Technical Literacy, Digital Etiquette Are Essential to Teaching Telehealth in Pharmacy Schools

In addition to teaching students about the Health Insurance Portability and Accountability Act (HIPAA) and other policies surrounding the use of telehealth, pharmacy students must learn technical literacy skills and digital etiquette, according to a session at the American Association of Colleges of Pharmacy Virtual Pharmacy Education 2021 conference.

Pharmacists are reimagining how they work within health care teams and how they can incorporate the rapidly changing field into pharmacy curriculums, according to session moderator Danielle Miller, PharmD, MEd, RPh, BCACP. Although telehealth was first suggested 140 years ago in an article published by The Lancet, its practice has drastically changed and is continuing to constantly evolve, according to the presenters.

“We need to prepare student pharmacists to both know and understand the various forms of telehealth,” said presenter Pamela Stamm, PharmD, CDE, BCPS, BCACP, FASHP, an associate professor at the Auburn University Harrison School of Pharmacy.

Stamm reviewed 6 different telehealth models and said students should be prepared for all of these. E-visits consist of messaging or email and can include the “store and forward” model, in which the patient takes a photo and sends it to the provider.

Remote patient monitoring is frequently used in diabetes or other chronic conditions to monitor patients’ medication adherence, adverse effects, and other issues. Finally, Stamm said patients can also connect with providers via audio-only and video visits, or with case-based teleconferencing that can include family members and caregivers.

Although these models all use different forms of technology, Stamm said she has found some skills that many students struggle with and that may not immediately come to mind for instructors. These include password management, integrating new technology, and using multiple screens rather than multiple windows. Notably, however, Stamm said the biggest challenge is managing all of these issues at once.

Presenter Tricia Gangoo-Dookhan, PharmD, a clinical assistant professor at the Nova Southeastern University College of Pharmacy, reviewed several other skills that students must know in order to effectively communicate via telehealth. These include digital etiquette, virtual communication skills, HIPAA compliance, and emergency care or triage via telehealth.

Expectations on digital health should be established early when preparing students for an experiential setting. Unlike in-person visits, students should ensure that their cameras are turned on, their lighting is good, and their background is clutter-free. These expectations can be set using modeling, discussions, vignettes, policies, simulation, and practice.

Similarly, although patients may understand the necessary communication skills for in-person visits, virtual communication can differ. Students should have a greeting and closure prepared and can use a script if they find that helpful, Gangoo-Dookhan said. They should also inform the patient that they are taking notes or looking up information if they are not making eye contact, so that the patient does not feel ignored or disrespected.

Ensuring HIPAA compliance is also incredibly important when using telehealth. Students should verify privacy by using headphone or earbuds, removing listening devices from the room, and documenting all security measures taken. Gangoo-Dookhan added that they should verify the privacy of their computer, whether by using an encrypted device borrowed from their institution or by using HIPAA-compliant software.

Finally, Gangoo-Dookhan said patients should verify the patient’s location and emergency contact information at the beginning of the call, in case emergency services are needed. Helping students work through what-if scenarios can also ensure that they are prepared for unexpected changes during telehealth visits.

All of this information can be overwhelming, so having pre-session preparation is essential, according to presenter Kylie Barnes, PharmD, BCPS, a clinical associate professor at the University of Missouri-Kansas City School of Pharmacy. Students can be encouraged to use a script if they find that helpful, and instructors can help them work through hypothetical scenarios in advance so that they feel prepared for any situation.

Although many students may feel adequately prepared for in-person patient interactions, telehealth can present new challenges and unexpected obstacles. However, by adequately working with students in advance and giving them ample opportunities to practice, pharmacy students can be prepared for the future of the profession.

REFERENCE

Barnes K, Gangoo-Dookhan T, Miller D, Stamm P. The Pivot Needed: Incorporating Telehealth Throughout the Pharmacy School Curriculum. American Association of Colleges of Pharmacy Virtual Pharmacy Education 2021 conference. July 19, 2021. Accessed July 19, 2021.