Telepharmacy services in acute care: Diverse needs within a large health system.

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In this paper, we describe CommonSpirit Health's telepharmacy service, which serves 64 hospitals in 10 states. Hospitals range in size from critical access to quaternary care centers. Telepharmacy services in acute care may be divided into 2 primary styles: hospitals requiring after-hours support utilizing telepharmacists to bridge shifts otherwise uncovered by pharmacists and hospitals with round-the-clock onsite pharmacy services utilizing telepharmacists to enhance efficiency in processing medication orders. When providing after-hours service, telepharmacists review all medication orders. The primary goal is to provide pharmacist care at all hours. In hospitals with round-the-clock onsite pharmacy services, telepharmacists focus on efficiency of medication order review. Median turnaround times in these hospitals decreased 50% to 70% after implementing a telepharmacy service. Barriers to implementation include managing different electronic health records, variability in hospital practices, and communicating with onsite clinicians. Regular interaction with onsite leaders is a key component in overcoming these barriers. This enables the telepharmacy team to respond to hospital-specific changes and maintain competence. The service adjusts to provide additional support based on the needs of the sites. Most telepharmacists work from home. While this can present challenges, we consider it an advantage in recruitment and retention. CommonSpirit Health utilizes its telepharmacy service for hospitals large and small to enhance efficiency in processing medication orders and to provide round-the-clock pharmacist care.