HEALTH

Telemedicine: A remote connection

BY Jim Frederick

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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The Apothecary Shops earns spot on Inc.’s fastest-growing private companies list

BY Alaric DeArment

PHOENIX Diplomat Specialty Pharmacy isn’t the only one to earn a spot on Inc. magazine’s list of the fastest-growing private companies.

The Inc. 5000 also listed specialty pharmacy The Apothecary Shops, ranking 2,394. That marked a jump of 322 spots from last year and 1,682 spots from 2008 in its fourth annual appearance on the list.

Drug Store News reported Thursday on Diplomat’s inclusion on the list.

“It’s no secret that we have undertaken a very aggressive growth strategy for The Apothecary Shops, but our approach, particularly in a down economy, has been targeted and strategic to be in a solid position to leverage that growth when the economy turns,” The Apothecary Shops president Keith Cook said. “Our movement on the Inc. 5000 list of fastest-growing companies reflects the success of our strategic direction.”

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CMPI survey: Alcohol, marijuana biggest substance problems among teens

BY Michael Johnsen

NEW YORK The Center for Medicine in the Public Interest on Thursday released the results of a national Teen Substance Abuse survey, indicating that police officers and high school teachers nationwide believe alcohol and marijuana are the most serious problem substances facing teenagers.

The results were released one week prior to a Sept. 14 Food and Drug Administration Advisory Committee meeting called to discuss whether or not additional sales restrictions need to be placed on dextromethorphan, a popular cold remedy ingredient that has been associated with teenage drug abuse. According to the survey, police and teachers polled do not believe it is a good idea to force Americans to visit a doctor to get a prescription to purchase commonly-sold cough-cold medicines.

When asked which substances do pose the greatest negative impact on teens, teachers and police identified marijuana and alcohol, followed by methamphetamine and cocaine. More than 1-in-4 police officers (27%) identified prescription drugs acquired by teens as having the greatest negative impact on teens, as compared with 15% of teachers. Nonprescription medicines were named by 1% of police officers as having the greatest negative impact; 2% of teachers identified over-the-counter medicines as such.

The survey also revealed that by a margin of 2-to-1, police officers and high school teachers support education efforts as a means to address abuse of OTC cough-and-cold medicines, versus restricted accessibility to consumers.

“Americans expect to be able to buy cough medicines conveniently at the supermarket or their neighborhood corner store,” stated CMPI VP Robert Goldberg. “Overly restricting access to cough-and-cold products containing dextromethorphan will create more health problems than it will solve, especially during cold-and-flu seasons. We need to find common sense solutions and invest more resources in education.”

The entire Teen Substance Abuse survey is available at Cmpi.org.

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