Providing Comprehensive Medication Management in Telehealth

Abstract

The goal of this white paper is to provide direction for clinical pharmacists providing telehealth. Telehealth care is rapidly emerging to improve patient access to health care and optimize patient health outcomes. With the increasing ability to access electronic health record portals, as many as 75 million telehealth encounters are expected in North America annually. Although electronic "point of access" undoubtedly increases the use of medical and pharmacy services, the real value of telehealth lies in improved access to patients in remote areas lacking adequate medical and pharmacy services and to high-risk patients requiring frequent monitoring. This document is intended to serve as a guide for those interested in or already using telehealth to provide direct patient care. Specifically, it focuses on general concepts of telehealth and demonstrates how the delivery of comprehensive medication management (CMM) by telehealth aligns with the Standards of Practice for Clinical Pharmacists set forth by the American College of Clinical Pharmacy. Although clinical pharmacists must be appropriately credentialed and privileged to provide CMM, their process of care must also be adapted to suit the remote patient. Patient assessment, evaluation of medication therapy, development and implementation of a plan of care, follow-up, monitoring, and documentation of all processes of care are influenced by the technology available, the collaborations established, and the applicable regulations and requirements for telehealth practice.

Report of the 2017-2018 Strategic Engagement Standing Committee

“…Released by the Joint Commission of Pharmacy Practitioners (JCPP) in 2014, the concept affirms the value of team-based patient-centered care in which pharmacists continually collaborate with patients, families and caregivers to optimize medication use and health outcomes. 30 Despite advances in pharmacy practice and incorporation of pharmacists in the patient care team, public perception of the role of pharmacists is often limited. Community practice is predominantly based in retail and mass-merchandiser settings in which the pharmacist may not be fully integrated in the health care team.…”

Implementation and evaluation of comprehensive medication management in telehealth practices

“…Telehealth is the use of technology to deliver health care, health information, or health education at a distance . Telehealth is a viable alternative to standard face‐to‐face methods of CMM and may be beneficial to a patient residing where access to health care is minimal or when transportation or time is a barrier to accessing medical services .…”

“…Telehealth is the use of technology to deliver health care, health information, or health education at a distance. 5,6 Telehealth is a viable alternative to standard face-to-face methods of CMM and may be beneficial to a patient residing where access to health care is minimal or when transportation or time is a barrier to accessing medical services. 6 Telehealth services can be delivered in many ways, including telephonically, video conferencing in real-time (synchronous), streaming media, and store-and-forward imaging (asynchronous).…”

Optimising health outcomes via pharmacist delivered telehealth medicines management: a systematic review

“…Innovative service delivery models such as pharmacistled telehealth have been suggested as novel approaches to medicines management. [1][2][3][4][5] Pharmacist-led telehealth may be an alternative model of care when access to usual care is limited, or due to consumer preference given the complexities of medicines management. Implementation into practice has been slow; however, recent momentum has been gained.…”