education on dietary intake, physical exercise, and sleep hygiene.10
Pharmacists in Public Health
Pharmacists also play a vital role in promoting public health.11 Telehealth pharmacist interventions have contributed to public health efforts, as demonstrated by improved vaccination uptake12 and increased medication-related assistance for underserved hospitals.13 As a method to improve medication access and reduce the spread of contagions during the coronavirus pandemic, community pharmacies used drone technology to deliver prescriptions to patients.14 Pharmacists continue to make significant contributions to public health as leaders in COVID-19 testing and vaccination efforts.15
Looking Ahead: The Future of Pharmacists in Telehealth
Despite exponential policy reform during the pandemic, there are still significant opportunities for pharmacists to positively impact patients who receive virtual care. While pharmacists can provide incident-to telehealth services, they cannot bill Medicare for these services16 – pharmacists can only seek reimbursement from the billing practitioners, as pharmacists are considered by the Centers for Medicare and Medicaid Services (CMS) as auxiliary personnel.
Ultimately, the era of virtual care is here to stay, and the role of pharmacists will continue to evolve in response to regulatory changes, advancements in technology, and fluctuating demands of the healthcare ecosystem. As technology-enabled solutions have revolutionized telehealth to new heights and created new definitions for virtual standards of care, pharmacy must leverage these technologies to substantiate pharmacists’ impact on health outcomes.
Footnote: These statements are solely opinions belonging to individual employees and not held by the company.
References:
1. Gershman J. Telehealth Offers Myriad Unique Opportunities for Pharmacists. Pharmacy Times. April 2020.
2. Bingham J, Campbell P, Schussel K, Taylor A, Boesen K, Harrington A, Leal S, Warholak T. The Discharge Companion Program: An Interprofessional Collaboration in Transitional Care Model Delivery. Pharmacy. 2019, 7(2), 68.3. Taylor A, Bingham J, Johnson K, Axon R, Dickman D, Boesen K, Martin R, Warholak T. Integrating Innovative Telehealth Solutions into An Interprofessional Team-delivered Chronic Care Management Pilot Program. Journal of Managed Care and Specialty Pharmacy. 2018 Aug; 24(8): 813-818.
4. Axon D, Vo D, Taylor A, Bingham J. Initial Assessment of an Interprofessional Team-delivered Telehealth Program for Patients with Epilepsy. Epilepsy Research. 2019 Dec;158:106235.
5. Michaud V, Smith M, Bikmetov R, et al. Association of a medication risk score with health care outcomes. Am J Manag Care 2021. (in-press)
6. Bankes D, Pizzolato K, Finnel S, et al. Medication-related problems identified by pharmacists in an enhanced medication therapy management program. Am J Manag Care 2021 (in-press)
7. Stein A, Finnel S, Bankes D, et al. Health outcomes from an innovative enhanced medication therapy management strategy. Am J Manag Care 2021 (in-press)
8. Margolis K, Asche S, Bergdall A, Dehmer S, Groen S, et al. Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control a cluster randomized clinical trial. JAMA J Am Med Assoc. 2013, 310, 46–56.
9. Rickles N, Svarstad B, Statz-Paynter J,; Taylor L, Kobak K. Pharmacist telemonitoring of antidepressant use: Effects on pharmacist-patient collaboration. J Am Pharm Assoc. 2005, 45, 344–353.
10. Bingham J, Axon D, Scovis N, Taylor A. Evaluating the Effectiveness of Clinical Pharmacy Consultations on Nutrition, Physical Activity, and Sleep in Improving Patient-Reported Psychiatric Outcomes for Individuals with Mental Illnesses. Pharmacy. 2019, 7(1), 2.
11. American Society of Health-Systems Pharmacists. ASHP Statement on the Role of Health-System Pharmacists in Public Health. Available at: https://www.ashp.org/-/media/assets/policy-guidelines/docs/statements/role-of-health-system-pharmacists-in-public-health.ashx (accessed 1 Sept 2021)
12. Hess R. Impact of automated telephone messaging on zoster vaccination rates in community pharmacies. J Am Pharm Assoc. 2013, 53, 182–187.
13. Baldoni S, Amenta F, Ricci G. Telepharmacy Services: Present Status and Future Perspectives: A Review. Medicina (Kaunas). 2019;55(7):327.
14. Bingham J, Tranchina K, Turgeon J. Telepharmacy Offers Opportunity Amid Pandemic: The Contributions to Patient Care Through the Incorporation of Digital Clinical Pharmacotherapy Will Help Legitimize the Role of Pharmacists in Telehealth. Pharmacy Times. January 2021.
15. Tanzi M. Pharmacists’ role during the COVID-19 pandemic. Pharmacy Today. 2021;27(3):54-63.
16. American Society of Health-Systems Pharmacists (ASHP). 2020. Issue Brief: COVID-19 and Telehealth Changes. Available at: https://www.ashp.org/Advocacy-and-Issues/Key-Issues/Other-Issues/Issue-… (accessed 1 Sept 2021)
