“There’s a way to do it better. Find it.” Thomas A. Edison
Introduction
In my search to find innovative healthcare companies, I have discovered “pockets of excellence”. These are healthcare organizations that address a clear need in the market, provide easy-to-use services, and offer a more cost-effective solution. One of these companies is Medication Review in Spokane, Washington. I will share their success story of pharmacists using telepharmacy to remotely serve rural hospitals in a six-state region.
About Medication Review
Medication Review provides pharmacy services for hospitals and clinics throughout the West Coast and Pacific Northwest. They serve critical access hospitals in rural communities, as well as small to mid-size hospitals in larger communities. Working 24/7, their pharmacists utilize telepharmacy to ensure that all medications are safe and effective.
Due to hospital staffing strains during our COVID-19 pandemic, Medication Review’s clinical pharmacists are being asked to play an even larger role in patient care. They are quickly expanding to provide remote clinical pharmacists to the facilities and patients that desperately need them. Their excellent medication management and pharmacy consulting services will help their hospitals through very challenging times.
Challenges for Rural Hospitals
Healthcare systems throughout rural communities are facing a pandemic that is overwhelming their employees and gravely straining their financial resources. It has been thoroughly reported that many of these hospitals and clinics have had to resort to layoffs and furloughs. To control costs and compensate for lost revenue, they plan to decrease the number of fulltime employees (FTEs). These plans are often an attempt to “keep the doors open”. This is a terrifying thought during a time when society is recognizing just how important local medical services are.
The healthcare market may be more resilient than other businesses during a recession, but the unique service-limiting aspects of a pandemic result in a world where even healthcare is vulnerable to closures. Federal funding and local support are keeping many facilities open today. To maintain options for care in many of these communities, more than temporary funding will be needed.
Services Provided
One opportunity for rural medicine and all of healthcare is to implement telehealth and leverage the savings over hiring additional FTEs. These services not only reduce hospital costs, but also help to optimize the clinical team in partner facilities. The use of remote doctors and mid-level practitioners is becoming more recognized as an alternative to traditional care, but remote PharmDs may have an equal impact in improving the quality of patient care.
Kevin Walker, PharmD and Director of Clinical Services at Medication Review, believes a single solution will not solve all our medical system problems, but greater utilization of clinical pharmacists is a major part of the answer. Deploying pharmacists to provide direct patient care in hospital and clinic settings has proven to increase patient satisfaction, decrease healthcare costs, decrease doctor burnout, and, most importantly, improve patient outcomes. This is not surprising given the fact that a significant percentage of patient issues are connected to their medications and no other medical professional has the breadth and depth of medication knowledge possessed by a pharmacist.
Benefits During COVID-19
During the COVID-19 pandemic, potential treatments are being reviewed by everyone on the healthcare team; however, the interactions between respiratory inflammatory pathways, fluid retention, and medications that treat diabetes may go unnoticed. This highlights why the expertise of a pharmacist reviewing every detail of a patient’s medical profile is so important. This type of essential review and oversight is not unique to COVID-19, but many diseases and disorders are positively or negatively affected by medications that are being taken for another ailment.
The Medication Review remote clinical pharmacists work with the healthcare team to scrutinize the drug regimen of every patient in the hospital and clinic setting. Their goal is always to maximize safety and efficacy while reducing overall costs. Some of their clinical duties include antibiotic drug monitoring, medical provider and nursing consults, laboratory value monitoring, dose adjustments, and pharmacogenetic consulting. When the stress of working in a healthcare setting taxes the staff on-site, it is essential to have a strategic partner that can focus on patient medication safety to prevent patient harm. The on-site medical teams greatly value the addition of remote team members that can provide an expert perspective and allow them to provide more direct patient care.
The pharmacy management team at Medication Review is playing a large role during this pandemic. These clinical pharmacists often serve as pharmacy directors or consultants and are charged with making the best financial, clinical, logistic, and legal decisions for facilities and their patients. Some of their duties include medication formulary decisions, order set and clinical guidance development, drug waste and takeback service oversight, policy and procedure adjustments based on state and federal requirements, identifying financial waste and savings, and analyzing opportunities for increased department revenue. This continued remote oversight allows the medical system to make the best decisions even when their pharmacy director is miles away and their on-site resources have been stretched thin by the pandemic.
Future Opportunities
According to Barry Ross, a Digital Transformation Consultant in Silicon Valley, healthcare companies will have excellent growth opportunities in 2021. He compares the business strategies of Kellogg and Post during the depression. While Post hunkered down, cut spending and waited for the good times to return, he recommends the Kellogg approach of continued marketing and researching of new business opportunities. He recommends that companies amp up their services to existing customers, obtain timely customer feedback, and develop a vision for future growth.
Dr. Walker believes that telepharmacy will enable pharmacists to provide patient care in every healthcare setting. Though telehealth has been utilized for over 20 years, this is the time to recognize that it is an essential piece of the healthcare puzzle. With all the negatives from the financial stress of this pandemic, positive movements to advance patient care and adopt new technology must be celebrated. This pandemic has placed a great deal of stress on healthcare, but options do exist, and they will be utilized by the facilities willing to approach current and future problems with innovative solutions. System success is not always connected to a lack of obstacles, but is often connected to the ability to adapt and improve.
Bruce Korus is the Founder of Korus Health Innovation. Powering up primary care teams to better utilize telehealth and improve access to affordable health services. Send your comments to bruce@korushealthinno.com