Evaluating the impact of telepharmacy.

Area of Science:

• Health Services Research
• Pharmacy Practice
• Patient Safety

Background:

• Small community hospitals often lack 24-hour pharmacy services, potentially compromising medication safety.
• Remote pharmacist order review, or telepharmacy, offers a solution to extend pharmacy oversight.
• Evaluating telepharmacy's impact is crucial for improving medication-use systems in underserved settings.

Purpose of the Study:

• To evaluate the impact of remote pharmacist review of medication orders in three California community hospitals.
• To assess changes in medication administration practices and adverse drug events.
• To determine the effect on nurse satisfaction and cost-effectiveness.

Main Methods:

• A longitudinal study compared medication order review processes before and after telepharmacy implementation.
• Automated dispensing cabinet override reports and patient charts were analyzed for errors and adverse drug events.
• Pharmacist interventions, cost savings, and staff surveys on safety and job satisfaction were assessed.

Main Results:

• Medication administration without pharmacist review decreased by 35.3%, with a significant reduction in high-risk medication errors.
• Potential adverse drug events dropped from three to zero post-implementation.
• Pharmacist interventions increased from 15 to 98 weekly, with estimated savings of $261,109 per hospital.

Conclusions:

• Remote pharmacist order review effectively reduced potential adverse drug events in community hospitals.
• Telepharmacy services improved medication-use safety and nurse job satisfaction.
• This model demonstrates a cost-effective approach to enhance pharmacy services in facilities with limited hours.