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CADTH » Search All Products » Environmental Scanning » Health Technology Update » Issue 2, January 2006 » Virtual pharmacists provide long-distance care

Virtual pharmacists provide long-distance care

Pharmacy technician, Betty Cheechoo, fills a prescription at the Weeneebayko General Hospital in Moose Factory, ON

Pharmacy technician, Betty Cheechoo, fills a prescription at the Weeneebayko General Hospital in Moose Factory, ON.

Photo courtesy of Kevin McDonald

An emerging type of delivery system may be a prescription for the current shortage of pharmacists in Canada.

Telepharmacy is an application of telehealth. It allows pharmacy services to be provided at a remote site, while a pharmacist supervises the work from a central site, using telecommunication and information technologies.

How telepharmacy works

A pharmacy technician at the remote site sends a copy of the doctor's medication order and the patient's complete medication record to the pharmacist by fax or e-mail. Alternatively, the pharmacist can view the patient's records by signing into the hospital's computer system through a secure portal.

The pharmacist reviews the order and discusses any medication-related problems with medical staff at the remote site. The pharmacy technician then fills the order. A second technician checks the final product; or if a reliable broadband transmission is available, the pharmacist can verify the technician's work with a videoconferencing camera. The high-resolution cameras can zoom in to see details of the actual dispensed medication.

Pharmacist shortage

Rural communities in British Columbia and Ontario have developed telepharmacy systems to help cope with a Canada-wide shortage of pharmacists, estimated in 2001 to number more than 2,000 positions.[1]

British Columbia

In June 2003, the East Kootenay Regional Hospital in Cranbrook, BC initiated the first Canadian telepharmacy service when a hospital in a neighbouring town could not recruit a pharmacist.[2] The service has since expanded to include supervision of pharmacy technicians at 20-bed hospitals in nearby Fernie and Creston. Other British Columbia hospitals have implemented telepharmacy services between Williams Lake and 100 Mile House; Quesnel and Terrace; and Prince George and Fort St. John. Telepharmacy also allows for vacation coverage and sick relief, particularly for hospitals that employ only one pharmacist.

Ontario

Pharmacist Kevin McDonald began telecommuting from his Ottawa home office in April 2004 to provide remote pharmacy services to the hospital in Moose Factory.

In September 2005, Kurt Schroeder began providing telepharmacy support to the Timmins hospital from his home outside of Ottawa. His remote order verification allows the on-site pharmacists, already short-staffed, to do more direct patient care on the hospital wards.

Evidence of effectiveness

Though this evidence gap was identified in 1999, assessments and systematic reviews of telepharmacy services are not yet available.[3]

Telepharmacy regulations

The College of Pharmacists of British Columbia is the only provincial licensing body in Canada with telepharmacy guidelines.[4] although the Manitoba Pharmaceutical Association is developing them. The Ontario College of Pharmacists does not have jurisdiction over hospital operations, including telepharmacy.

Cost

Set-up costs include basic computer equipment, software and a videoconference camera. Telepharmacy is funded in British Columbia under the pharmacy budget of the hospital providing the services. Hospitals in northern Ontario are contracting the services of pharmacists employed by a community pharmacy in Moose Factory

References

[1] Peartree Solutions Inc. A situational analysis of human resource issues in the pharmacy profession in Canada . Ottawa : Human Resources Development Canada; 2001. Available: http://www.pharmacists.ca/content/about_cpha/whats_happening/government_affairs/pdf/executive_summary.pdf.

[2] Technology drives telehealth in Kootenay boundary and East Kootenay [news release]. Vancouver: IH Communications; 2003 Nov 3. Available: http://www.interiorhealth.ca/NR/rdonlyres/9AD12211-732D-4EDA-A3BB-F7AD7E03B572/694/TechDrivesTelehealth.pdf.

[3] Angaran DM. Am J Health Syst Pharm 1999; 56(14):1405-26.

[4] College of Pharmacists of British Columbia. Professional practice policy: Telepharmacy. Vancouver; 2005. Available: http://www.bcpharmacists.org/resources/councilcommittees/pdf/telepharmacy.pdf.