The business case for telepharmacy

Remote dispensing of medications — tomorrow’s telepharmacy.

healthcare prescription
Credit: George Doyle

Have you ever had health symptom you know you needed to see a doctor about, but somewhere between the walk from the car to the office the symptom miraculously cleared up? Then, of course, the symptom, reoccurred once you got home. This is the core business case for telehealth. Symptoms surface when patients are living and doing activities they enjoy.

Telehealth can become more common and more widely adopted through telepharmacy. According to the Centers for Disease Control and Prevention, 67.2% of physician visits involve drug therapy and 72.5% of drug prescriptions (329.2 million) are ordered or provided as a result of hospital outpatient department visits. Staggeringly, according to researchers at the Mayo Clinic and Olmsted Medical Center, 70% of Americans take at least one prescription drug, and more than half take two.

Telepharmacy is a good place to start.

How telepharmacy can help

Telepharmacy delivers pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. Telepharmacy is part of the broader phenomenon of telemedicine.

The teams at PokitDok are working to make healthcare better. PokitDok is changing the way healthcare communicates by creating interfaces for formulary and benefit information in real time, improving utilizations of medications covered by the insurance formulary, and aiding in prescription insight. This result is a decrease in call center volumes and a better formulary lookup tool.

Remember the last time you were at the pharmacy? A member of the pharmacy staff greeted you and asked for your health insurance information. After confirming that you were covered, it’s unlikely the staffer would be able to tell you the cost of the medications you were expecting to fill, without looking up each prescription. You’re unclear of what you’ll be paying, and this is an extremely time-consuming process, both for yourself and the other eight people in line behind you.

What PokitDok offers is an in-network pharmacy API. This interface can be included in a provider or health plan app to take into consideration a member’s plan coverage and formulary; this API assists patients in finding in-network pharmacies close and convenient to them. Also, utilizing basic demographic information, the API can return data including premium, deductible, initial coverage limit and copay/coinsurance for all drug tiers. You’re now empowered as a patient. The use of this formulary API allows your members, patients, and customers to make better treatment plan decisions around drug costs.

Telepharmacy

PubMed published an analysis of 195,930 prescriptions to evaluate primary non-adherence in community-based practices and identify predictors of non-adherence. The findings were that 32% of the prescriptions went unfulfilled and that medication class was the strongest predictor of adherence.

What if the patients didn’t need physical contact with the pharmacist? Would adherence go up if patients could essentially Skype and then reorder with a click of a phone app? It's likely adherence would drift up. 

There are several reasons for alternative delivery for care. Through 2009, there were prescription drug discount cards and the rise of the Medicare Part D program, a Medicare prescription drug benefit to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries. The financial crisis of 2007 to 2008, better known as the global financial crisis, threatened the end of the major financial institutions. The banks were saved with a bailout by the federal government. This didn’t stop the stock markets from dropping worldwide. Pharmacies also took a hit, especially in rural areas. The Rural Health Research and Policy Centers conducted an analysis of closures of independently owned pharmacies in rural America and found that between March 2003 to December 2013, there was a loss of 12.1% of independently owned rural pharmacies in the United States. The most severe loss occurred between 2007 and 2009.

In 2015, there were 4.1 billion prescriptions filled in the United States, across 67,000 pharmacies. That is 61,194 prescriptions filled a year and, if averaged, 1,176 prescriptions filled a week and 197 filled daily (assuming a six-day workweek) per pharmacy.

Rethinking hospital pharmacy

PipelineRx offers a telepharmacy technology platform called PowerGridRx. This HIPAA-compliant solution is a remote telepharmacy service for next-generation medication order queue management. It’s an industry-first telepharmacy technology platform. The system provides 24/7, real-time medication order review and verification, improves medication order workflow visibility and operational control, and benefits from national coverage. What’s the bottom line? It has the potential to save better than 20% of costs when compared to in-house staffing. One of the benefits is that PowerGridRx allows the telepharmacist one processing view of orders from all IT systems, and across various hospitals and care settings. PowerGridRx creates a clear benefit not only for rural towns but also for traditional pharmacies that are looking to compete with the larger chains.

In February 2016, Dartmouth-Hitchcock (D-H) Medical Center selected the PowerGridRx technology platform to help optimize pharmacy workflow and improve patient care. Founded in 2009, today, PipelineRx has 120 folks supporting its operations, with $14.92 million raised in funding.

Telepharmacy provides access to healthcare providers, prevents sick patients traveling long distances and reduces dispensing errors. This new-age pharmacy workflow enters the data, technicians image the prescription, the remote pharmacist verifies the prescription and the patient is counseled by a pharmacist. Think back to the last time the pharmacist explained your prescription to you. I can’t even remember the last time, myself — why would you when people are waiting?

Telepharmacy helps to create an integrated care experience. We can improve access to pharmacists and decrease the cost of prescriptions with telepharmacy. The next question is, Why can’t this be integrated into to the patient rooms directly?

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