Telepharmacy at rural hospitals provides big savings, quality improvements

As technology vendors increasingly specialize on telepharmacy, rural providers are deploying the tools to offer patients 24/7 pharmacy services.
By Bill Siwicki
10:21 AM
Telepharmacy for rural hospitals

When a prescription is updated the system sends an order via an electronic interface to Grand River nursing staff to dispense to the patient.

Grand River Hospital and Medical Center, a 13-bed critical access hospital in Western Colorado which sees an average of seven patients a day, has saved about $300,000 in staffing costs by using telehealth tools to establish a round-the-clock pharmacy.

Telehealth products and services is on the rise among small and rural hospitals. In mid-December, for instance, NewYork-Presbyterian forged a pact to provide emergency physicians via Walgreens in-store kiosks. Last year, Cleveland Clinic inked an arrangement with CVS to use American Well’s telemedicine platform to make clinicians accessible for visits from CVS Minute Clinics in Ohio. 

[Also: Telehealth policy changes mean big revenue opportunities for hospitals]

And telepharmacy has become its own specialty among tech vendors, including CPS TELEpharmacy, eVisit, PipelineRx, ScriptPro Telepharmacy and TelePharm. 

Tiny hospital saves big money

Grand River clinicians use PipelineRx to connect with remote pharmacists who verify orders and handle clinician questions, after which an automatic dispensing machine doles out the medications. 

Nancy McClew, PharmD, director of pharmacy at Grand River Hospital and Medical Center, said the investment in the telemedicine technology is well worth it compared with the cost of staffing the pharmacy 24/7. Let alone the possibility of staffing the pharmacy 24/7.

“There are many nights when we do not admit a patient, or have just a few pharmacy orders that do not require pharmacist intervention – protocol use, dose adjustments, formulary substitutions,” McClew explained. “We would be hard pressed to find a pharmacist willing to work the night shift and we believe their workplace satisfaction would be low.”

Here’s how it works: staff scan a paper medication order over to one of a team of remote pharmacists dedicated to the hospital through the tele-pharmacy system from PipelineRx, which also provides the pharmacists. The remote pharmacist obtains the order from a work queue for the hospital, giving the tele-pharmacist access to the Grand River electronic pharmacy system.

From there, they verify the order. Once that happens, the patient’s medication record is updated electronically and the system sends an order via an electronic interface to an automated dispensing cabinet. At the cabinet, a medication label is generated to the nursing unit. From there, the RN adds the medication label to the patient’s paper medication administration record and will document administration on this order profile sticker in the medication administration record.

Approximately 95 percent of the medications delivered via the telephramacy program, in fact, are located in the dispensing machine. When prescriptions are not available that way, a charge RN obtains them from the pharmacy. 

Rural providers ripe for telehealth

Grand River is by no means alone among small and rural hospitals tapping into telehealth tools for a range of services, including pharmacy of course. 

HIMSS Analytics researchers, in fact, asked executives ahead of a free December webinar what IT initiatives topped their priority lists. No surprise: 55.2 percent said telemedicine, followed by security (47.9 percent), business continuity and disaster recovery (43.8 percent), physician satisfaction (41.7 percent), population health management (29.2 percent), clinical intelligence and analytics (24.0 percent), patient portal (17.7 percent), financial intelligence and analytics (17.7 percent), mobile technology (13.5 percent), patient education (8.3 percent) and precision medicine (2.1 percent).

HIMSS Analytics Senior Director of Research Bryan Fiekers said in a previous article that telemedicine is driving greater access to care for patients that would otherwise have to travel long distances to interact with doctors. 

The same holds true in of patients and pharmacists in Grand River. And in addition to the staffing costs Grand River Hospital saves, having access to a pharmacist 24/7 pays other dividends.

“Grand River also has generated savings through tele-pharmacist interventions, the majority of which are safety related – clarifications, QI, prevention, renal assessment, therapeutic,” McClew said. “In Q3 2017, pharmacists documented more than 350 interventions, representing more than $50,000 in cost savings.”

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