Telehealth has transformed significantly over the past few years. The widespread closure of physician offices and clinics during the COVID-19 pandemic spurred interest in providing healthcare online rather than the traditional in-person visit to the doctor.
State and federal regulations and guidance were created to facilitate the practice and both healthcare providers and patients reported high levels of satisfaction with the new arrangement. So, how has telepharmacy been affected by this? Also, how does this affect both community and long-term care (LTC) pharmacies?
Read on to learn more about the current state of telepharmacy in 2024.
Despite its popularity, telepharmacy has no well-accepted definition. The DEA, in a notice of proposed rulemaking (NPRM) in 2021, gave this definition:
Telepharmacy is considered to be the provision of pharmacist care by a remote pharmacist, through the use of telecommunications and other technologies, to a patient located at a dispensing site. Such pharmacist care may include, but is not limited to: The dispensing and distribution of prescription drugs, drug use review, patient counseling services, and drug therapy monitoring.
The context of this definition is the DEA’s concern over appropriate regulation of online pharmacies regarding prescriptions for controlled substances. The DEA’s effort in this document is focused on differentiating between online pharmacy and telepharmacy in the dispensing and ordering of controlled substances.
The National Association of Boards of Pharmacy, in its Model Pharmacy Act, uses this definition:
Provision by a pharmacist of patient care activities with or without the dispensing of drugs or devices, intended to achieve outcomes related to the cure or prevention of a disease, elimination or reduction of a patient’s symptoms, or arresting or slowing of a disease process.
The key consideration both in telepharmacy and telehealth, or telemedicine, is the lack of in-person interaction between the patient and the healthcare professional. During the COVID-19 pandemic the Centers for Disease Control and Prevention (CDC) encouraged the use of telepharmacy to minimize contact between pharmacy staff and patients to prevent exposure to the virus. Now that the pandemic is no longer raging, we can expect regulators to begin assessing the impact of telepharmacy and payers to determine whether this is a cost-effective option for the future.
A pharmacy desert is defined as a suburban area where most residents live more than two miles from a pharmacy and a rural pharmacy desert is where most residents live more than 10 miles from a pharmacy. Living in a pharmacy desert frequently means a lack of access to medications and an inability to receive medication counseling, adherence monitoring, and chronic disease management from professional pharmacists without needing to travel long distances. Telepharmacy has helped fill the gap between the need for services and the availability of those services.
A frequently cited example is the establishment of a pharmacy not staffed by a registered pharmacist, but with pharmacy technicians with access to a remotely located pharmacist to verify prescriptions and provide patient counselling.
LTC pharmacies have experience with providing remote access to medications through emergency kits located in nursing homes. Advanced systems allow the pharmacist to evaluate the request from nursing home staff, contact the prescriber if necessary, and remotely release a pre-packaged drug through a vending machine located at the facility.
Consultant pharmacists have skills that could be valuable in telepharmacy, even outside the institutional setting. Evaluating complex drug regimens and helping to eliminate unnecessary drugs is suited to a broader market that could be developed through telepharmacy.
Now let’s look at community pharmacy and how it and telepharmacy can coalesce.
One significant challenge is its reliance on a stable Internet connection, which can be problematic for patients in remote and rural areas (see the pharmacy deserts section). However, a telepharmacy model can expand your pharmacy’s outreach to these pharmacy deserts.
A crucial aspect of telepharmacy is the handling of protected health information (PHI). Telepharmacies exchange PHI with patients, providers, and payors through digital channels, necessitating additional measures to prevent data breaches and ensure patient confidentiality.
You’ll also need a pharmacy software to help balance out your pharmacy operations. Some of the industry’s leading software systems like PioneerRx have integrations and vendors who specialize in telepharmacy, creating a seamless transition in your workflow.
These capabilities ensure you can care for your patients and those in areas who wouldn’t get these services — a pillar of the community in every sense.
The ability to engage in telepharmacy is dictated by state laws and regulations promulgated by the state board of pharmacy. At the time of writing, 28 states have authorized telepharmacy but there is almost no consistency between the states on how the practice is regulated. This contrasts with the universal acceptance of telemedicine.
Not every state is prepared to embrace telepharmacy.
States with underdeveloped technology infrastructure may not feel ready to open the gates to telepharmacy, fearing bad outcomes. State boards of pharmacy may be especially cautious when new technology is involved. Privacy opponents may advocate for a slow approach due to recent widespread data hacking events. Insurers may be hesitant to endorse the expansion of telepharmacy when they are forced to pay the same rates for online services as for in-person services.
Despite the obstacles, telepharmacy has much promise and seems destined to prove itself a valuable tool in providing access to specialized healthcare services that are often difficult to obtain. Keep an eye on this and see how you might take advantage of the telepharmacy option to expand your practice.
