Telepharmacy allows for the delivery of pharmaceutical care via telecommunication to patients in remote locations without direct access to a pharmacist. It involves a central pharmacy using audio/video technology to provide clinical services like counseling to remote sites staffed by technicians. The document discusses different telepharmacy models used in various countries and states how it works through the central pharmacy verifying prescriptions and remotely monitoring medication dispensing. While it improves access to care, challenges include ensuring compliance with pharmacy laws and providing continuous care through technology.

1. TELEPHARMACY
PREPARED BY:
MS.CHAVDA PRATIBHA.H
M.PHARM(CEUTICS):SEM II
2019-2020.
DEPARTMENT OF PHARMACEUTICAL
SCIENCE SAURASHTRA UNIVERSITY RAJKOT
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2. What Is TelePharmacy?
 Telepharmacy is the delivery of pharmaceutical care via telecommunication to patient in
locations where they may not have direct contact with a “Pharmacist”
 Telemedicine; is the use of telecommunication & information technology to provide clinical
health care from a distance.
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3.  Telepharmacy services include drug therapy monitoring, patient counseling, prior
authorization and refill authorization for prescription drugs, and monitoring of formulary
compliance with the aid of teleconferencing or videoconferencing.
 It can be delivery at retail pharmacy sites or through hospitals, nursing homes or other
medical care facilities.
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4. Traditional Full
Service Pharmacy.
Remote
Consultation Sites.
Hospital
Telepharmacy
TYPES OF TELEPHARMACY MODELS:
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5. 1.TRADITIONAL FULL SERVICE PHARMACY:
 These telepharmacy sites have complete drug inventories that include prescription and over
the counter medications along with other-health and beauty aids and other general
merchandise.
 These types of pharmacy running mostly in rural areas.
2.REMOTE CONSULTATION SITES:
 In the remote consultation sites, there is no prescription drug inventory at the site and it does
not require a registered pharmacy technician.
 Courier picks up and delivers prescriptions filled by a pharmacist at a central pharmacy site a
short distance away.
 Prescription are prepared at the central pharmacy and the patient counseling & education is
provided by the pharmacist via audio and video computer link.
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6. 
3.HOSPITAL TELAPHARMACY:
 Hospital pharmacist in urban medical center reviews, processes and verifies the prescription
that are issued and electronically send from rural hospitals.
 Automated dispensing device(ADD) is used to electronically release the prepackaged
medication, A nurse in the rural hospital, with password authorization to the ADD work
station.
 The pharmacist at the urban medical center is able to electronically monitor the verification
process and to oversee the restocking of the ADD via a videoconferencing.
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7. IMPLEMENTATION OF TELEPHARMACY
AUSTRALIA
 A form of telepharmacy has been in use by Australia’s Royal Flying Doctor
Services(RFDS) since1942.Medical chests containing medications and equipment are placed
in remote communities where they can be administered to patients during a telehealth
consultation.
 Some 3500 chests were distributed around Australia as of 2006.
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8.  In one year Queensland recorded 21,470 telehealth consultation, of which 13.7% resulted in
administration of medication from a medical chest.
 The medication types administration most often are antibiotic, analgesics and gastrointestinal
medication.
 This system improves access to both emergency and routine medical care in remote parts of
Australia.
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9. UNITED STATE.
 Implementation of telepharmacy in the US began in the 2000s.
 A combination of factor, including changes medicare reimbursement for medication &
recession of 2007-8, led to a decline in the number of independent pharmacist & alternative
delivery of pharmacy services in rural communities lacking of a full-time pharmacist.
 Several midwestern & northwestern state with wide rural are have much more development
of policy &implementation method for telepharmacy.
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10.  In 2001 North Dakota become the first U.S state to pass regulation allowing retail
pharmacies to operate without requiring a pharmacist to be physically present.
