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Multisite implementation of a pharmacist-led telehealth transitions-of-care program: Design and execution.

Daniela Farzadfar1, Samantha Liaw1, Carissa Escober Doran1

  • 1VIVO Health Pharmacy, Northwell, New Hyde Park, NY, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
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PubMed
Summary

A pharmacist-led telehealth transitions-of-care (TOC) program improved medication management and care continuity for patients post-discharge. This program optimized patient outcomes through remote medication reconciliation and education.

Keywords:
implementationmedication reconciliationpharmacist-led servicespostdischarge counselingtelehealthtransitions of care

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Area of Science:

  • Pharmacy Practice
  • Health Services Research
  • Telehealth

Background:

  • Transitions-of-care (TOC) programs are crucial for managing patients with complex medication regimens post-discharge.
  • Telehealth offers a scalable solution to extend the reach of TOC services, particularly within integrated health systems.

Purpose of the Study:

  • To detail the design and phased implementation of a pharmacist-led telehealth TOC program.
  • To describe the integration of this program across multiple hospitals within a large health system.

Main Methods:

  • A centralized, pharmacist-led telehealth TOC program was implemented in two phases.
  • The program targeted patients with multiple discharge prescriptions filled at system pharmacies.
  • Expansion included additional hospitals, all age groups, and services like pharmacy services coordinators (PSCs) and bedside delivery.

Main Results:

  • The telehealth TOC program was successfully implemented across multiple hospitals.
  • Pharmacists conducted virtual follow-up visits within 2-3 business days post-discharge.
  • Services included medication education, reconciliation, and problem resolution via telephone or video call.

Conclusions:

  • The telehealth TOC program facilitated continuity of care and optimized medication management.
  • Successful implementation aimed to improve patient outcomes through enhanced post-discharge support.
  • Collaboration across multidisciplinary teams was key to program integration.