With the ubiquity of smartphones and tablets these days it seems that pharmacy would finally come out of the dark ages and start using these tools to their benefit. I recently read an article at MEDCITY | News that talked about the use of tablet technology for “telerounds”.
Telerounds: The sexy idea is about providing a way for patients in a hospital setting to communicate with their physicians even when they are not at the hospital. An early version of the concept in 2005 took the form of physician robots on account of the tablet screens being attached to “robots” that move from patient to patient. A study conducted by Johns Hopkins researchers in 2005 met with positive feedback from patients and the Henry Ford Hospital in Michigan has been testing the concept with patients using iPads equipped with a Apple’s Face Time program, similar to Skype, in post surgery settings. On industry expert rattled off several reasons why it just isn’t practical right now. First, it would assume that surgeons are always available when the patient needs to speak to them. Current reimbursement models don’t support it. Most hospitals don’t grow iPads on trees for patients to use upon admission. It wouldn’t work with physicians since they could not be reimbursed. Still, it might work better when patients are discharged as a solution for providers trying to reduce readmission rates.
While the telerounds model may not work for surgeons in the post operative setting, it could surely help pharmacists with patient discharge and admission consultation/interview. As a pharmacy student at UCSF I was part of a medical team that included an attending, several residents (medical and pharmacy), and several students (medical and pharmacy). Part of the responsibility of the pharmacy students was to interview every patient that was admitted to our service during the admission process. Basically we were performing medication reconciliation. And, as a pharmacy students, we were responsible for patient counseling and education as it related to medications during the discharge process. Early MTM? Perhaps.
Not all hospital systems have the luxury of pharmacy residents and students to do these tasks. Using video calling on tablets would be an interesting way to interview patients during admission and prior to discharge. If you had tablets at the bedside, the patient would simply have to hold the tablet and speak to a pharmacist. Simple really.
Here’s the thing, not all patients want to be interviewed during admission or receive discharge counseling. Forcing it on them creates some very uncomfortable moments for both the pharmacist and the patient. Allowing the patient to use technology to make the choice sounds like a solid alternative. And if the patient decides that they’d like to talk to the pharmacist in person, no problem, just pick up the tablet and send a message requesting the presence of a highly trained professional at their bedside.
Afterthought: You could use the tablet to capture co-pays on at the bedside as well. The technology is there. No need for the patient to ever see the inside of an “outpatient” pharmacy. It’s a win-win for the patient and the pharmacy. The patient gets to have their medications in hand before leaving the hospital and the pharmacy has fewer people standing in the waiting area getting upset over slow fill times. Just a thought.