Pharmacist remote order verification, i.e. checking something from afar

The current pharmacy practice model utilizes pharmacists to check everything that leaves the pharmacy. Right or wrong that’s the way it is. I don’t think it’s necessary, but I’m not the guy in charge of such things.

Pharmacy has tools to help get pharmacists out of the physical pharmacy, namely tech-check-tech and remote order verification, but I don’t see such things used with consistency. My position on tech-check-tech is well documented; it’s underutilized. Using technicians “at the top of their license” would go a long way in freeing up pharmacists to do other things. The problem at the moment is that many pharmacists don’t want to relinquish the “final check” responsibilities. It’s silly, but true.

Remote order verification is a concept that hasn’t taken off like I thought it would. The concept is really simple: use telepharmacy technology to allow pharmacists to review medications pulled or compounded by technicians. The pharmacist could be anywhere. And with the continued advancement of camera technologies and the explosion of tablet use in healthcare it’s a no-brainer. No longer do pharmacists have to be in the pharmacy  to check an order, nor do they need to have an advanced PC workstation. An iPad, Android tablet, or even Surface tablet would work just fine. If radiologists can use these tablets to view imaging results I’m sure a pharmacist can see that a technician pulled the correct item off a shelf.

I think remote checking would have the biggest impact in the cleanroom environment. It doesn’t make sense to have a pharmacist gowned up in the IV room every minute of the day, especially if they’re only in there to check IV compounds. Workflow software and telepharmacy can take care of that.

I remember when I was working in an ICU satellite. It was just me and a technician named Tim. Tim was the best pharmacy technician I had ever worked with and I let him run the pharmacy satellite operations. I spent my time in the ICU rounding with the medical team, reviewing charts and interacting with the nurses. Tim would make the IV batches and I’d return to the satellite throughout the day to check the batch. When Tim received a STAT order for a IV – pressor, antibiotic, insulin infusion, etc – he’d page me back to the satellite. The IV would be sitting there waiting for my signature. I’d sign it and walk it out to the unit, or if I was rounding in another area Tim would deliver the IV to the bedside himself. Having a remote checking option in those situations would have been convenient. I’d likely already be using a tablet, so when Tim had a STAT IV I’d get an alert on my screen, review the images, give it a thumbs up and truck on. It would be even cooler if you could do something like this with a HUD, a.k.a. Google Glass.

Just thinking out loud here people. Make use of the technology that’s at your fingertips. None of this is futuristic. It’s all here right now and just begging to be integrated into your workflow.


6 thoughts on “Pharmacist remote order verification, i.e. checking something from afar”

  1. There is a significant remote order checking facility here in MA that checks orders for Cardnial around the country. I like taking that extension to checking IV compounding.

    Here are my rants on need to eliminate Near Universal Pharmacist Order Review- NUPOR.

    Perfect app for Google Glass….. Interested in getting funding for such a venture? There is a incubator looking for ideas in San Diego, btw….. Happy to take off line….

  2. Hi Jerry, I came across your website while browsing the net about pharmacy practices. I am a licensed pharmacist in NJ and I agree with a lot that you have to say about this almost obsolete practice.

    I graduated in 2009 and have been practicing in community pharmacy since then. It hasn’t been professionally fulfilling and I am currently looking for a field of study (Health informatics, Masters in Public Health, etc.) that would help me use the knowledge that I have gained in pharmacy school and build on it. Basically, something connected to healthcare.

    Do you have any suggestions/recommendations about what might be a good area of study for me to dabble in to?

    Thank you in advance for your time!

  3. Hi Shreya –

    That’s a tough question to answer. The pharmacy degree will certainly help you move into an informatics role if you so choose. I realize that community pharmacy doesn’t exactly feel glamorous, but I believe that outpatient pharmacy services are the next big area for technology; so in that case you’re primed and ready.

    I’ve heard that an MPH is a good degree to have, but it all depends on what you want to be doing. I prefer automation, technology and informatics. That stuff keeps my mind humming along. If that were the case for you I’d look into places that offer degrees in Health Information Technology. I know there are schools that offer such things.

    Good luck. Let me know how it goes.


  4. Hi Jerry,

    Thank you for the reply. Out of curiosity, how did the transition happen for you? From a dispensing role to Information technology? And if its not too much to ask, what school did u study Health Information Technology from?

    Thanks again! I appreciate your time. And I have to mention that your website and blogs are quite interesting. I’m glad I came across it!

  5. Hi Shreya –

    My transition was a bit of a journey. I have no “formal education” in informatics, software engineering, etc. I was a hospital pharmacist for about 5 years before I started playing around on the informatics side of things. I gravitated toward projects in the pharmacy that involved database design, new technology and so on. I developed some database to track PK consults, handle pharmacist interventions, pushed Palm Pilots on the pharmacists, etc. Then I became the go-to guy for all out IT related projects. About 10 years into my career the idea of an IT pharmacist was just starting to blossom. A position opened up here in the Central Valley – I believe one of the first of its kind around here – and I jumped on it. That’s it.

    You are entering the field at a time when things are beginning to become more formalized, which in turn makes things better and worse all at the same time. Better because the field is getting more interest from within the profession. Worse because positions are hard to come by and facilities are looking for formal education and prior experience. I doubt very much that I could find an IT pharmacist role for myself in today’s climate based on my background.

    Feel free to reach out should you have any additional questions.


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