Viewpoint: Pharmacy and telehealth: Perfect together

Dec 11, 2006

By: Sheldon Prial, R.Ph.

Drug Topics

Every day we read about the many pressures retail pharmacists face: Medicare Parts A, B, D—all affect the industry. Major discounters offering lowball drug prices as "loss leaders" to build their sales are truly frightening.

In the midst of these dark clouds, I have found an exciting opportunity for pharmacists to bring a new service to their patients with chronic illnesses. It is called home telehealth.

To understand what this is, one has to refer back to the first successful launching of astronauts into outer space. NASA needed a means of checking the vital signs of the astronauts as they traveled around the earth. What was developed has blossomed into home telehealth.

Sheldon Prial, R.Ph.

This gives physicians, healthcare professionals, and family caregivers the capability to monitor patients without having to make a call in person or bringing them to an office. They can obtain all the vital signs they need almost instantly via home telehealth. Weight, blood pressure, glucose level, pulse rate, and cardiac monitoring are some of the vitals the practitioners need to maintain their patients' health.

How simple this is can best be described as follows: The patient steps onto a scale and then utilizes a pulse oximeter, spirometer, blood pressure cuff, glucose meter, or any other equipment required. All these vital signs are immediately reported to the nurse or physician. The recipient can then make a hard copy or transfer the information to the patient's record via his computer.

If there are any significant changes, the physician or nurse can follow up to determine what's happening with the patient. If the patient's weight has jumped, the clinician might find that the patient went out for dinner the previous night and there is no problem. If the patient's blood sugar or pressure rises, the health professional can ask and determine whether a personal call must be made. It's been reported that emergency room visits have been reduced by as much as 80% when a home telehealth unit monitors the patient. The need for a patient to be hospitalized has been reduced dramatically via this technique.

So how does the local pharmacy fit into this program? Right in the middle; that's how! Active community pharmacies have staff with the necessary knowledge to make this a success. They must prove to manufacturers of home telehealth equipment what they know, whom they know, and how they will be able to become local distributors.

Pharmacies should begin by identifying all of their bedridden or house-bound clients and then listing those with congestive heart failure, asthma, the ostomates, chronic obstructive pulmonary disease, and other debilitating illnesses.

Now the names of the physicians and therapists these patients use and the Visiting Nurse Association or home health agency taking care of them should be added to the list. Be sure it includes the name of the family caregiver. As an old pharmacist, I can look back to my days behind the counter. My partner and I knew all of our patients by their first name; we were a friend of the family caregiver and the practitioner. Yes, retail pharmacists are in the center of the activity, and in that position, they will be able to best provide this service.

Armed with this information, pharmacies should contact companies that provide telehealth equipment. Show them how many people the pharmacy services. Introduce them to the staff. Your pharmacy is a valuable asset to these companies.

Communicate with all of the resources identified, from the patient to the therapists, and miss none. One member of your team should be trained to be the "outside" salesperson, carrying the message to the potential referral sources. The manufacturer you arrange with to become its distributor will provide your team with the necessary knowledge to successfully market its equipment.

Nothing will happen unless you roll up your sleeves and work to get a piece of what is predicted to be a $2 billion-plus market. I believe that pharmacists can be very effective in building this new discipline.

For the pharmacist, this will be a cash business, since you will either be selling the equipment or leasing it. I prefer leasing and providing a maintenance contract. Of course, these are all cash sales.

So what have you got to lose—seize this opportunity before it slips away from you!

THE AUTHOR is a healthcare consultant based in Melbourne, Fla. He can be reached at shelly.prial@att.net


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