Tip of the Week: The Time is Now to Provide Telehealth, Telepharmacy Services

Telehealth has emerged as an unsung hero of delivering vital information and care to patient populations. The Covid-19 pandemic has elevated telehealth as a viable alternative to face-to-face interactions under certain circumstances, the list of which is expanding as technology expands and clinicians become more accustomed to and adept in its use. Telehealth or telemedicine has been around since the 1990s with a projection of its expansion to occupy about $30 billion in health care spending in 2020.1 Telehealth uses technology (ie. phone calls or video conferencing) to deliver health care over distances, thus saving time and money by eliminating the need to travel.

Results of a scoping analysis of 29 studies examining medication order reviews, medication management, and antimicrobial stewardship performed by pharmacists, infectious disease specialists, and geriatricians in hospital and outpatient settings was published in Research in Social and Administrative Pharmacy.2 The authors found improved clinical and medication outcomes as well as high levels of patient satisfaction. They noted that the frequency of telepharmacy recommendations and interventions were similar or greater than those that occur during in-person consultations. Among the many clinical endpoints observed following implementation of telehealth medication management programs were a lowering in the rate of hospital-acquired Clostridium difficile infections, and a statistically significant reduction of A1C levels among patients with diabetes. The authors also acknowledged improved access to health care in areas that lacked these services, as well as cost savings from eliminating the need to travel to obtain services. The analysis found that despite savings compared to face-to-face interventions, the cost of establishing these services is high, and government support is often needed, particularly in small, under-resourced, rural health care centers.

A cohort study published in JAMA Otolaryngology-Head & Neck Surgery examined 1162 patients and found age, sex, income levels, insurance type, and marital status to be associated with utilization of telehealth services.3 The authors noted that the patients most likely to utilize telehealth services were younger than 65 years, educated, married females who are insured by a PPO. They noted further the issue of income disparities, wherein persons with annual household incomes less than $30,000 are less likely to have access to telehealth services. Despite telehealth being a feasible alternative and capable of servicing multitudes of patients, telehealth that requires use of the internet or smartphones can limit patient utilization.

Pharmacy would facilitate its available services and prominence in public health by embracing telehealth and telepharmacy. Pharmacy managers should explore available options for expanding their telepharmacy services, particularly those that do not represent substantial financial outlays for the business. They might also seek to partner with manufacturers of digital telehealth technology as well as employers, insurers, and other provider groups to establish a place in the delivery of telehealth. This would be especially beneficial in serving vulnerable populations. There might also be opportunities for grants that can kick-start such an endeavor, although telephone-only telehealth services might be first considered in addressing the needs of those in greatest financial need.

Additional information about Marketing Applicationscan be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

Mindy Chen, BS, is PharmD Candidate at Touro University California College of Pharmacy.

Shane P. Desselle, RPh, PhD, FAPhA, is Professor of Social/Behavioral Pharmacy at Touro University California College of Pharmacy.

REFERENCES

1. CDC. Telehealth and Telemedicine. Accessed February 09, 2021 https://www.cdc.gov/phlp/publications/topic/telehealth.html
2. Hanjani L, Caffery L, Freeman C, et al. A scoping review of the use and impact of telehealth medication reviews. Res Social Adm Pharm. 2020;16:1140-1153
3. Darrat I, Tam S, Boulis M, et al. Socioeconomic Disparities in Patient Use of Telehealth During the Coronavirus Disease 2019 Surge. JAMA Otolaryngol Head Neck Surg. Published online January 14, 2021. doi:10.1001/jamaoto.2020.5161