Advancing Clinical Pharmacy through Telepharmacy Matthew J Maughan PharmD We are an Academic Health System 6 campuses 20 affiliate and alliance hospitals 29 clinical locations Serving a population of ID: 787906
Download The PPT/PDF document "Dartmouth-Hitchcock Telepharmacy" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Dartmouth-Hitchcock
Telepharmacy
Advancing Clinical Pharmacy through
Telepharmacy
Matthew J. Maughan,
PharmD
Slide2We are an Academic Health System
6
campuses
20
affiliate and alliance hospitals
29
clinical locations
Serving a population of
2 million
Slide3396 Licensed Beds
NCI Comprehensive Cancer Center
Level 1 Trauma Center
Comprehensive Full-Service Children’s Hospital (
CHaD
)
MICU, SICU, Neonatal ICU, Pediatric
ICU
Helicopter and
Critical Care Ground
Transport Service (DHART)
Serving a Broad and Rural Region
Slide4Current Telemedicine Services
D-H
Connected
Care
Emergency
Urgent Care
ICU
Neurology
Psychiatry
Pharmacy
Specialty
Slide5Telepharmacy
Services
18
total hospitals
2 Health Systems5 locations
4 locations
Over 50,000 orders reviewed each month
Slide6Goals of Clinical Pharmacy
Prospective review of 100% medication related activity
Prioritizing patients with biggest impact
Slide7Principles of Clinical Pharmacy
American Society of Health-System Pharmacy Statements
1
Pharmacist’s Role in:
Antimicrobial stewardship and infection prevention and controlClinical pharmacogenomics
Primary care
Medication reconciliation
Public health
Age specific competencies; Pediatric or Geriatric
Pharmacy services to the Emergency Department
Slide8Principles of Clinical Pharmacy
What are the barriers?
Costs of a pharmacist vs expected
r
eturn
Availability of pharmacists with expertise
Slide9Telepharmacy
Services
Value proposition is simple
Lower costs of pharmacist services
Onsite pharmacist perform tasks only they can do
Access to antimicrobial stewardship
Assistance with Medication Reconciliation
Slide10Principles of
Telepharmacy
Create more efficiency
Consolidate expertise
View the system as a whole
Slide11Principles of
Telepharmacy
Procure
Store
Prescribe
Order Review
Prepare & Dispense
Administer
Document
Monitor
Slide12Principles of
Telepharmacy
Procure
Store
Prescribe
Order Review
Prepare & Dispense
Administer
Document
Monitor
Slide13Principles of
Telepharmacy
Procure
Store
Prescribe
Order Review
Prepare & Dispense
Administer
Document
Monitor
Slide14Telepharmacy
Services: Example 1
Community Hospital
Rural community with recruitment issues
Pressure to save on expenses
Clinical needs that were unmet
Slide15Telepharmacy
Services: Example 1
Traditional overnight shift 10pm – 8am
Weekend
evening coverage
Solves the recruitment problem
Savings on the shift
Slide16Telepharmacy
Services
: Hospital 1
51%
4
1%
40%
44%
46%
4
1%
4
2
%
43%
45%
47%
51%
56%
$
Slide17Telepharmacy
Services
: Hospital 1
54% Savings
$
Slide18Telepharmacy
Services:
Hospital 1
2 Pharmacists on leave
Fathers who were sick or diedPreviously granted vacation
Slide19Telepharmacy
Services: Hospital 1
$
Slide20Telepharmacy
Services: Hospital 1
Onsite Pharmacists had capacity to do orders
$
Slide21Telepharmacy
Services: Hospital 1
More Pharmacists out which diverted more volume to
telepharmacy
$
Slide22Telepharmacy
Services: Hospital 1
Continued clinical rounding with medical teams
Maintained medication reconciliation activities for every admission
$
Slide23Telepharmacy
Services: Example 2
24hr coverage from the beginning of service
Antimicrobial stewardship
Clinical rounding
Slide24Telepharmacy
Services: Hospital 2
$
Slide25Telepharmacy
Services: Hospital 2
$
Slide26Telepharmacy
Services:
Hospital 3
Staff that needed leave for medical reasons
Maintained clinical servicesPost Acute Care Unit
Same Day Surgery
Slide27Telepharmacy
Services: Hospital 3
$
52%
Savings
Slide28Telepharmacy
Services:
Hospital 3
After hour coverage
ER Coverage
Slide29Telepharmacy
Services: Hospital 3
52% Savings
Slide30Telepharmacy
Services: Hospital 3
Started work with Emergency
Slide31Conclusions
Clinical pharmacy activities provide tremendous value to patient outcomes
Telepharmacy
provides a cost effective solution to increasing clinical pharmacy
Telepharmacy is versatile tool to assist with staffing needs
Slide32References
https://www.ashp.org/Pharmacy-Practice/Policy-Positions-and-Guidelines/Browse-by-Topic/Medication-Therapy-and-Patient-Care
Slide33Telepharmacy
Services Update
5 initial partner hospitals
Contract renegotiated to reduce price to partners
Now 18
total hospitals
2 Health Systems
5 locations
4 locations
Over 50,000 orders reviewed each
month
Slide34Telepharmacy
Services
Update
Patient Safety
Nearly 700 patient safety interventions
33% Clinical pharmacy activities like dosing adjustments to medications
33% Errors in medication order that could have resulted in patient harm
Cost Savings