December 15, 2016
Inside: Here’s what your pharmacy needs to know about telepharmacy and how it can help your pharmacy compete, reach more patients, and expand your business.
As operational challenges grow for independent community pharmacies today, many have had to sell their businesses—or close their doors altogether.
The number of independent pharmacies has decreased steadily over the past five years from 23,106 in 2011 to 22,160 in 2015, according to the 2016 edition of the NCPA Digest, an annual publication from the National Community Pharmacists Association (NCPA) that profiles the independent community pharmacy market.
With the number of independent pharmacies dwindling, those operating must consider how to compete to stay in business.
A possible solution is telepharmacy. Telepharmacy serves as an extension of a pharmacy’s current business, and allows for remote dispensing of prescriptions.
“For a long time, independent pharmacists have been used to things getting more difficult for them,” said Greg Janes, director of marketing at TelePharm, a Cardinal Health company that offers telepharmacy software. “Now, it’s really exciting for them to be able to turn that around and have the opportunity to expand.”
Telepharmacy can provide health care access for patients in medically underserved areas, improve patient care and increase the odds that independents will keep their doors open and their lights on.
“The addition of telepharmacy service is really reversing the trend of independent pharmacies closing, enabling independent pharmacies to reach more patients and allowing them to stay open more hours,” said Adam Chesler, director of regulatory affairs at Cardinal Health, a global, integrated healthcare services and products company.
The National Association of Boards of Pharmacy (NABP) defines the practice of telepharmacy as “the provision of pharmacist care by registered pharmacies and pharmacists located within U.S. jurisdictions through the use of telecommunications or other technologies to patients or their agents at distances that are located within U.S. jurisdictions.”
At a telepharmacy, a certified pharmacy technician dispenses prescriptions at the remote site and a pharmacist verifies the scripts at a host store. The pharmacist communicates with patients via live video conferencing technology.
“The pharmacists doing the video counseling can assess whether the patient understands the program and will be able to follow it,” said Mike Coughlin, president and CEO of ScriptPro, a company that provides robotics-based pharmacy management, workflow and telepharmacy systems. “If this assessment turns out to be negative, corrective action can be taken by recruiting a caregiver or planning more intensive follow-up tasks.”
Telepharmacy allows pharmacies to expand with small- footprint locations and increase business to areas they weren’t previously operating in.
Independent pharmacy owners are continually looking for ways to grow their businesses. “Once they feel that they have tapped the customers within their trade area, they start looking outside that area for other areas of growth,” said Brian Glaves, director of sales at ScriptPro. “This strategic growth typically follows doctors from their area who have part-time practices in surrounding communities or satellite clinics that are served by the local hospital. They might be offering delivery to these towns currently as well.”
Glaves said another opportunity for telepharmacy is when a pharmacy owner is looking to retire, and the prospects for selling the pharmacy are limited. “A pharmacy in a small town is considered an essential service,” he said. “An independent from a neighboring town could turn this site into a telepharmacy location and nearly maintain business as normal.”
Independent pharmacies don’t have to sacrifice the personal patient care and quality customer service they provide with a telepharmacy. “The objective is to have the same level and quality of experience for the patients that they would have in a live, fully-staffed pharmacy setting,” Coughlin said.
Telepharmacy provides greater convenience and increases pharmacist access for patients located in rural communities and medically underserved areas.
“Normally these customers would go into the grocery store and buy over-the-counter (OTC) medications without a consultation,” Chesler said. “A telepharmacy in these towns means customers can now walk into the pharmacy at any time and speak to a pharmacist.”
And patients benefit from it. “There’s no better way to ensure that patients get their medications and take them properly than to make the medications and counseling available as quickly as possible after prescribing occurs, and at a location that’s convenient for the patient,” Coughlin said. “When this is done through telepharmacy, patients are given medications along with the knowledge and motivation to use them properly.”
When patients located in rural areas participate in routine pharmacist interactions, it can help increase medication adherence and improve outcomes.
“By implementing telepharmacy, you’re helping improve patient outcomes; you’re increasing patient adherence because patients are receiving and being educated on taking their medications,” Chesler said. “They’re getting better because a pharmacist is now accessible to those patients.”
Glaves agrees. “The average patient will interact with their local pharmacist almost monthly compared with one to two times per year with their primary care provider,” he said. “These routine interactions help patients to stay compliant with their meds. Take that option completely away and now they depend on their mailman to get them their meds on time and an overburdened health system to handle increased doctor’s appointments.”
Before you delve into the business of telepharmacy, you need to consider your state’s regulations. “Telepharmacy is regulated by the state and it does vary depending on your location,” Glaves said. “Some states have had rules allowing telepharmacy for more than 20 years while others require a variance to be applied for. There are still quite a few states that either haven’t addressed it or do not allow it.”
If you’re unsure of the legality of telepharmacy in your state, visit NABP at nabp.pharmacy.
Although implementing a telepharmacy may seem like a giant undertaking, telepharmacies aren’t so different from your brick-and-mortar pharmacy.
“The requirements are very similar to what is needed for a normal retail pharmacy,” Glaves said. “You’ll need space, drug stock, a pharmacy software system with point-of-sale and a certified pharmacy technician for the site. There are also added licensing requirements that vary by state. High speed Internet access or a point-to-point T1 line aid in the connectivity of the stores.”
It’s also important to have a healthy host store before considering opening a telepharmacy site. “I’ve met with numerous owners of underperforming stores that think they can open up five to 10 telepharmacy sites to support their current single store,” Glaves said.
Ultimately, telepharmacy should be an extension of what independent pharmacies already do—care for their patients.
“Telepharmacy provides easy access to getting scripts filled by a live person in the community with a consultation by a pharmacist,” Glaves said. “Contrast this with driving to the next county or waiting on the mailman to deliver much-needed meds; this can really decrease the quality of life in these areas.”
Are you unsure about telepharmacy? The experts answer common misconceptions about telepharmacy.
Telepharmacy eliminates pharmacists’ jobs. “Rural pharmacies are closing at an alarming rate, and when a rural pharmacy closes, that’s the loss of a job,” said Adam Chesler, director of regulatory affairs at Cardinal Health. “When you add a telepharmacy, you’re not only helping the overall economy of that town, but you’re actually increasing the amount of pharmacists’ jobs there; you’re increasing access to the pharmacists. Every time you open a telepharmacy you’re creating jobs.”
Telepharmacy will take prescription business away from your other pharmacy. “Telepharmacy is actually improving adherence, which increases the overall number of filled prescriptions,” Chesler said.
Telepharmacy increases the risk of diversion or robbery. “If someone wants to rob a pharmacy, they’re going to rob a pharmacy, whether a pharmacist is on site or not,” Chesler said. “Telepharmacies have cameras covering every square foot of their facility and panic buttons are also put in place. Regarding diversion, you want your top technicians in these pharmacies; the ones who look at their profession as a career, and are ready to take that next step in advancing their role.”
Telepharmacy is less accurate. “Telepharmacy, when performed correctly, can be more accurate than a traditional pharmacy due to all the additional checks and balances that are built into the system,” Chesler said.
Telepharmacy is similar to FaceTime and Skype. “Telepharmacy is not FaceTime or Skype, but a secure point-to-point video feed that is electronically documented and barcode scanned of a prescription to the patient from point-of-entry through remote dispense,” said Brian Glaves, director of sales at ScriptPro.
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