Telepharmacy services in an urban community health clinic system

Objective: To describe telepharmacy-related services and outcome. Setting: Suburban western Washington State during 2007 to 2008. Practice description: Five network clinics without in-house pharmacies are remotely connected to a central pharmacy to provide telepharmacy services. Practice innovation: Automated drug dispensing system (ADDS) units, webcams, and electronic medical charts were used to provide remote medication order processing/ dispensing, patient counseling, refill authorizations, and medication assistance referral services. Main outcome measures: Patient demographics; numbers of dispensed medications, patient consultations, refill authorizations, and service referrals; pharmacist feedback; and workflow changes. Results: At five network sites, 12,000 patients received 3,282 new prescriptions per month with webcam-enabled consultations, 589 monthly refill prescriptions, 2,800 pharmacist-provided refill authorizations, and 250 medication assistance referrals. Antibiotics were the most frequently dispensed medications. Pharmacists commented that webcam-enabled interviews provided better privacy and longer counseling duration. Six new staff members (one pharmacist and five pharmacy technicians) were added. Workspace and staff responsibilities were reassigned to facilitate medication prepackaging and ADDS prescription processing. Conclusion: Expanded application of telepharmacy technology can improve patient access to pharmaceutical care beyond remote medication dispensing to include point-of-care refill authorization and medication assistance referrals. Further research to explore patient-focused services and to assess economic, humanistic, and clinical outcomes of telepharmacy services is needed.