Article by Clare Morrison, Senior Clinical Quality Lead and Lead Pharmacist (North) at NHS Highland
What do you do when you need to offer pharmaceutical care across a huge geographical area but you only have a small team of pharmacists? You turn to telehealth.
NHS Highland has two distinct areas: the urban area around Inverness which is well served with community pharmacies, and a vast remote and rural area which is sparsely populated and, to a large extent, relies on dispensing GP practices.
The Pharmacy Anywhere project started in January 2017, following an “Innovating for Improvement” funding award from the Health Foundation. It is testing the use of telehealth to provide medication reviews to patients of remote dispensing practices.
Supporting dispensing practices is something we have done for a long time (the first pilot of a pharmacist providing medication reviews was 12 years ago). The issue is not with the need for the service, but how to provide it: our pharmacists were spending far too much time driving to remote locations instead of working in a clinical role.
Pharmacy Anywhere uses two forms of telehealth:
- Vision Anywhere which enables the pharmacist to have remote access to the patient’s medical record, replicating the access they have when they work at the practice.
- Attend Anywhere which is a video consulting system that enables patients to have a consultation at home using an internet-connected computer or smartphone. We did have to use the telephone as a back-up in some locations due to a lack of internet connectivity.
The GP practice staff make patients appointments for medication reviews. The pharmacist then consults the patient by video/phone, makes any changes needed to medicines, and updates the patient’s record.
Pharmacy Anywhere is currently being evaluated with the support of Robert Gordon University. What we can say now is that telehealth has enabled the pharmacists to do their job remotely and has saved huge amounts of travel time. But what has struck us most is the patient stories: how much easier it is to attend appointments from home, not having to arrange transport, not having to go out in icy weather, and even being able to focus on the whole appointment rather than spending the first few minutes catching their breath from the walk in.
It has been this response that has led NHS Highland to create NHS Near Me, a new telehealth service that will provide appointments as close as possible to patients’ homes. But telehealth has further advantages. It delivers resilience to services in rural areas where recruiting health professionals is a challenge. And, on the other hand, it enables pharmacists to work remotely, which means they can live and work full-time in rural locations where historically there might only have been small part-time jobs.
In short, telehealth is no longer a distant dream: it’s a reality.