Remote pharmacy services: Not just for small hospitals anymore

CONTRIBUTOR

Kelly Morrison

Director
Marketing and Product Management
Innovative Delivery Solutions
Cardinal Health

E ngaging an outside organization for remote pharmacy services can enable pharmacy staff to focus on strategic projects that drive improved performance and cost savings. Most hospitals that have typically required outside support to provide 24x7 coverage are smaller facilities.  However, as healthcare is continuing to change, large health system pharmacies are also pressured to perform an increasing number of tasks– and are looking to partner with external providers to supplement service. Remote pharmacy services can be leveraged to supplement pharmacy staff, free up time to focus directly on patient and clinical initiatives and  to help pharmacies and hospitals meet their strategic initiatives.

Supplementing pharmacy staff: examples in action

As a supplement to current staff, remote pharmacy services provide the flexibility to cover order entry while also meeting strategic objectives – without having to hire additional FTEs. If your staff has challenges meeting the demands of peak volume times, or needs to focus on direct patient care initiatives, supplemental pharmacy coverage enables you to redeploy your staff to those strategic initiatives while remote pharmacists cover your order entry needs. The presence of remote pharmacists ensures that each dose receives pharmacist review prior to administration. It also mitigates the risk of medication errors. Here are three examples where supplementing staff has proven beneficial to hospitals.

CPOE implementation

Most healthcare organizations have, are in the process of, or are planning to implement CPOE over the next two years. CPOE implementation is a time-consuming task that requires pharmacist focus, which means that they have less time for their day-to-day activities. An increasing number of pharmacy leaders are turning to remote pharmacy providers to provide coverage for order entry while hospital pharmacy staff focuses on preparation and implementation of CPOE.

For example, a 600-bed academic hospital on the West Coast was faced with the challenge to efficiently balance CPOE implementation with other pharmacy initiatives. The 24x7 pharmacy operation was focused on the implementation of CPOE, which was preventing the staff from providing consistent levels of pharmacy service. By partnering with a remote pharmacy provider, the hospital pharmacists were able to build and train on the CPOE system. At the same time, the remote pharmacy services team began the initial load of orders from the old pharmacy information system into the new CPOE system. As a result, the transition was seamless, patient care was continuous, and the pharmacy met their Meaningful Use goals without having to hire additional FTEs.

Meaningful Use compliance

Healthcare reform has positioned medication reconciliation and transitions-of-care programs as key elements in improving quality, reducing hospital costs and improving the patient experience. The pharmacy is usually asked to manage these initiatives, yet lacks enough pharmacy staff to take responsibility for more initiatives/programs.With pharmacy staff stretched to capacity, completing daily operational tasks while implementing major initiatives can be overwhelming.

For example, in Southern California, a non-profit health system needed to meet Meaningful Use requirements within a six- month timeframe, but lacked the pharmacy resources needed to do so. So as a cost effective alternative, they leveraged remote pharmacy services to supplement the current staff by entering discharge orders into a patient portal used for medication reconciliation, enabling their current staff to continue to focus on their existing priorities. Not only was the task completed within five months, the pharmacy experienced financial labor savings while providing continuous care to its patients.

Driving clinical initiatives

Pharmacy often focuses on clinical initiatives to drive savings and to improve performance and outcomes. However, most pharmacists lack the time or resources to implement clinical programs that drive change in the hospital, while also handling all of the other tasks they need to attend to daily. Even hospital pharmacies with robust clinical teams are beginning to be stretched for resources with new strategic priorities.

At a 17-hospital healthcare system spanning seven states, the pharmacy needed to deploy current pharmacists to clinical initiatives and were challenged recruiting additional staff. Therefore, their solution involved transferring the majority of the order volume to a remote pharmacy service provider during the day, enabling the pharmacy to redeploy pharmacists to focus on specific clinical initiatives.As a result, pharmacists now attend daily case management and ICU rounds with physicians.The health system experienced a decrease in antibiotic costs per Adjusted Patient Day, an increase in clinical interventions and overall labor and productivity savings. In addition, the patient experience at the facility improved.

Overall, there are many benefits of engaging a remote pharmacy services provider, even for large hospitals and health systems.From providing supplemental service to the current staff and redeploying pharmacists to focus on clinical initiatives, to freeing up time for short- or longer-term projects, remote pharmacy providers are being called upon to help out some of the most progressive hospital pharmacies. Even hospitals that have 24x7 coverage provided internally or by a sister facility, are finding the benefits of collaboration with a remote provider to be beneficial.