4 top tips to manage telehealth and your pharmacy practice

When we think about healthcare services with the prefix "tele," such as telehealth or telepharmacy, we typically associate them with convenience for both patients and providers. Prior to COVID-19 pandemic, it was the norm for patients to book appointments, travel to clinics, wait in the waiting room and then the examination room, and subsequently visit a pharmacy to obtain the prescribed medication(s), which can take hours. Since the pandemic, the adoption rate of virtual care in Canada has increased dramatically from 10%-20% in 2019 to 40% of all healthcare visits across provider categories in 2021 (1).

Before I talk about the relevance of this to pharmacy practice, let us define a couple of relevant terms. Telehealth, also known as telemedicine, is defined as “the delivery of various types of healthcare when patient and provider are geographically separated — it can involve video conferencing, telephone calls, electronic data transmission, and other ways of communicating over the Internet” by Canada’s Drug and Health Technology Agency (CADTH) (2). Virtual care is another term that is often used; it is defined by CIHI as “any interaction between patients and/or members of their circle of care, occurring remotely, using any forms of communication or information technologies, with the aim of facilitating or maximizing the quality and effectiveness of patient care." (4) I will primarily use the term virtual care.

The big question is: Is virtual care relevant to brick and mortar pharmacy practice?

The answer is, it depends on your clientele and the overall vision and mission you have for your pharmacy. If your goal is to serve your community around you and your patients live geographically close to your pharmacy and value face-to-face interactions, then offering virtual care may not add any additional value. If your goal is to serve a disease-focused clientele base and to offer expertise that other pharmacies do not, then virtual care may add great value to your potential customers and become a new revenue stream for your business.

Many pharmacies in Canada are brick-and-mortar establishments, but there are numerous online pharmacies that are taking advantage of the shift towards online ordering of products and medications. I want to emphasize that offering the same service/products you offer in the brick-and-mortar pharmacy via online delivery has only one advantage for patients, convenience. Keep in mind, this is only beneficial if the patients are able to access, navigate and use the virtual care platforms.

Virtual care can provide a competitive advantage by offering patients more options to engage in healthcare services. The disadvantage of offering online services is that it can cost the pharmacy money and human resources if these services do not offer high value (more than just convenience) for your patients.

Before offering virtual care, pharmacist-owners should first consider regulatory requirements, such as whether they can document patient information securely and provide effective care without meeting patients face-to-face, as well as the impact on current operational flow of the pharmacy. Next, to successfully adopt virtual care delivery, pharmacists/owners need to have a well thought-out plan, understand patients' needs, know what value the services are offering, set appropriate prices, and forecast the offering.

1. Having a plan is crucial when offering virtual care consultations as it can be a new source of revenue and a new service for your patients. It's important to treat it like any other product offering and not simply offer it to claim that you have virtual care options. You must think through the specific steps and be aware that it may take away staff resources and time, which can impact the operational flow.
2. It's essential to understand what your patients need and not create offerings that may not be useful. Asking patients what they want is crucial, as you don't want to create make-work projects.
3. Knowing your value offering is essential to understand what exactly you are offering through the virtual care space. Are you using these consults to engage patients in learning about a disease condition? Who are the potential clients? What additional values do your service and/or product offerings provide for your patients other than convenience?
4. Setting the right price for your service is crucial. I would recommend that you conduct a quick survey about patients' willingness to pay (WTP) for the service and/or products. This will help you understand the appropriate price to set for your services. If prices are set too high, no one will consider trying your services, if prices are set too low, you will be looking at no margin or low margin which you will have to consider the opportunity cost of continuing this type of service and/or product offering.

With the expanded scope of practice for pharmacists, I believe virtual care will play a much bigger role in future pharmacy practice. I recognize that the current business models are pressuring pharmacists to do more with less. Let’s chat about potential strategies for developing more inventive methods for delivering patient care and ways to receive compensation for our clinical expertise and service offerings.

References:

1. Canadian Medical Association. Virtual Care in Canada: Progress and Potential [Internet]. Ottawa (ON): Canadian Medical Association; 2022 [cited 2023 Apr 17]. Available from: https://www.cma.ca/sites/default/files/2022-02/Virtual-Care-in-Canada-Progress-and-Potential-EN.pdf
2. Canadian Agency for Drugs and Technologies in Health. Telehealth: Rapid Response Bundle [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2020 [cited 2023 Apr 17]. Available from: https://www.cadth.ca/sites/default/files/pdf/telehealth_bundle.pdf
3. American Journal of Health-System Pharmacy. Volume 79, Number 11, June 1, 2022.
4. Canadian Institute for Health Information. Virtual Care in Canada [Internet]. Ottawa (ON): Canadian Institute for Health Information; [modified 2021 Sep 22; cited 2023 Apr 17]. Available from: https://www.cihi.ca/en/virtual-care-in canada#:~:text=Virtual%20care%20has%20been%20defined,effectiveness%20of%20patient%20care%22%201

Jane Xia is principal consultant with Cedar Health Consulting