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The National TelehealthWebinar Series
Presented byThe National Network of
Telehealth Resource Centers
Webinar Tips & Notes
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What You Need to Know About Telepharmacy
Thursday, December 15, 2016(9:00AM HAST, 10:00AM AKST, 11:00AM PDT, 12:00PM MDT, 1:00PM CDT, 2:00PM EDT)
Greg Janes
TelePharm
First Impressions
What is your first thought
when you hear telepharmacy?
Remote Order Entry
Review
Retail Telepharmacy
(Remote Dispensing)
Remote CounselingIV Admixture
Agenda
1. Utilize technology to improve patient adherence
2. Allow pharmacist access in rural towns
3. Increase pharmacist outreach (urban)
Brief History
Where did telepharmacy come from and why?
Rural independent pharmacies closed
2003-2013
Mar 2003 - Dec 2013
independent rural
pharmacies closed
924
Source: Update: Independently Owned Pharmacy Closures in Rural America, 2003-2013;
RUPRI Center for Rural Health Policy Analysis, Rural Policy Brief June 2014; Fred Ullrich, BA; Keith J. Mueller, PhD
490rural communities lost
their only pharmacy
North Dakota
Telepharmacy
Project
North Dakota Telepharmacy Project
2002-2008
81pharmacies
28hospitals
53retail
Study
Result
<1%
DISPENSING ERRORS
National
Average
~1.7%
Source: The North Dakota Experience: Achieving High-Performance Health Care Through Rural Innovation And Cooperation. May 2008
Australia Alaska
U.S. NavyMinnesota
Source: Telepharmacy project expands across country; 9/12/2008; Dave Kolpack, Associated Press
2008
Source: Quarles & Brady LLP analysis & report, July 2016
2016
Patient Adherence
How can telepharmacy help improve
medication adherence with patients?
Source: Osterberg, L., Blaschke, T. (2005). Adherence to medication. N Engl J Med, 353(5), 487-497.
187 millionAmericans take 1+ prescriptions
Source: Thinking Outside the Pillbox, A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease; A NEHI Research Brief – August 2009
13%
healthcare expenses directly related
to non-adherence avoidable costs
$290 billion
100
Source: IMS Health Data, March 2011
50-70 48-66 25-30 15-20new
prescriptions
arrive at a
pharmacy
picked up by
the patient
taken
properly
refilled as
prescribed
“The Leaky Bucket”
Source: New Prescription Medication Gaps: A Comprehensive Measure of Adherence to New Prescriptions; Harvard Business Review Vol 44 | Num 5 | Oct 2009.
95%
patients filled initial prescriptions
when offered at doctor’s office
Access in Rural Areas
How does telepharmacy improve access
to a pharmacist in rural areas?
77%rural counties considered
health professional shortage areas
Source: The Crisis in Rural Primary Care; WWAMI Rural Health Research Center, Policy Brief April 2009
946independent pharmacies closed
2011-2015
Source: NCPA Digest 2016
BEFORE
AFTER
Telepharmacy helps
create a new patient-
pharmacist relationship
that wasn’t possible
before.Angela Falk, PharmD
80-100new jobs created in North Dakota
2003-2008
Source: North Dakota Telepharmacy Project https://www.ndsu.edu/telepharmacy/
$26.5millioneconomic development
to local rural economy
Source: North Dakota Telepharmacy Project https://www.ndsu.edu/telepharmacy/
$640kannual local economic impact
of a telepharmacy
Source: Rural Economic Technical Assistance Center (RETAC) in Macomb, IL; Economic impacts of a pharmacy for Deiterich, Illinois, June 2015
Increased Reach
Are there applications for telepharmacy
in urban settings?
~1 millionChicago residents live in “pharmacy deserts”
Source: ‘Pharmacy Deserts’ Are Prevalent In Chicago’s Predominantly Minority Communities, Raising Medication Access Concerns, Dima M. Qato,, Martha L. Daviglus, Jocelyn
Wilder, Todd Lee, Danya Qato and Bruce Lambert.
1 miledistance to nearest pharmacy
to be considered a pharmacy desert
Source: ‘Pharmacy Deserts’ Are Prevalent In Chicago’s Predominantly Minority Communities, Raising Medication Access Concerns, Dima M. Qato,, Martha L. Daviglus, Jocelyn
Wilder, Todd Lee, Danya Qato and Bruce Lambert.
75%
patients would prefer to fill
prescriptions at point-of-care** if given the choice
Source: Patient Attitudes toward Point-of-Care Medication Dispensing in a Primary Care Office Setting. July 19-22, 2007 by Opinion Research Corporation on behalf of Purkinje.
www.purkinje.com.
better education
+ better access
= better outcomes
4
times/year a patient visits
a healthcare professional
9
35
Primary care
physician
Other
healthcare
providers
Pharmacist
Source: Pharmacists as Influencers of Patient Adherence, August 21, 2014, Joseph Moose, PharmD, and Ashley Branham, PharmD, BCACP
Common Questions
What are some of the most common questions
and concerns with telepharmacy?
Workload
balancingHospitals
Accessible
specialists
Pharmacy
deserts
New prescription arrives at Pharmacy A
Licensed telepharmacyLicensed pharmacy
Pharmacist present at all times
Technician A
Technician B
Pharmacist B
1
2
3
4
A B
Patient picks up Rx and Pharmacist B counsels
Pharmacist B reviews images to verify fill is accurate
Technician A fills, taking images of the process
FAQ➔Fill accuracy
➔Safety (staff & location)
➔Diversion
➔Internet outage
Review
1. Utilize technology to improve patient adherence
2. Allow pharmacist access in rural towns
3. Increase pharmacist outreach (urban)
Questions
Greg Janes
greg.janes@telepharm.com
(319) 774-1625
For updates and more info, visit telepharm.com/learn
The National Telehealth Resource Center Webinar Series
3rd Thursday of every month
Next Webinar:
Telehealth Topic: Funding Do’s and Don’ts
Presenter: Heartland TRC
Date: Thursday, January 19, 2017
Times: 9:00AM HaST, 10:00AM AKST, 11:00AM PDT, 12:00PM MDT, 1:00PM CDT, 2:00PM EDT
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TRC activity is supported by grants from the Office for the Advancement of Telehealth, Office of Health Information Technology, Health Resources and
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