This is a question I have been pondering lately as more and more data suggests alarming future healthcare worker shortages. The US Department of Health and Human Services healthcare workforce projections published this year estimate there will be a 23% shortage of primary care providers and a 55% shortage of psychiatrist by 20361. The projected provider gaps are worse in regions of the country deemed medical care “deserts”. Is this an opportunity for pharmacists to help fill these provider gaps using telehealth modalities?
The pandemic served as a forcing mechanism requiring all healthcare providers including pharmacists to pivot from traditional face-to-face care to telehealth care as the routine care delivery model. Hursman et al demonstrated the positive impact on patient access and interdisciplinary team integration during and post-pandemic when clinical pharmacists utilized telehealth modalities to provide comprehensive medication management across practice areas2. Goodman et al published an article this year that highlighted the impact mental health (MH) clinical pharmacists have on patient access when integrated into virtual interdisciplinary telehealth teams as MH primary prescribers. This article described how the MH clinical pharmacist provided rural clinic coverage in an integrated healthcare system via a hub and spoke telehealth model during MH prescriber vacancies, same day substance use disorder clinic coverage, and provided new telehealth learning experiences for psychiatric pharmacy residents3.
Incorporation of telehealth practices in pharmacy can extend beyond clinic-based models, across the continuum of care. A recent review demonstrated the contribution of independent prescribing by community pharmacists on improved patient access to primary care, reduction in treatment delays, and improved quality of life. The community pharmacist managed chronic conditions, such as hypertension and tobacco use disorder, and minor ailments such as impetigo and urinary tract infections4. Many of these services can leverage telehealth modalities, for example utilizing telephone appointments to conduct medication reviews, address medication related issues, and medication monitoring. These services can prevent urgent care visits and extend the interval between primary care provider appointments.
The pandemic created the infrastructure and confidence needed for clinical pharmacist practicing in healthcare systems and the community to shift towards inclusion of more telehealth care in their practice. Three years post-pandemic we are at a crossroads. We can merely maintain telehealth gains established during the pandemic or we can lean into this care modality to better position our profession to be a solution to the anticipated prescriber workforce shortages. Yes, there are policy and legislative barriers, and appropriate payment must be provided to sustain these services, but there are signals that states are beginning to recognize the need to expand telehealth and pharmacist prescribing authorities. It is time to develop and expand pharmacist telehealth hub and spoke models, increase pharmacist integration into virtual interdisciplinary teams, increase telehealth trainee experiences, and expand community pharmacists use of telehealth to prepare our profession to fill future healthcare workforce prescriber shortages.
References:
1. 1. National Center for Health Workforce Analysis Projections Dashboard. Accessed August 16, 2024.
2. 2. Hursman A, Vang C, Thooft T, Stone K. The Role of Telepharmacy in the Delivery of Clinical Pharmacy Services Following the COVID-19 Pandemic: A Descriptive Report. J Pharm Tech; 2024, 40 (2), 66-72.
3. 3. Goodman C, Chiulli D, Seratt K, Smith T. Improvement of access to mental health care through implementing telehealth services by clinical pharmacist practitioners. JACCP, 2024, 7(2), 172-176.
4. 4. Piraux, A, Bonnan D, Ramond-Roquin A, Faure S. The community pharmacist as an independent prescriber: a scoping review. JAPH, (Online) July 2024.
Recommended Readings:
Telehealth Is the Future of Clinical Pharmacy Practice - ASHP NewsCenter