Implementation and evaluation of telepharmacy during COVID-19 pandemic in an academic medical city in the Kingdom of Saudi Arabia: paving the way for telepharmacy

Abstract

King Fahad University Hospital, a leading public healthcare institution in the Eastern region of KSA, implemented a disruptive innovation of Telepharmacy in pursuit of compliance with the National COVID-19 Response Framework. It emerged and proved to be an essential and critical pillar in suppression and mitigation strategies. Telepharmacy innovation resulted in Pharmacy staffing protection and provided uninterrupted access and care continuum to the pharmaceutical services, both for COVID-19 and Collateral care. This reform-oriented initiative culminated in adopting engineering and administrative controls to design the workflows, practices, and interactions between healthcare providers, patients, and pharmaceutical frontline staff. Pharmaceutical services enhanced its surge capacity (14,618 OPD requests & 10,030 Inpatient orders) and improved capability (41,242 counseling sessions) to address the daunting challenge of complying with the inpatient needs and robust outpatient pharmaceutical consumer services. Pharmacy services established a harmonious momentum between spatial and temporal consumers amidst the peak of the pandemic, where footfalls, air gaps, physical proximity and use of crisis standard of care was an institutional priority and national obligation. This powerful tool of Telepharmacy significantly had an impact on the technical efficiency and healthcare system's effectiveness on resource utilization in this newly adopted institutional pandemic response model. Core determinants of safe, integrated medication management use were protected by using e-tools and vehicles such as WhatsApp, webpage portals, and applications along with express shipping couriers.

Telepharmacy during COVID-19: A Scoping Review

“…Reimbursement issues were also noted by one case study from Bangladesh [ 47 ]. A challenge not noted by expert opinion was limited legislation allowing implementation of telepharmacy; this was also seen in the literature review articles [ 37 , 41 , 47 ]. The literature reviews also discovered that pharmacists lacked appropriate training related to disaster management and had difficulty navigating the COVID-19 pandemic [ 46 ].…”

“…The most commonly observed telepharmacy initiatives were virtual consultations, home delivery of medicines and patient education based on case studies and original research articles [ 35 , 37 , 38 , 39 , 41 , 42 , 43 , 45 , 46 , 47 , 48 ]. At least one case study from a cancer institute reported offering telepharmacy to patients at-risk [ 33 ].…”

“…Another hospital in China introduced “zero-contact pharmaceutical care” using online medication consultation [ 39 ]. An institutional response to the pandemic was also implemented in the Kingdom of Saudi Arabia by adapting new e-tools such as a business WhatsApp and webpage portals [ 37 ]. In another review article from Sri Lanka, they reported the use of teleprescriptions along with videoconferencing and audio consultations [ 44 ].…”

“…The privacy issues that were uncovered included digital privacy as well as challenges in finding the physical space for pharmacists to conduct private teleconsultations [ 43 , 47 , 49 ]. Decreased quality of care was seen in the form of increased dispensing and filling errors by pharmacies utilizing remote services and the inability to adapt assessment tools for telepharmacy usage [ 33 , 35 , 37 , 42 ]. One of the case studies from the Kingdom of Saudi Arabia reported the lack of a national policy as well as practices and processes at healthcare organizational levels as challenges in implementing telepharmacy [ 37 ].…”

“…Decreased quality of care was seen in the form of increased dispensing and filling errors by pharmacies utilizing remote services and the inability to adapt assessment tools for telepharmacy usage [ 33 , 35 , 37 , 42 ]. One of the case studies from the Kingdom of Saudi Arabia reported the lack of a national policy as well as practices and processes at healthcare organizational levels as challenges in implementing telepharmacy [ 37 ]. A case study from 54 Commonwealth countries reported issues with the internet, social isolation, difficulty keeping a regular schedule, difficulty accessing tools, lack of physical workspace and difficulty communicating with co-workers as challenges to telepharmacy [ 40 ].…”