Outpatient clinical pharmacy practice in the face of COVID-19 at a cancer center in New York City

Abstract

Purpose With the rapid spread of COVID-19 in New York City since early March 2020, innovative measures were needed for clinical pharmacy specialists to provide direct clinical care safely to cancer patients. Allocating the workforce was necessary to meet the surging needs of the inpatient services due to the COVID-19 outbreak, which had the potential to compromise outpatient services. We present here our approach of restructuring clinical pharmacy services and providing direct patient care in outpatient clinics during the pandemic. Data sources We conducted a retrospective review of electronic clinical documentation involving clinical pharmacy specialist patient encounters in 9 outpatient clinics from March 1, 2020 to May 31, 2020. The analysis of the clinical pharmacy specialist interventions and the impact of the interventions was descriptive. Data summary As hospital services were modified to handle the surge due to COVID-19, select clinical pharmacy specialists were redeployed from the outpatient clinics or research blocks to COVID-19 inpatient teams. During these 3 months, clinical pharmacy specialists were involved in 2535 patient visits from 9 outpatient clinics and contributed a total of 4022 interventions, the majority of which utilized telemedicine. The interventions provided critical clinical pharmacy care during the pandemic and omitted 199 in-person visits for medical care. Conclusion The swift transition to telemedicine allowed the provision of direct clinical pharmacy services to patients with cancer during the COVID-19 pandemic.

The impact of COVID-19 on oncology professionals—one year on: lessons learned from the ESMO Resilience Task Force survey series

“… 19 Virtual outpatient patient visits conducted by Clinical Pharmacy Specialists in New York City optimised treatment delivery and patient safety whilst reducing in-person visits. 20 …”

Systematic literature review of adopting eHealth in pharmaceutical care during COVID-19 pandemic: recommendations for strengthening pharmacy services

“… 31 50 57 59 61 Initiatives to upgrade remote information technology and outpatient clinic systems might be launched by the government. 33 35 Continuous supervision and evaluation of PC-eHealth interventions by the government had been suggested, 28 57 which might require a special department or taskforce to lead and faciliate the adoption and implementation of eHealth in PC and other healthcare services alike. 50 61 It was also important for the government to provide reliable and up-to-date information about the COVID-19 pandemic to be disseminated via the PC-eHealth platform.…”

“…22 54 Staff had been asked to sign codes of conduct to protect patient confidentialiaty. 33 Pharmacist professional organisations were expected to define PC-eHealth services, 41 47 offer advice to pharmacists about making eHealth plans and provide guidelines for PC-eHealth service provision, 25 43 52 53 62 and support pharmacists with funding 47 and human resources 44 to establish the PC-eHealth infrastructure. At the pharmacist level, communication and collaboration among pharmacists from different sectors to care for complicated patients, 20 29 34 self-motivation to learn about the PC-eHealth guidelines, 25 training and supervision by more experienced pharmacists, 29 38 60 participation in the eHealth multidisciplinary working group 43 and closer collaboration with other healthcare providers and other key stakeholders 51 were considered important factors.…”

“…For some patients who had already receiving PC-eHealth interventions, a lack of adherence to the services could negatively impact on the outcome of eHealth service model. 28 For the PC-eHealth tool suppliers, some of the biggest challenges experienced during the COVID-19 pandemic included the unstable network connectivity, 21 49 inadequate interoperability of systems provided by different providers, 21 a lack of standardised platform and technical support within and across the care settings, 33 errors in digital systems, 43 cybersecurity considerations 27 42 and the lack of complete patient data for sharing. 22 To support the adoption of eHealth in PC for better management of patients during the pandemic, several enablers had been suggested.…”

Challenges and opportunities of clinical pharmacists during COVID-19: A review of the literature

“…Changes in work schedules of clinical pharmacists in order to provide 24/7 consultation services while decreasing work burnout and limit exposure to sick patients was also one of the strategies developed by clinical pharmacists, where a pharmacist would alternate between 2 weeks of on-site services and 2 weeks of off-site services (Moye et al, 2021). Other institutions also developed other pharmacy staffing plans to cope with the hospital's needs during the pandemic to ensure continuous provisions of services (Arain et al, 2021;de Val et al, 2021;Yerram et al, 2021). To minimize duplication of efforts and avoid coverage gaps, clinical pharmacists were also assigned clear roles and responsibilities.…”