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Throughout the ongoing COVID-19 pandemic, healthcare professionals have been reexamining their roles and responsibilities as well as reflecting on lessons learned and successful practices implemented.
As core members of the care team, this includes pharmacy staff who are playing a vital role in adopting innovative strategies to minimize the pandemic’s adverse impacts.
Whether on the frontlines or virtual, COVID-19 has tasked pharmacists, as well as pharmacy technicians, with driving innovation in patient care delivery and pharmacy operations.
1. Administering COVID-19 Tests and Vaccines
New guidance issued in April 2020 under the Public Readiness and Emergency Preparedness Act authorized pharmacists to order and administer COVID-19 tests. This guidance from the U.S. Department of Health and Human Services (HHS) has positioned pharmacists to practice at the top of their license and provides them opportunities to add greater value on the frontlines, servicing patients from diagnosis to follow-up.
In certain states, pharmacy technicians can perform rapid point of care testing (POCT) to help enable greater preventative and supportive care for COVID-19 as well as help to reduce emergency department visits.
Pharmacists, as well as pharmacy technicians and students, have also played a key role in COVID-19 vaccine administration. Additional guidance from HHS announced in the fall of 2020 authorizes state-licensed pharmacists - and state-licensed, registered pharmacy interns acting under the supervision of a qualified pharmacist - to order and administer COVID-19 vaccinations to individuals 3 years of age and older.
Enabling pharmacists and technicians to administer COVID-19 tests and vaccines recognizes these vital roles as front-line healthcare workers who make a meaningful difference in combating the pandemic.
2. Digital Access to Care
According to the Centers for Disease Control and Prevention (CDC), during the first quarter of 2020, the number of telehealth visits increased by 50 percent, compared to the same period in 2019, with a 154 percent increase in visits noted in surveillance week 13 in 2020, compared to the same period in 2019.
Through telepharmacy visits, pharmacists have been working collaboratively with their patients’ providers, making recommendations to care plans and providing vital education and medication counseling throughout various disease states.
During these virtual pharmacist-patient connections, pharmacists provide reliable drug information and awareness to patients’ disease management – which, in turn, helps free up provider time and instill greater trust in pharmacists. Additional benefits of pharmacy telehealth services include:
Throughout the pandemic, clinical pharmacists mobilized remotely, while still maintaining all of their current roles and responsibilities. For one large academic medical center, pharmacists provided clinical pharmacy services via virtual video rounding in pediatric and neonatal intensive care units, helping to improve social distancing and infection prevention efforts.
For even greater care delivery support amid the pandemic, pharmacists and pharmacy technicians with valid licenses should be able to operate across state lines through telehealth services as well as conduct routine pharmacy tasks remotely, including prescription data entry and script verification.
3. Conducting Remote Order Verification and Overseeing Compounding
During the pandemic, some health system pharmacists have transitioned from hospital-based functions to remote order entry and verification as well as telepharmacy services. Remote order verification is a process that allows pharmacies to expand services without having to add new pharmacists - and can expand medical care in rural or underserved communities.
Remote order verification has helped providers optimize staffing as well as supplement staffing at facilities where 24/7 pharmacy support is not present on-site. Given social distancing guidance, the use of remote order verification has increased, as have considerations to centralize remote order verification in multi-hospital organizations. In responding to rapidly evolving situations, since mid-March, many states have issued waivers or otherwise amended regulations to permit the use of remote processing or telepharmacy to oversee a wide range of pharmacy operations.
Many of the changes follow recommendations in a joint statement for addressing COVID-19 from leading pharmacy organizations, including the American Society of Health-System Pharmacists (ASHP), American Pharmacists Association, National Alliance of State Pharmacy Associations, National Association of Chain Drug Stores and National Community Pharmacists Association.
In addition, technology has enabled pharmacists to oversee and verify intravenous compounding, eliminating the need for pharmacists to physically enter a clean room to confirm accurate compounding of drugs and doses. Utilizing this technology can also help conserve the use of personal protective equipment (PPE) during a time when these vital supplies can be scarce.
4. Reimbursement of Pharmacy Services
Through crisis comes opportunity for pharmacists to be recognized as providers. ASHP states that while pharmacists can provide telehealth services as an "incident to" a Medicare-eligible provider, they cannot directly bill Medicare for these services.
It is imperative that the Centers for Medicare and Medicaid Services (CMS) recognize front-line pharmacists as providers during these unprecedented times as pharmacists and technicians are valuable sources of information and treatment to serve patients and support a strained system at its most critical time.
Providing information and education to federal and state policymakers and health officials on the vital role that pharmacy has played during this pandemic is critical. Pharmacy is no longer an unsung hero, but a visible and integral part of the patient care team.
ASHP has been advocating for expanded scope of practice and payment for testing services related to COVID-19, as well as support for pharmacists and their families throughout the pandemic.
5. Pharmacy Technicians as Extenders and Technology Experts
The expansion of telepharmacy services has provided opportunities for pharmacy technicians to practice at the top of their licenses and act as extenders for pharmacists.
Traditionally, pharmacy technicians have facilitated the day-to-day functions of the medication use process - from order entry and drug product preparation to dispensation, allowing pharmacists to focus on direct patient care and medication therapy management. With the implementation of a variety of pharmacy technologies deployed throughout the medication use process, pharmacy technicians trained in information technology have become experts in day-to-day telepharmacy operations.
Having a dedicated pharmacy technician to operate such systems can provide a new career path as telemedicine technicians who are trained in information technology and are responsible for the operations and interface of telemedicine services’ hardware and software. These support staff set up, troubleshoot, maintain and run the technology (e.g., microphones, conferencing programs, privacy safeguards) - and help assure that the technology aligns with high-quality care delivery.
Elevating the role of the pharmacy technician as a telemedicine technician could improve patient/clinician satisfaction through streamlined telemedicine delivery, saving providers time and money. These positive outcomes have already been documented with comparable, existing support roles such as scribes who have been known to help reduce burnout and improve care service delivery and efficiency.
Telemedicine technicians can also act as care extenders, assist in billing and optimize technical aspects of service delivery and provide patients with IT training and ongoing support by acting as facilitators. Dedicated telemedicine technician support staff could also likely improve clinicians’ acceptance of telemedicine programs by helping to remove IT barriers. The COVID-19 crisis may be the final push needed to make these support roles a reality, leading to higher quality care and improved integration of pharmacists into virtual care teams.
The Future is Bright for Pharmacy
COVID-19 has provided new opportunities for pharmacists and technicians both to expand their roles and help ensure quality patient care.
These roles remain essential to the healthcare workforce and are even more equipped with an expansive skillset to service patients both near and far. These accomplishments and new capabilities will help to grow and diversify the field of pharmacy during the pandemic – and beyond.