Implementation of pharmacy services in a telemedicine intensive care unit

Meidl, Tracy M.; Woller, Thomas W.; Iglar, Arlene M.; Brierton, Dennis

doi:10.2146/ajhp070682

Cited by 43 publications

(34 citation statements)

References 5 publications

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“…et al report appropriate antimicrobial coverage and formulary support as the two most common recommendations made by pharmacist in a telemedicine intensive care unit. 8 In this study, a large number of DDI alerts was generated. Considering patient-specific risk factors, the clinical pharmacist passed only 8% of DDI alerts to tele-ICU rounds for discussion.…”

Section: Discussionmentioning

confidence: 99%

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Medication safety in a German telemedicine centre: Implementation of a telepharmaceutical expert consultation in addition to existing tele-intensive care unit services

et al. 2018

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Introduction Tele-intensive care unit (tele-ICU) services offer the possibility to provide specialized medical care in remote areas and to improve patient outcomes. The aim of this study was to implement and evaluate an additional telepharmaceutical expert consultation as part of tele-ICU services. Methods This is a prospective observational study conducted in the telemedicine centre of the University Hospital RWTH Aachen, Germany. Between March and July 2015, all tele-ICU patients of one internal and two remote ICUs received telepharmaceutical consultation. Number and type of drug related problems (DRPs) were identified in a comprehensive medication safety check. Implementation of DRPs was discussed interdisciplinarily by tele-ICU pharmacist, tele-ICU physician and remote ICU physician. Special focus was on drug–drug interactions (DDIs) and dosage adjustment in renal and liver failure. Results A total of 210 DRPs in 103 patients were identified and discussed. On average, 2.0 (range 0–17) DRPs per patient were found. At least one DRP was found in 62% of patients. Antibacterials for systemic use were most involved in DRPs. A total of 1129 DDI-alerts were generated by ID PHARMA CHECK®. Fifty-six DDIs (5%) were discussed in tele-ICU rounds. The tele-ICU team discussed 28 cases of dosage adjustment in organ failure. Discussion Telepharmaceutical consultation as part of tele-ICU services was successfully implemented and can improve medication safety. Telemedicine infrastructure provides the possibility to implement guidelines recommending pharmaceutical service in the ICU in remote hospitals not having access to clinical pharmacists. Thus, quality of care can be improved.

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Section: Discussionmentioning

confidence: 99%

“…Meidl et al report on the provision of telepharmacy in a telemedicine ICU in the United States. 8 In Germany, however, telepharmacy service as part of tele-ICU service for remote hospitals is new. In 2013, a centralized tele-ICU service for surrounding hospitals was successfully implemented in Aachen, Germany and surrounding areas.…”

Section: Introductionmentioning

confidence: 99%

Medication safety in a German telemedicine centre: Implementation of a telepharmaceutical expert consultation in addition to existing tele-intensive care unit services

et al. 2018

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“…Simple cost analysis was used by (n=14) (52,(63)(64)(65)(66)(67)(70)(71)(72)(73)(74)(75)(76)(77) studies measuring the cost avoidance, cost saving and added revenue. While (n=15) (27,30,35,58,68,69,(78)(79)(80)(81)(82)(83)(84)(85)(86) studies conducted a cost minimization analysis as a method to assess the economic benefits of telemedicine. The cost of providing telemedicine services was compared to the cost of providing the same healthcare service in a conventional face-to-face manner, whether it was a hospital based visit where the patient travels to get the service, or an outreach clinic where the provider travels to provide the care.…”

Section: Economicmentioning

confidence: 99%

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

AlDossary

Martin‐Khan

Bradford

et al. 2017

International Journal of Medical Informatics

108

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Our systematic review identified only 137 telemedicine services. This suggests either telemedicine service implementation is still not a part of mainstream clinical services, or it is not being reported in the peer-reviewed literature. The depth and the quality of information were variable across studies, reducing the generalisability. The reporting of service implementation and planning strategies should be encouraged. Given the fast paced technology driven environment of telemedicine, this may enable others to learn and understand how to implement sustainable services. The key component of planning was underreported in these studies. Studies applying and reporting more rigorous methodology would contribute greatly to the evidence for telemedicine.

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“…27 Implementation of intensive care unit telemedicine services, including telepharmacy, led to decreased durations of hospitalization, an increase in institutional bestpractice adherence, and lower rates of preventable complications. 28 Pharmacists are being encouraged to use mobile applications to communicate with patients to help them manage their diseases and medications. 29,30 Expanding Pharmacy Services.…”

Section: Patient Counseling and Monitoringmentioning

confidence: 99%

ASHP Statement on Telepharmacy

Alexander¹,

Butler

Darr

et al. 2017

American Journal of Health-System Pharmacy

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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...

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Implementation of pharmacy services in a telemedicine intensive care unit

Abstract: Implementation of a remote ICU pharmacy service in a 13-hospital health system resulted in the provision of consistent pharmaceutical care while minimizing costs.

Cited by 43 publications

References 5 publications

Medication safety in a German telemedicine centre: Implementation of a telepharmaceutical expert consultation in addition to existing tele-intensive care unit services

Medication safety in a German telemedicine centre: Implementation of a telepharmaceutical expert consultation in addition to existing tele-intensive care unit services

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

ASHP Statement on Telepharmacy

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