Telepharmacy: "Pharmacists should still not sit in the Bahamas"
Health Minister Karl Lauterbach also wants to promote telepharmacy with the pharmacy reform. However, it is still unclear what the term actually means.
The term telepharmacy is used heterogeneously and is the subject of much debate.
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In addition to the construction site "de-bureaucratization" – for both doctors and pharmacists –, Health Minister Karl Lauterbach also wants to tackle the issue of "telepharmacy", as can be seen from a key issues paper on pharmacy reform published at the end of 2023. But what does telepharmacy actually mean? Experts discussed this at the Federal Chamber of Pharmacists' symposium "Telepharmacy – opportunities and limitations".
Telepharmacy refers to any patient-specific pharmaceutical service provided by on-site pharmacies and hospital pharmacies (hospital pharmacies) at a distance. It includes any form of information and advice, care and the provision of pharmaceutical information and services that do not necessarily require physical contact between the patient1 and pharmaceutical professionals, as well as interprofessional consultations.
To this end, telepharmacy makes use of all types of synchronous or asynchronous telecommunications as well as digital applications, digitally networked dosage forms and therapeutic systems that determine, monitor, record, evaluate, store or transmit therapy-relevant parameters for the purpose of optimizing drug therapy.
Source: BLAK position paper.
According to the pharmacies, telepharmacy in the context of messenger services is nothing new. According to the participants in the discussion, working from home is possible, but is no substitute for direct contact with customers – similar to video consultations. Especially when patients are informed about the use of certain medications for the first time, this should not be done purely telepharmaceutically. emphasized Dr. Hannes Müller, board member of the Federal Chamber of Pharmacists and member of the Digital Hub of the Federation of German Pharmacists' Associations.
"With every new prescription [of a medication] for a chronic illness, the patient receives instructions from the pharmacist," says Müller. He then visits the pharmacy regularly, as "side effects often occur with a new prescription. These very often lead [...] to discontinuation of therapy. This can be detected early on by pharmacists," explains Müller. If necessary, there is then an exchange with the doctor.
Local pharmacies are important
According to Matthias Mieves, e-health spokesperson for the SPD parliamentary group, "a great deal of medical expertise and capacity has been withdrawn from the local area" in Sweden. This has improved healthcare provision for the "urban clientele [...] but worsened it for the rest of the population", explains Mieves. As a result, pharmacies were required to provide on-site pharmacies in the regions they supply digitally.
According to the President of the Bavarian Medical Association, Thomas Benkert, pharmacists, as drug specialists, should also be able to adjust patients' dosages from the pharmacy. The initial diagnosis should, of course, be made by the doctor. The electronic medication plan could soon be used for this purpose. Assisted telepharmacy could also play a role here, with a GP or hospital doctor calling in a pharmacist as part of a teleconsultation to provide information on how to take the medication. According to Müller, this could help if hospitals do not have their own pharmacy. Nevertheless, studies have shown that personal contact is the most effective.
No call center in the Bahamas
Overall, there is a need for better networking between the various experts; something that telemedicine experts also regularly emphasize. There is talk of hybrid doctors and pharmacists – i.e., those who interact with patients both remotely and on site. According to the panelists, personal contact with patients is essential. "It can't be that I open a call center somewhere in the Bahamas," said Benkert, and that he looks after everyone remotely via a database.
Lack of clarity about telepharmacy terms
Only recently, the North Rhine Chamber of Pharmacists (AKNR) and the BLAK each published a position paper setting out what they understand by the term telepharmacy. According to the Deutsche Apothekerzeitung, both "link the term to public pharmacies and hospital pharmacies and want to create opportunities for pharmaceutical staff to work from home".
The BLAK sees telepharmacy as an opportunity to provide better care for patients in rural areas or less mobile people and to ensure that they take their medication correctly. Taking medication incorrectly could not only be expensive, as it could cause medication to lose its effectiveness, but could also endanger human lives.
Battle for interpretative sovereignty
However, according to the key issues paper, Health Minister Karl Lauterbach wants to establish a concept with telepharmacy in which pharmaceutical technical assistants manage pharmacies and pharmacists are only connected via video conference when necessary. According to the DAZ, the position papers and the event organized by the Federal Chamber of Pharmacists are an expression of the fact that pharmacists are fighting for the right to interpret the term telepharmacy. BLAK President Thomas Benkert clarified at the symposium that Lauterbach's concept is not telepharmacy for pharmacies.
(mack)