Telemedicine: A remote connection

NEW YORK —The doctor and the pharmacist will see you now. Just look into the webcam on the computer.

Spurred by a perfect storm of conditions—a fractured economy that has made some pharmacy labor costs prohibitive, an explosion in new digital communications technologies and a flood of new federal cash to spur the adoption of health information technology—pharmacies, physicians and managed care organizations increasingly are turning to telemedicine to bring real-time care to hard-to-reach patients in remote locations throughout the United States.

Linking distant, far-flung patients in real time with pharmacists by a secure dispensing and two-way video-communications kiosk at a clinic, retail site or even a dedicated room in a city hall—which is the case in at least one small town that lost its sole pharmacy—can mean accessible pharmacy care for millions of patients in rural and small-town settings. The potential benefits of telemedicine go way beyond pharmacy dispensing and video-link counseling, of course. Properly applied, telemedicine—more broadly defined by some as telehealth—can put patients in immediate touch with a whole battery of healthcare professionals for any number of interventions. Those interventions can range from smart phones that monitor a diabetic patient’s glucose levels to a trauma team walking a medic through a triage procedure for a wounded soldier on a battlefield in Afghanistan—and can come through mobile phones, webcams or any other device that opens an instant link between patient and practitioner.

One big impetus for the growth of telemedicine will be the federal government. As part of the Obama administration’s $787 billion economic stimulus plan contained in the American Recovery and Reinvestment Act, more than $19 billion has been allocated to support the health system’s conversion to electronic record-keeping and health IT—including telemedicine.

Telepharmacy solutions are coming from a slew of technology providers, sometimes in partnership with retail pharmacy chains. For Maple Grove, Minn.-based Thrifty White Drug Stores, its commitment to remote-site dispensing beginning in 2003 was driven by necessity; the high costs of operating a fully staffed pharmacy in some distant, smaller communities were prohibitive.

Thrifty White’s answer: Operate a smaller store with a prescription kiosk, staffed by a technician and monitored by a company pharmacist at a full-service pharmacy dozens of miles away. “Our goal is to provide pharmacy services to these under-served areas and keep the business local” said Gary Boehler, EVP pharmacy operations for Thrifty White.

More recently, another Minnesota pharmacy operator, Sterling Drug, turned to pharmacy automation specialist ScriptPro to install its Telepharmacy unit in the town of Adrian, Minn., after that town lost its one drug store. The unit, staffed by a pharmacy technician, serves the prescription needs of the town’s roughly 1,200 residents from a Sterling Drug location in a larger, nearby town, Worthington, Minn.

“Mail order should not be the answer to these communities,” said Tim Gallager, VP pharmacy operations for Sterling’s parent company, Astrup Drug. “You can expand pharmacy services for less than the cost of opening a new pharmacy and support remote pharmacies without adding staff or recruiting pharmacists.”

Major chains also are weighing in. Rite Aid unveiled a new online chat capability in early August that gives customers enrolled in its wellness+ rewards program direct, 24-hour access to a Rite Aid pharmacist. Wellness+ members can access the feature, called “Ask a Pharmacist—Chat Live Now,” via a link on their online personal health page.

Walgreens also rolled out a new, real-time link between patients and pharmacists early last month called Walgreens Pharmacy Chat. The service puts customers in touch with a pharmacy staff member via an online link, 24/7.

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