Virtual clinical pharmacy services: A model of care to improve medication safety in rural and remote Australian health services

Abstract

Purpose: To describe a virtual clinical pharmacy service as a model of care to support rural and remote Australian hospitals that otherwise would not have access to onsite pharmacists.

Summary: Many small hospitals in Australia do not have an onsite hospital pharmacist and struggle to support and optimize patient care. To increase access to a hospital pharmacist's specialized skills and medication knowledge, a virtual clinical pharmacy service was designed and implemented in 8 hospitals across rural New South Wales, Australia in 2020. The virtual clinical pharmacy service focuses on the core role of hospital pharmacists, including obtaining a best possible medication history, medication reconciliation at transitions of care, medication review, interprofessional team meetings, provision of patient-friendly medication lists, antimicrobial stewardship, and patient and clinician education. The model is aligned with recognized standards of practice for the delivery of clinical pharmacy services in Australian hospitals. This article details a model of care for translation across other settings. It provides the necessary details on clinical services, processes, supporting structures, an evaluation framework, and other important considerations for implementing virtual pharmacy services.

Conclusion: This research provides policymakers, health service planners, and practitioners with a model for providing comprehensive clinical pharmacy services virtually to increase the safe and effective use of medicines. Future publication of the findings of a formal evaluation of the model's acceptability and effectiveness is planned.

Keywords: hospital pharmacy service; rural health; rural hospital; telemedicine; telepharmacy; virtual pharmacy.

Figure 1.

Simplified project plan with key considerations and barriers to implementing a virtual clinical pharmacy service. eMeds indicates electronic mediation management; EMR, electronic medical record; VC, videoconferencing.

Figure 2.

Process of care for delivering a virtual clinical pharmacy service, including facilitating technologies and health-system benefits. eMeds indicates electronic mediation management; EMR, electronic medical record.

Figure 3.

Electronic medical record (EMR) documentation workflow and templates used to document virtual clinical pharmacist consultations. ADR indicates adverse drug reaction.