Expansion of Pharmacy Services During COVID-19: Pharmacists and Pharmacy Extenders Filling the Gaps Through Telehealth Services

Abstract

Purpose: The Coronavirus 2019 (COVID-19) pandemic created a significant disruption in healthcare. In our health-system located in New York City, the provision of care in the ambulatory care setting moved to a remote model virtually overnight. We describe interventions made during the pandemic to transform ambulatory care pharmacy through expansion of telehealth services. Summary: In March of 2020, the closure of primary care clinics and provider appointment cancellations due to inpatient redeployment created a void. Collaboration with other health care providers and development of standardized telehealth workflows served as a conduit for creating new roles and opportunities for pharmacy team members. Three main interventions where the pharmacy team filled gaps include; (1) Expansion of pharmacist telemedicine visits for high-risk patients to improve access to primary care visits, (2) Partnership with nursing to create a centralized refill call center workflow, (3) Integration of pharmacy extenders into the prior authorization process to prevent medication access issues. Existing collaborative practice agreements for chronic disease management were utilized. A virtual pharmacist model for patient care contributed to an increase in telehealth visits from 51 in 2019 to 2997 total visits in 2020. In addition, the health-system refill call center expanded its services through collaboration with our pharmacy team. Pharmacists and pharmacy interns partnered with nurse practitioners to improve the call center workflow and address the significant increase in refill requests during the outbreak. Furthermore, a prior authorization process was created across multiple ambulatory care clinics to expedite medication access and prevent delays in therapy. Conclusion: Our ambulatory care pharmacy team leveraged technology, innovative workflows, and collaborative teamwork to catalyze a shift in pharmacists’ and pharmacy extenders’ roles in healthcare delivery to expeditiously meet patients’ needs during a pandemic.

The U.S. Travel Health Pharmacists’ Role in a Post-COVID-19 Pandemic Era

“…Prior to the COVID-19 pandemic, telehealth was already being used for patients with inflexible schedules who were unable to attend in-person appointments with their healthcare provider. However, there has been a surge in telehealth implementation during the past two years during the pandemic [ 37 , 39 , 40 , 41 , 42 ].…”

“…There are various benefits of telehealth to both the patients and providers such as increased access to care, flexible scheduling, decreased transportation costs, and lower cancellation rates [ 39 ]. Education and training programs that incorporate resources on telemedicine and remote patient care would be helpful in improving confidence for pharmacists during their assessments [ 37 , 43 ].…”

The Role of Telepharmacy in the Delivery of Clinical Pharmacy Services Following the COVID-19 Pandemic: A Descriptive Report

“…The authors cast a vision for the evolving role of pharmacists to not only include practice expansion but also the incorporation of telepharmacy into standard workflow. 8,9 The use of virtual visits has been shown to be important in multiple health care settings as well as multiple areas of pharmacy practice, including both inpatient and outpatient services. 6 The Association of Health System Pharmacists (ASHP) issued a position statement in 2022 regarding telehealth pharmacy services, supporting its use to expand pharmacy access, enhance patient safety, and improve patient outcomes.…”

“…The authors cast a vision for the evolving role of pharmacists to not only include practice expansion but also the incorporation of telepharmacy into standard workflow. 8,9…”

Key performance indicators for pharmaceutical services: A systematic review

“…Studies reported an improvement in the quality use of medicines with the involvement of pharmacists in patient treatment. 5 , 6 , 7 , 8 , 9 , 10 The implementation of pharmaceutical services is a complex process that needs to be monitored and evaluated to ensure that the service is provided with consistent quality. 11 , 12 In recent decades, assessing the quality of service, mainly involving clinical areas, has become increasingly important to providers, regulators, and purchasers of care.…”