Simplified logistics and lower cost have motivated interest in telehealth for years. Today firms such as Doctor on Demand, American Well, MDLive and Health Tap offer telehealth services. While two providers have ceased operations over the past year (Better and Healthspot), the expansion of telehealth services nationwide steadily continues.
Telepharmacy has seen parallel growth. This was the case in rural Idaho-when the only pharmacist in the town of Arco retired. Answer? A telepharmacy solution developed by the Idaho State University Foundation and deployed during 2015.
Adventist Health operates TelepharmacyWest for rural hospital settings, and eighty-one pharmacies are involved in the North Dakota Telepharmacy Project (NDTP), which reaches an estimated 80,000 rural citizens - now including those in Arco.
Services provided by telepharmacy can be restricted to certain types of care, but in systems such as the NDTP, all services- drug utilization review, prescription verification, patient counseling- are technically feasible on most platforms via a live video and voice connection with a pharmacist.
The North Dakota project is expected to grow. Recently the Iowa PressCitizen reported that state legislators have introduced a bill that would make approval of telepharmacies routine, going beyond limited pilot tests.
Behind the Scenes Tech
Catholic Health Initiatives (CHI), based in Englewood, Colo., operates a Virtual Health Services subsidiary that supports the North Dakota Project. Technology from California-based PipelineRx, beneficiary of $9 million in venture capital funding last summer, offered the project scalability and efficiency advantages.
Offering similar capabilities is Telepharm, also a cloud-based, HIPAAcompliant service that includes secure video. Telepharm cites successful implementations at NuCara Pharmacy and Victor Drug in Iowa, Skywalk Pharmacy in Wisconsin, and Axline Pharmacy in Illinois.
Providers of electronic health records may move to host telepharmacy platforms. This was the direction taken by pharmacy automation company ScriptPro, whose comprehensive system features include inspection and clean room cameras designed to allow "one pharmacist [to] support multiple remote facilities ."
Other tests come from health systems. Seton Healthcare Family, part of Ascension Health, posted a video to YouTube with the explanation that it was "experimenting with something new called telepharmacy."
Pharmacies wishing to try telepharmacy may face only modest startup effort. Providers such as Apo Thera estimate that telepharmacy services can be started up for a new facility in as little as 15 days, depending on the size of the facility and what types of software are used.
The push to adopt telepharmacy can come from outside the profession. Local civic leaders in Atwood, Ill., lobbied to have a telepharmacy located in their town, and Paxton, IlL-based Sav-Mor Pharmacy responded with a telepharmacy facility that opened in March 2016. Sav-Mor President Dave Falk was enthusiastic.
"It's technology working in our favor. It's a pretty neat concept. Everything from start to finish is still verified by a pharmacist," Falk told the Piatt County Journal Republican.
Telemedicine Providing a Link Between CVS, Cleveland Clinic
CVS is planning to expand its MinuteClinic operations to around 1,500 of its stores by 2017, and telemedicine is a key part of that growth.
According to Tobias Barker, VP of medication operations for CVS MinuteClinic, patient visits to its clinics in Texas and California may encounter virtual waiting rooms equipped with HDTV connections. A licensed vocational nurse or nurse practitioner serves as the on-site provider connected to a remote physician, with technology support from American Well and other healthcare companies.
Patients at MinuteClinic locations in Ohio may even be connected to specialists at the Cleveland Clinic.
One report demonstrates a serious commitment to telemedicine by the prestigious, Cleveland-based health center. "Some of our best doctors see that this [telehealth] is where the world is going," Peter Rasmussen, medical director of distance health for the Cleveland Clinic, told Fast Company.