 The next year state agencies and grants established the North Dakota Telepharmacy project,
which now supports more than fifty remote retail and hospital pharmacy sites throughout
North Dakota
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11.  In this program a licensed pharmacist at a central site commutated with remote site
pharmacy technician & patient through videoconferencing.
 A 2004 study of the program found that telepharmacy delivery the same quantity of
pharmacy services as traditional facilities.
 North Dakota pharmacy business from 2002-004 found the while medication inventory
turnover was lower than industries average.
 The remote site were able to be operate profitably.
 This successful program is an inspiration & model for programs laws in other states.
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12. CANADA
 Adoption of telepharmacy in CANADA began as a response to a nationwide shortage of
Pharmacist.
 Canada’s first telepharmacy service started by a hospital in CRANBROOK,BRITISH
COLUMBIA, in June 2003 in order to assist a hospital in a nearby town that was unable to
hire a pharmacist.
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13.  To meet the need for service, a hospital pharmacist in Cranbrook began using telepharmacy
technology to oversee pharmacy technician at the other hospital.
 a similar service was subsequently extended to other small hospital in the province, It’s also
used to provide coverage when a hospital’s sole pharmacist is absent due to illness or
vacation.
 REMOTE DISPENSING machine for medication began operation in ONTARIO Canada in
2007.
 After a patient insert a prescription into the dispensing machine, the prescription is scanned
and the patient is connected by telephone, videoconference to pharmacist at a remote site.
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14. HOW DOES TELEPHARMACY WORK
STEPS INVOLVED IN
STEP 1:-
 Small pharmacy or clinics in remote, isolated areas is
connected central pharmacy (In larger Urban),through
Novel software, videophone system and ADM.
That have greater access to pharmacist staff for 24 hours.
Patient
Pharmacy Technician
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15. STEPS 2 :
 Patient bring their prescription to the remote sites,
which are staffed by either pharmacy technician.
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16. STEP 3:-
 The pharmacy at the rural site, then scans the barcode
so that the prescription matches with it’s label.
 Then pharmacist at central can visual monitoring to ensure
that the right medication have been filled & physical
presence of drug in packing then release several
items to patient.
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17. STEP 4:-
At the end of process, the central pharmacist provide
way of video consultation for the patient to ensure
that they understand the intended for the medication
use and administration.
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18. INVOLVEMENT OF PHARMACIST
 In any telepharmacy model, pharmacist can play an active role in the delivery of
pharmacy service.
 The pharmacist involving in telepharmacy models ensures high quality care for the
community particularly areas such as medication reviews and patient counting.
 A 2013 study of the impact of telepharmacy services has shown that the involvement of
pharmacist in the remote review of medication orders when the hospital pharmacy was
closed resulted in a decrease number of adverse drug events reported.
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19. Step By Step Guide To Creating A Successful Program.
Starting A Telepharmacy
1.Become Familiar With The Laws And Regulation.
A. General principle & first point of contact.
 Pharmacy probably has more laws and regulation in every state than any other area of health
care. A careful analysis of existing state and federal laws and rules related to operating a
pharmacy is necessary.
 To operate telepharmacy services in the state and the remote site must be properly licensed
with the state board of pharmacy.
 The state board of Pharmacy should be the first point of contact when considering
establishing telepharmacy services to ensure that the current rules and regulations allow this
type of pharmacy to operate within the state, and also to ensure that any future plans for
establishing telepharmacy services are in full compliance with state law.
 SBP will provide the proper process to follow for official applying for a telepharmacy permit.
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20. B. License Application:
 The applicant must obtain registration number from the, National Council for Prescription
Drug Programs (NCPDP), and the Federal Drug Enforcement Administration(FDEA).
 The State Board of Pharmacy, NCPDP and FDEA registration number for both the central
pharmacy and remote telepharmacy sites are also needed for obtaining reimbursement from
third party payer for telepharmacy services.
 The regulation approval process may vary depending upon each state’s rules and regulation it
may take 2-3 months or longer for approval of the telepharmacy operating permits.
