As states develop new legislation permitting the use of telepharmacy in retail pharmacies, there is a lot to absorb as a pharmacy professional, government official, or member of the public. Many states have already grappled with the changes, and others are mid-stream.

First, it should be clear that using a telepharmacy model should never be driven by greed. It should not be a solution to unfairly low reimbursement. And it has to be acknowledged that the on-site personal presence of a healthcare professional is superior to the alternative. Yet, we have to admit, even in our current state, we make choices to optimize professional efficiency. That is, it would be great if pharmacies were only staffed by licensed pharmacists, but for many good reasons, we employ technicians and clerks to manage low risk and many legally delegatable tasks.

As retail telepharmacy emerges, we should remember the history of telepharmacy in the health system environment. Every single client that we have supported added telepharmacy to their hospital without reducing the existing professional hours of coverage. Despite the immense savings in hourly cost to the organization, clients did not trade on-site pharmacist coverage for telepharmacy coverage. Due to lower volume coverage times and efficiency, a telepharmacy program is likely to be 11-36% of the cost of normal staffing. The conclusion is that telepharmacy is an expansion of pharmacy services designed to improve patient outcomes and safety.

The new telepharmacy legislation in Michigan, recently signed into law by Gov. Whitmer, is seemingly designed to make it more financially feasible to operate a pharmacy with lower revenue because the law allows for one pharmacist to oversee up to two remote pharmacies through telecommunication. This, along with the rules requiring telepharmacies not be within 10 miles of an existing pharmacy, make it seem like we could see pharmacies opening in small rural communities, making healthcare more accessible to residents. This option is great for communities that are just too small to support a traditional pharmacy. However, we should keep in mind that prescription reimbursement is at an all-time low, and creating a new pharmacy full of expensive drugs is not only expensive, but risky. This simply suggests that there is a limit as to the volume and revenue that would support even a retail telepharmacy operation.

Ways To Apply Telepharmacy Initiatives in a Retail Pharmacy

There’s multiple ways to apply telepharmacy initiatives within retail and community pharmacies that are not limited to only operating with a remote pharmacist 100% of the time.

Expanding Service Hours

Another great use of retail telepharmacy is making a pharmacy more competitive in its community by expanding service hours. In eligible stores, it is possible to envision having the pharmacist leave at the usual time, and allowing telepharmacy to take on additional hours of service, hand in hand with the client pharmacy’s technicians and clerks. Low cost, extended hours, makes it easier for patients to get to their prescriptions earlier, later, or on days the pharmacy was otherwise closed.  This model is financially attractive because it does not require a large investment in a new inventory, building, and start-up costs. 

Remote Pharmacy Technicians

Another clever telepharmacy plan doesn’t involve the pharmacist at all. In some stores, there are “slow times”. While there is always work to be done, sometimes pharmacies staff a team of pharmacy technicians and pharmacists solely based on the technician’s skill in prescription processing. An opportunity may exist in some stores to enable a pharmacist to stay on duty without a pharmacy technician, and let telepharmacy technicians process prescriptions for that pharmacy. 

Like above, a remote pharmacy technician can also help an overly busy store. If there are predictable, or unpredictable workload peaks, consider additional throughput by leveraging a remote pharmacy technician. Some states have shortages of pharmacy technicians caused by new licensing requirements. In order to stretch existing resources, telepharmacy technicians at certain times may be a way to lower overall cost while shortening wait times.

Pharmacy Call Centers

Another non-pharmacist use of telepharmacy would be through the use of a pharmacy call center. Phone calls are very important, as long as they are coming from a patient or provider. And, while decent phone technology exists, routing your calls from providers, patients, and solicitors away from your counter may be a way to do more with less. Indispensable’s new pharmacy call center can manage calls, and keep the on-site staff focused on patient care.

The call center can also be used after hours. Whether patients have clinical questions, or there is a need to be compliant with insurance contracts ensuring that you have an after-hours emergency service program, a pharmacy call center team offers a store a competitive edge.

As Needed Telepharmacist Support

Telepharmacists are also available to support a retail operation by supporting the clinical functions of the pharmacy. Comprehensive medication reviews (CMRs) and Tips, adherence reminder calls, clinical follow-up, and handling patient drug information requests may be a way to off-load some work that tends to bog down the pharmacy throughput. A well-designed Telepharmacy program may enable a pharmacy to take care of sporadic, but clinically and financially important tasks, more efficiently than attempting to work them into existing efficient workflows.

Technology continues to evolve and enable our profession to innovate and find more efficient methods of fulfilling our patient care mission. Telepharmacy is another tool available for practitioners to have a positive impact on the health and lives of our patients. Like any tool, we have an obligation to assure it is used constructively. 

• Todd Raehtz, Pharmacist