ASHP believes appropriately trained and equipped pharmacists can use telepharmacy to remotely oversee pharmacy operations and provide distributive, clinical, analytical, and managerial services. ASHP advocates that telepharmacy be applied to suitable functions of pharmacy operations and patient care to improve patient outcomes, expand access to healthcare, and enhance patient safety. ASHP further advocates that boards of pharmacy adopt compatible regulations that enable the use of U.S.-based telepharmacy services within and across state lines for appropriate practice settings and that further research be conducted to establish best practices for telepharmacy. Background Telemedicine. The Centers for Medicare and Medicaid Services (CMS) describes telemedicine as a means for improving a patient's health by permitting two-way, real-time, interactive communication between a patient and a healthcare provider who are geographically separated. 1 This communication is conducted via interactive telecommunications equipment that includes, at a minimum, audio and video equipment to meet standards for telehealth set by the U.S. Department of Health and Human Services. 2 It is important to recognize, however, that telemedicine is a rapidly evolving field and that new methods of telecommunications, such as texting and mobile applications, are already in use. Standards for interactive telecommunications equipment that include text and binary data must address interactions with and without audio and video. The Food and Drug Administration (FDA) has established definitions, standards, and methodologies for mobile medical applications. 3 Definitions of Telepharmacy. The Model State Pharmacy Act and Model Rules of the National Association of Boards of Pharmacy (Model Act) defines the practice of telepharmacy as "the provision of pharmacist care by registered pharmacies and pharmacists located within U.S. jurisdictions through the use of telecommunications or other technologies to patients or their agents at distances that are located within U.S. jurisdictions" and provides definitions of related terms (i.e., coordinating pharmacy, remote pharmacy, and remote dispensing site). 4 For the purposes of this document, ASHP defines telepharmacy as a method used in pharmacy practice in which a pharmacist utilizes telecommunications technology to oversee aspects of pharmacy operations or provide patient care services. Telepharmacy operations and services may include, but are not limited to, drug review and monitoring, dispensing, sterile and nonsterile compounding verification, medication therapy management (MTM), patient assessment, patient counseling, clinical consultation, outcomes assessment, decision support, and drug information. Practice Advancement Initiative. The ASHP Practice Advancement Initiative states that "sufficient pharmacy resources must be available to safely develop, implement, and maintain technology-related medication-use safety standards ." 5 It further recommends that telepharmacy technology should be available for u...
