Evaluation of telepharmacy and the use of a gravimetric technology–assisted workflow system for remote sterile product pharmacist checks

Abstract

Purpose To evaluate the impact of remote sterile product pharmacist checks when used with a gravimetric-based technology-assisted workflow (TAWF) system on product checking accuracy, pharmacist review time, workload sharing, cost savings, and staff perceptions. Methods A double-arm, prospective study was conducted at 4 pharmacy locations for a 90-day period. Each compounded sterile product (CSP) checked by a remote pharmacist was also checked by a local pharmacist at the site of CSP preparation. An anonymous, online survey was emailed to staff before and after implementation to evaluate perceptions of the accuracy, timeliness, safety, potential impact, and value of the remote process. Results There was no statistically significant difference in the numbers of errors detected through the remote process and through the current, nonremote process (P = 0.177). The median pharmacist review time in the local process was significantly lower (P < 0.001). Remote pharmacists in the study workflow verified 30.4% of the total number of CSPs verified in the 90-day period. Annualized cost savings were calculated to be $23,770.08. Percent agreement increased from the preimplementation to the postimplementation period for survey questions about the safety of the remote process, opportunity for workload sharing, and optimization of current workflow. Percent agreement decreased for questions about the accuracy, timeliness, and value of the remote process and its impact on job security. Conclusion The study demonstrated that with use of a gravimetric-based TAWF system, there was no difference in the accuracy and safety of sterile product pharmacist checks performed remotely and those performed at the product preparation site. In addition, the remote process allows for opportunities for workload sharing and cost savings.

Telepharmacy in oncology care: A scoping review

“…24–26,31–33,37–39,41,42 ‘ Synchronous’ alone was the second most common modality ( n = 5). 23,30,35,36,40 ‘Asynchronous’ alone ( n = 1), 27 ‘asynchronous combined with mobile health’ ( n = 2), 22,28 ‘asynchronous combined with synchronous’ ( n = 1) 29 and ‘synchronous combined with mobile health’ ( n = 1) 34 were the least commonly reported modalities.…”

“…Most articles described the use of telepharmacy in terms of ‘patient follow-up, monitoring and counselling’ ( n = 11). 24–26,31–33,37–39,41,42 Other articles focused on ‘Intravenous chemotherapy and sterile compounding’ ( n = 5), 23,27,29,30,40, ‘expanding pharmacy services’ ( n = 4) 22,28,34,35 and ‘remote education’ ( n = 1). 36 The telephone (mobile health) was a common mode of telecommunication used by pharmacists to deliver oncology pharmacy services.…”

“…‘High patient satisfaction’ ( n = 5), 30–32,41,42 ‘high healthcare professional satisfaction’ ( n = 5) 27,28,30,31,36, and ‘increased the use of pharmacy services’ ( n = 3) 33,37,42 were most commonly cited. Patient satisfaction with telepharmacy 30–32,41,42 was consistent among studies, but healthcare professional satisfaction varied.…”

“…22,28 Telepharmacy assisted workflow by verifying 30.4% of the total number of the compounded sterile products. 27 Telepharmacy was reported as resulting in an annualized saving of US$1,132,144 associated with a 42% increase in the number of clinical interventions. 28 A total annual cost saving of materials for intravenous chemotherapeutic compounding was estimated to be US$23,770.08.…”

Impact of technology-assisted versus manual sterile compounding on safety and efficiency in a Canadian community hospital

“…Novel technologies with sensitive error detection techniques, including barcode verification and digital photograph reviews, 16-20 gravimetric workflow systems, 21-24 and robotic compounding 25-27 have been developed to address manual compounding risks. These technology-assisted workflow system (TAWS) capabilities are purported to reduce reliance on human memory by providing standardized workflow prompts, improve measurement accuracy, 9 , 11 , 12 , 28 create a time-stamped audit trail of compounding steps with photographic records, simplify drug inventory management, and reduce transcription errors.…”