 For telepharmacy services that are based in a hospital pharmacy, a new license may not be
necessary.(Washington State)
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21. 2.Assess The Need.
3.Development Of Community Partners.
In determining the level of support for telepharmacy services and defining the scope of service
needed in the targeted community, feedback from the following project partners may be
beneficial.
 Individual Patient
 Senior Citizen Groups
 Rural Health Clinic Personnel
 Community Business Leaders
 Local Community Leaders
 Local Government Officials.
 State Board Pharmacy Administration.
 Pharmacist Practicing In The Area
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22.  State Pharmaceutical Association.
 School Of Pharmacy.
4.Secure a Physical Location.
I.Criteria To Consider For Location Of Retail Telepharmacy Services.
 Convenient Access For The Public.
 Proximity To Other Clinic Facilities,proximity To Nursing Homes.
 Leased After Development By Local
 Lease Space In An Existing Business.
 Technology Transmission Or Connectivity Capability In The Community.
II.Criteria To Consider For Starting Hospital Telepharmacy Services.
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23. B. Planning Construction.
 Retail Telepharmacies.
1 Design.
2 Fixture.
3 Inventory.
4 Information Technology Consideration.
Computer, Video, Transmission, Security of information-HIPAA Compliance.
C. Personnel Considerations.
Pharmacy Technician.
Licensed Pharmacist.
D. Patient Considerations.
E. Quality Assurance.
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24. Clinical Benefits & Challenges of TelePharmacy
Access to Healthcare Services.
 The primary advantage of telepharmacy is the easy access to healthcare in remote
and rural locations.
 Pharmacist can provide high-level pharmaceutical care services in remote areas, that
have lost or are losing access to healthcare services.
Economic Benefits.
 Because avoiding expense of new equipment, recruitment of pharmacist & pharmacy
store.One skilled pharmacist can provided services to multiple sites, rising pay scale
for pharmacist &further expense in hiring additional pharmacist for rural sites,cost
also minimized.
 Garrelts Etal study the impact of telepharmacy in multihospital health system,which
showed a net estimated saving of US $ 1132,144.
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25. Patient Satisfaction.
 A telepharmacy model targeted to low income population showed that > 60% of
patient would have faced difficulty in affording their medication, if the telepharmacy
model did’nexist.
 Medication access & information in rural area via telehealth had advantages of patient
satisfaction.
 This remote technology has allowed to pharmacist to review patients medication
without them having travel.
Effective Patient counseling.
 A study on telepharmacy-related services & outcomes in the USA reported that
pharmacist recommended, using the webcam-enabled telepharmacy services because
they provide better privacy longer counseling duration via compressed video.
Minimal scarcity of pharmacist.
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26. EMERGENCY USE OF THE TELEPHARMACY:
Urgent care center:-
 Imagine this: your child has a fever so you take it to the nearest urgent care clinic.
 You’re finally discharged at midnight with a diagnosis of an ear infection and a prescription
for an antibiotic. You check google maps for 24 hour pharmacy.
Translation:-
 Traditionally, if a patient entered the pharmacy ad did not speak english the only available
solution was a phone-a-pharmacist service, which provide access to pharmacists who speak
other lenguages.
Physical Dispensing
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27. Disaster Relief:
o The global online Or telepharmacy market is anticipated to rise at a considerable rate.
o E-pharmacy as the lifeline for cities under lockdown to fight against the pandemic. It is also
known to be providing many benefits for micro, small, and medium enterprises(MSMEs).
o The consumer during the pandemic also benefitted by getting essential supply of medicines,
hand sanitizers and face masks. It is a safe shopping process during lockdown.
o The consumers would be able to order medicine in a convenient manners.
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28. Disadvantages.
 Pharmacy regulation law.
 Operational difficulties.
 Security.
 Reluctance to use technology.
 Continuity of care
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29. Google Source
www.telepharmacyconcept.com
www.customdata.com
www.telepharmacynakota.com
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30. THANK YOU
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