Using pharmacy technicians and telepharmacy to obtain medication histories in the emergency department

Abstract

Objectives: To determine if telepharmacy can be used to collect medication histories on patients admitted in the emergency department (ED) in a large health system.

Practice description: As part of an effort to address safety concerns, resource limitations, and a decline in medication history completions, a program was developed to use telepharmacy to conduct medication histories on patients admitted in the ED.

Setting: The medication history program covers 5 large facilities. It is staffed by 6 full-time pharmacy technicians 7 days a week and is overseen by a pharmacist.

Innovation: Medication histories are conducted with the use of mobile carts enhanced with videoconferencing equipment allowing technicians to operate from a remote central location. The program allows the technicians to observe multiple EDs at one time, interview patients through videoconferencing, and document completed medication histories in the electronic medical record (EMR). The technicians also transcribe preoperation (pre-op) medication lists for patients being admitted for surgeries.

Evaluation: Medication history completion rates and barriers were assessed. In addition, potential medication errors, medication history accuracy rates for nursing and pharmacy technicians, and a cost analysis of preventable ADEs were explored.

Results: The program, on average, conducts medication histories on 56% to 79% of patients admitted through the ED during hours of operation. In fiscal year 2018, the technicians entered 24,980 medication histories and pre-op lists. A cross-sectional analysis of data collected from December 2016 to March 2017, including 124 patients, revealed 320 potential medication errors among a total of 382 high-risk medications.

Conclusion: Based on the current performance and continued expansion of this novel strategy, use of telepharmacy to obtain medication histories in the ED has led to resource optimization for the remote delivery of a pharmacy service.