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Home , Nursing, Telepharmacy

9/17/2016

What Are We Going To Discuss

• Learning Objectives • The Why Behind the Presentation • Benchmarking with the Smilow Cancer at Yale-New Haven • Defining • A Telepharmacy Workflow Advancing the Practice – Telepharmacy • Advancing the Practice Pennsylvania Society for -System • Now What? Annual Assembly - October 12, 2016

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Pharmacist Learning Objectives Technician Learning Objectives

• Describe the law as it relates to direct supervision of • Describe the role of the technician in a telepharmacy technicians. operation. • Discuss the process and benefits of telepharmacy from a • Discuss the process and benefits of telepharmacy from a ’s perspective. technician perspective. • Discuss the legal requirements for remote technician • Describe the safety steps implemented in the telepharmacy management through the use of telepharmacy systems. system. • Discuss the opportunities for improving clinical care team • Discuss the legal requirements for a telepharmacy system. management through the use of telepharmacy.

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The Why Behind the Presentation Exploring the Concept of Telepharmacy

• The Joint Commission’s • Pennsylvania State Board of Pharmacy – Chapter 27 Standard MM.05.01.07 – 27.12 Practice of Pharmacy and Delegation of Duties – Elements of Performance • The shall provide direct, immediate and personal – A pharmacist, or pharmacy staff supervision to pharmacy interns and pharmacy technicians under the supervision of a working with the pharmacist. Direct, immediate and personal pharmacist, compounds or admixes all compounded sterile supervision means that the supervising pharmacist has preparations except in urgent reviewed the prescription or drug order prior to its being situations in which a delay could dispensed, has verified the final product and is immediately harm the patient or when the available on the premises to direct the work of product’s stability is short. interns and technicians and respond to questions or problems.

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Benchmarking with The Smilow Cancer Hospital Telepharmacy in Connecticut

• Legislative obstacle was that direct supervision of a technician was defined as the pharmacist being present and able to monitor the activities of the technician. • Additional language set pharmacist to technician ratios for direct supervision depending on the setting. • Remote order entry is not the same as “telepharmacy” and would not include remote management of chemotherapy preparation. • American Society of Pharmacists (ASHP) Excellence in Use and Safety Award 2014

• Distance to each sites (10-60 miles from New Haven)

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Public Act 12-28: An Act concerning the Use of Defining Telepharmacy Telepharmacy by

• Effective on July 1, 2012, permits all of Connecticut’s “Telepharmacy” is defined as an What it is NOT – Remote order hospitals to use telepharmacy in the dispensing of sterile electronic technology or process entry is not the same as products whereby each step in the “telepharmacy” and would not ordering, verification and include remote management of • Required Elements: preparation of I.V. admixtures is chemotherapy preparation – Bar code tracking system and digital photography. captured electronically. The – Live video and audio communication. pharmacist and designated – Pharmacist to technician ratios must be met. technician are directly linked via – All orders shall be verified by a pharmacist prior to the delegation of live audio/video and an such orders to a technician and administration by appropriately electronic workflow system. licensed personnel. – Must conduct periodic quality assurance evaluations. – In the event of a malfunction of the technology, no sterile products prepared by a technician may be distributed to a patient.

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Camera Installation for Observation / Telepharmacy View of Digital Camera in Biological Safety Cabinet

A pharmacist must monitor the ’s activities through both audio The dispensing process for the and video communication. sterile product must be verified through the use of a bar code tracking system and documented through digital photographs, which are recorded and preserved.

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Biological Safety Cabinet Set Up Chemotherapy Pharmacy Technician

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Dose Verification Advancing the Practice

• Allow future expansion into remote settings and to improve access to quality care. • Allows for flexible staffing to accommodate changes in workload and staffing needs. • Allows for emergency coverage due to pharmacist illness or weather related interruptions. • Prevents rescheduling or rerouting to receive their chemotherapy.

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Pharmacist Role in Patient Care Now What?

• Telepharmacy can serve as an enabler for the integration • The UPMC Hillman CancerCenter Pharmacy is developing and expansion of the pharmacy practice: a telepharmacy practice model to support its hospital-based – Participation in multidisciplinary daily patient huddles and practices. The objective is to improve – Patient the quality of the chemotherapy products that are being – Oral chemotherapy counseling compounded through the deployment of a telepharmacy – Collaboration on patient treatment plans technology solution. This will allow pharmacists to provide – Medical staff and education remote oversight or observation of compounding technicians at these sites.

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References

• Pharmacy Challenges and Outcomes - Telepharmacy Presented to UPMC Cancer Center • Implementation of Remote Management of Compounded Sterile Products through the use of a Telepharmacy System – Safe Medication Management Associates http://www.smmacorp.com/ • Merging Community Practices with an Academic Cancer Center: A Roadmap for Success – Society National Congress, Washington, DC, April, 2013 • Connected: Telepharmacy Unites the Team, Drug Topics, May, 2016, Anthony Vecchione

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