Telehealth has emerged as an unsung hero of delivering vital information and care to patient populations. The Covid-19 pandemic has elevated telehealth as a viable alternative to face-to-face interactions under certain circumstances, the list of which is expanding as technology expands and clinicians become more accustomed to and adept in its use. Telehealth or telemedicine has been around since the 1990s with a projection of its expansion to occupy about $30 billion in healthcare spending in 2020.¹ Telehealth uses technology (i.e. phone calls or video conferencing) to deliver health care over distances, thus saving time and money by eliminating the need to travel.

Hanjani et al. performed a scoping review of twenty-nine studies examining medication order reviews, medication management, and antimicrobial stewardship performed by pharmacists, infectious disease specialists, and geriatricians in hospital and outpatient settings.² The authors found improved clinical and medication outcomes as well as high levels of patient satisfaction. They noted that the frequency of telepharmacy recommendations and/or interventions were similar or sometimes even greater than those that occur during in-person consultations. Among the many clinical endpoints observed following implementation of telehealth medication management programs were a lowering in the rate of hospital-acquired Clostridium difficile infections and a statistically significant reduction of A1C levels among diabetes patients. The authors of the review acknowledged improved access to healthcare in areas that lacked these services as well as cost savings from eliminating the need to travel to services. Despite savings compared to face-to-face interventions, the cost of establishing these services is high, and government support is often needed, particularly in small, under-resourced, rural healthcare centers.  

A cohort study by Darrat et al. examined 1162 patients and found age, sex, income levels, insurance type, and marital status to be associated with utilizing telehealth.³ The authors noted that the patients most likely to utilize telehealth services were younger than 65, educated, married females insured by a PPO. They noted further the issue of income disparities, wherein persons with annual household incomes less than $30,000 are less likely to have access to telehealth. Despite telehealth being a feasible alternative and capable of servicing multitudes of patients, telehealth that requires use of the internet or smartphones can limit patient utilization.

Pharmacy would facilitate its available services and prominence in public health by embracing telehealth and telepharmacy. Pharmacy managers should explore available options for expanding their services telepharmacy services, particularly those that do not represent substantial financial outlays for the business. They might also seek to partner with manufacturers of digital telehealth technology as well as employers, insurers, and other provider groups to establish a place in the delivery of telehealth. This would be especially beneficial in serving vulnerable populations, and there might be opportunities for grants that can kick-start such an endeavor, although telephone-only telehealth services might be first considered in addressing the needs of those in greatest financial need. 

Additional information about Marketing Applications can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

References:

1. Telehealth and Telemedicine. Accessed February 09, 2021 https://www.cdc.gov/phlp/publications/topic/telehealth.html
2. Hanjani L, Caffery L, Freeman C, et al. A scoping review of the use and impact of telehealth medication reviews. Res Social Adm Pharm. 2020;16:1140-1153
3. Darrat I, Tam S, Boulis M, et al. Socioeconomic Disparities in Patient Use of Telehealth During the Coronavirus Disease 2019 Surge. JAMA Otolaryngology-Head & Neck Surgery. Published online January 14, 2021. doi:10.1001/jamaoto.2020.5161

Authored by:

Mindy Chen, BS, is PharmD Candidate at Touro University California College of Pharmacy.

Shane P. Desselle, RPh, PhD, FAPhA, is Professor of Social/Behavioral Pharmacy at Touro University California College of Pharmacy.