The definition of telemedicine is â€œthe use of telecommunication technologies to deliver medical information and services to locations at a distance from the care giver or educator.â€ So whatâ€™s the definition of telepharmacy? Iâ€™m not quite sure, but replacing â€œmedical information and servicesâ€ with â€œpharmacy information and servicesâ€ seems reasonable.
I saw a lot of interest in telepharmacy at the ASHP Midyear meeting in New Orleans last month. Based on all the activity one might think itâ€™s a new concept. Au contraire, telemedicine has been around since at least the 1960â€™s, when NASA built this technology into spacecraft and astronautsâ€™ suits to monitor physiological parameters. Crud, one could argue that the concept has been around much longer than that (see image to the right from April 1924).
I know that pharmacy has been interested in telemedicine since at least the 1990â€™s as indicated by the article by David M. Angaran in the American Journal of Health-System Pharmacy in 1999.1 The article does a good job of describing the basics of telepharmacy, including the technology and its potential use.
Adoption of telepharmacy has been slow, but I think the convergence of available technology and renewed interest in a new pharmacy practice model has created a set of circumstances that may present the perfect opportunity for telepharmacy. Advancement in computer technology, videoconferencing, voice over IP (VoIP) technology, ubiquitous internet access, and mobile computing will make the use of telepharmacy simpler than ever before. Combined with improvements in pharmacy automation and pharmacy technician practice, the use of telepharmacy as a tool to help build a new practice model has become a reality.
Think about it. Something as ubiquitous as a smartphone could be used as an ideal telepharmacy device. Using technology like this would allow pharmacists to perform many common functions from remote locations. Off the top of my head a pharmacist could:
- Remote order entry and verification in acute care as well as long-term care environments
- Remote distribution approval in acute care and long-term care environments
- Remote patient consultation for patients in rural areas with no pharmacy services
- Remote medication distribution for patients in areas with no pharmacy services (or limited pharmacy services after hours, weekends, holidays, etc)
- Remote drug information. Think poison control model
- Remote clinical consultation from experts in various fields. Hey, you canâ€™t be everywhere at once.
- Remote product approval for IV room operation
Iâ€™ve already seen telepharmacy start to take off in various acute care pharmacies; specifically in the IV room. A few telepharmacy products I ran across while at ASHP Midyear include:
- DoseEdge by Baxa â€“ Pretty much the de facto standard for IV room prep at the moment
- Pharm-Q In The Hood (ITH) System by Envision Telepharmacy â€“ This is intriguing as the company offers both a product similar to DoseEdge as well as telepharmacy services. I had a great conversation with their CEO (sheâ€™s a pharmacist too). Cool stuff.
- ScriptPro SP Central Telepharmacy System â€“ Relatively new system and details were limited.
People arenâ€™t exactly lining up to implement telepharmacy services, but it may be just what the pharmacist ordered. It has the potential to move pharmacy toward that panacea of a pharmacist-less distribution model. Is it a bridge technology or something that will become a permanent part of our practice? Only time will tell. For the time being we need to expand the scope of telepharmacy and begin the process of investigating new ways to use it.
1. Am J Health-Syst Pharm. 1999; 56: 1405-26