Telepharmacy model may work for hospital pharmacies
Outlying clinics could benefit greatly
The driving mission of a telepharmacy model is to help people take a central role in their own health care by providing pharmacy support, along with counseling, an expert states.
Research shows that the clinical pharmacy support model works well with helping patients who have chronic diseases and who need assistance in adhering to medication and dietary guidelines to keep their diseases in check.
"It's clear that as you give therapy support through counseling, people can achieve better outcomes, providers are more satisfied, and there are improvements in physical outcomes and economic benefits," says R. William Soller, PhD, executive director of the University of California-San Francisco (UCSF) Center for Consumer Self Care, and a clinical professor in the UCSF School of Pharmacy.
One of the chief drawbacks is how health systems might apply this pharmacy support, which is often not reimbursed, in as cost-effective and efficient way as possible.
A solution might be telepharmacy services.
Researchers have been working on a telepharmacy model that could be applied across large geographic regions and that could provide a variety of pharmacist care services, Soller adds.
"We set up the Northern California Pharmacist Care Collaborative," Soller says. "For the near term, we think this is one of the key models for extending disease management through pharmacist counseling, and it could be done at an academic site, a medical center base, or through an independent pharmacist."
The collaborative includes UCSF School of Pharmacy, an affiliated medical center, and both academic and community pharmacists, he adds.
The key is to use telepharmacy for health screenings and standard care much in the same way face-to-face pharmacist-patient counseling might be provided.
For example, researchers are studying a project in which six pharmacies in Asheville, NC, have collaborated and contracted with the Asheville municipality to provide diabetes management services to city employees and their dependents, using telemedicine resources, Soller explains.
So far, the outcomes look promising.
"We've studied patients with diabetes and we're in the process of collecting these data," Soller says. "We're not through a full 12-month cycle, but we're seeing early on that those with six-month values are having improved hemoglobins, and everything is going in the right direction."
Plus the program has elicited very high satisfaction ratings by both patients and providers, Soller adds.
Researchers also would like to demonstrate that telepharmacy is a cost-effective way to provide medical support to patients.
"Some of the things we think about are providing cameras to computer-illiterate elders who are unable to leave their homes, which we're not doing yet, and looking at ways to make access more convenient for pharmacy services," Soller says.
A chief advantage of telepharmacy is that it provides pharmacy support to patients in communities and urban centers where such support is not available, he notes.
For example, patients could talk with a pharmacist via video from a location that's convenient for them, such as a local doctor's office or union office. The pharmacist experts wouldn't have to leave their own medical center building to provide the education and screening.
"It's a more convenient way for us to teach, and we don't waste time commuting," Soller says.
These pharmacist-patient interactions enhance the patient's medical care by providing up to 30 minutes of one-on-one time with the pharmacist, Soller says.
"It doesn't take away from the physician's role because generally the physician's referrals will go up [because of the telemedicine]," he adds. "And we put a strong emphasis on the pharmacist as a facilitator for the community health team."
From a hospital pharmacy's perspective, this type of model fulfills a goal on some health systems' part to have the medical center work in underserved communities, Soller notes.
People from lower socioeconomic backgrounds have access-to-care problems that telemedicine can address.
"Academic pharmacists with clinical service in a medical center could incorporate this type of outreach in the community, and this would reduce the burden on the [urban hospitals]," Soller explains. "As people are better at self care, you could answer some of the burden applied in a publicly funded medical setting."
Telemedicine holds even more promise in today's high gasoline prices environment, Soller notes.
"We're a society that's been highly mobile for many years, and now we're hit with gas prices that put us on par with the United Kingdom," Soller says. "It's quite likely that we still will be a mobile society, but we'll be even more e-mobile to address some of the financial restraints that we get with being petro-based."
The driving mission of a telepharmacy model is to help people take a central role in their own health care by providing pharmacy support, along with counseling, an expert states.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content