The Potential for Telehealth Within the Pharmacy Space

Excerpt (Full article published in the Pharmacy Times)

By Jeffrey Kosowsky, MD, PhD, Senior Vice President of Corporate Development

Pharmacists have faced unique new challenges as the pharmacy industry has evolved. According to the Kaiser Family Foundation, more than 4 billion prescriptions were filled in U.S. pharmacies in 2014,¹ which has inevitably led pharmacists to focus more on volume and efficiency than on delivering personal care. Pharmacists often have little time to provide education about a specific prescription nowadays. Bureaucracy and regulatory procedures within the pharmacy space also make it difficult for pharmacists to provide the same intimacy of care that our parents and grandparents remember.

The Benefits of Telehealth
Telehealth is a cost-saving solution that uses telecommunications technologies to expand health care outside the walls of a retail pharmacy while complementing and enhancing existing retail pharmacy services. When implemented, telehealth can also assist pharmacists with creating and managing new relationships with customers. However, it is important to note that telehealth is not a one-size-fits-all product; there are many different applications for it within the pharmacy environment. As with any new health care investment, the key-use cases should be tailored to the customer population and needs of each specific store and chain:

Customer-Initiated Consultations
Customers with questions about their medication can use online video visits to connect with local pharmacists from the comfort of their own home.

Pharmacist-Initiated Consultations
There are many scenarios in which pharmacists may wish to connect with a customer to ask questions or follow up. Whether a customer has an unclaimed script or is due for a refill, telehealth provides pharmacists with a personalized way to connect in real time.

Pharmacist-to-Pharmacist Consultations
An effective telehealth solution can immediately connect any pharmacist with a network of available, more experienced, or specialty pharmacists from anywhere within the pharmacy chain.

Connecting Pharmacists to Care Management Teams
Whereas telehealth initially focused on urgent care conditions, it is now moving toward chronic care and population health management. In many of these medical situations, patients have a pre-established care team with whom they are in regular communication.

On-demand Care via In-store Kiosks 
In-store kiosks offer an affordable pharmacy urgent care service without the expense and staffing challenges of on-premise nurses, especially for smaller, lower traffic stores. A companion pharmacy-branded mobile or web app is also available to consumers who wish to access the same telehealth platform from home, work, or while traveling, and encourages patients to pick up any prescriptions at the associated pharmacy.

The Value Proposition
For pharmacists, telehealth can enhance patient relationships and maintain customer loyalty while simultaneously improving care and extending patient services. For consumers, telehealth offers convenient, immediate access to the pharmacist and high-quality urgent care services from a trusted, neighborhood source. By implementing a range of pharmacy-related telehealth services, pharmacy chains can move beyond competing as an undifferentiated mass marketer of health and beauty items to becoming a hub for trusted consumer health and pharmaceutical care services.

Positive Steps
Over the past year, there has been substantial movement toward creating a more positive national telehealth environment. The Federation of State Medical Boards (FSMB) has been working on a State Licensure Compact to allow physicians living in states that participate in the compact to provide telehealth care for patients across state lines, making it easier to extend care across geographic boundaries. In April 2014, the FSMB published a Model Policy for Telehealth that highlights the most critical factors for safe telehealth. These factors include patient choice of provider, informed visits, and audio-video capability (phone-only consults are not substantial enough for an effective telehealth consult). In May 2014, the American Medical Association endorsed this policy. The American Telemedicine Association launched the first national accreditation program for telehealth solutions providing online care.

Remaining Challenges 
Pharmacy boards have perhaps not been as active as their medical counterparts in discussing and evaluating the proper and safe application of telehealth. As referenced above, the majority of medical boards have already identified the critical components of a legitimate telehealth interaction. The time is now for pharmacy boards to join the discussion regarding the creation of state regulations to support safe and effective telehealth pharmacy care.

These challenges, although relevant, should not deter pharmacies and retailers from integrating telehealth into their business models. If implemented correctly and with the right partner, telehealth is an exciting new way to engage consumers and bring care into the community. Finally, it is important to recognize that telehealth should not be viewed as competition for retail pharmacy, but rather, as a complementary service offering that can build on existing customer relationships and brand recognition to enhance customer loyalty and drive in-store foot traffic.

The Last Word
Never lose sight of the main objective: consumer satisfaction. Telehealth, although relatively new to mainstream media and culture, has been around for the past decade. We may not be able to go back in time to the era of Leave It to Beaver, but we can leverage powerful new socially oriented technologies to recreate the intimate relationship between consumers and their pharmacists of years past. Telehealth solutions bring more convenient, affordable, quality, and trusted care to consumers; pharmacies and pharmacists are an important part of this solution.

Jeff Kosowsky is Senior Vice President of Corporate Development for Amwell. Jeff leads our corporate and business development efforts focusing on strategic partnerships, large investors, major client deals, and M&A opportunities. Jeff brings to American Well more than 20 years of experience in healthcare, high tech, and business management and consulting. Prior to joining Amwell, he led efforts in business and clinical analytics and population health at MEDITECH. He also has extensive experience in e-commerce and software services, including leadership roles at GSI Commerce and Idiom Technologies. Prior to that, Jeff was an Associate Partner at McKinsey & Company where he focused on healthcare and high-growth technology companies. He graduated from Harvard University with an MD from Harvard Medical School and a PHD, AM, and an AB Summa Cum Laude in Applied Mathematics. He completed his surgical internship at the Harvard-affiliated New England Deaconess Hospital before transitioning to the business world.