Telepharmacy

Telepharmacy encompasses a range of services, including remote prescription verification, patient counseling, medication therapy management, and clinical consultations. It is often implemented in community pharmacies, hospitals, and correctional facilities, using videoconferencing, secure messaging, and electronic health records. The American Society of Health-System Pharmacists (ASHP) defines it as the use of telecommunications to provide pharmaceutical care to patients at a distance.¹ Telepharmacy can be synchronous (real-time video) or asynchronous (store-and-forward), and it may involve a remote pharmacist supervising a technician who operates the dispensing site.

The first formal telepharmacy program in the United States was launched in 2001 in North Dakota, where rural hospitals and pharmacies used video links to provide after-hours coverage. Early programs in Canada, particularly in Ontario and British Columbia, demonstrated feasibility in remote communities. The COVID-19 pandemic accelerated adoption, as regulators relaxed restrictions on remote dispensing and counseling. By 2023, most U.S. states had enacted laws or regulations permitting telepharmacy, though requirements vary widely regarding supervision ratios and technology standards.

Studies indicate that telepharmacy can achieve comparable clinical outcomes to in-person care for chronic disease management, such as hypertension and diabetes, and can improve medication adherence.² However, challenges include licensure portability, reimbursement, and the need for robust technology infrastructure. Privacy and security concerns are addressed through HIPAA-compliant platforms, but disparities in internet access remain a barrier in some rural areas.

Telepharmacy has been used in correctional facilities to reduce medication errors and costs, and in disaster response to provide continuity of care. In some states, telepharmacy allows a single pharmacist to supervise multiple remote dispensing sites, a model that has been criticized for potential workload issues. The University of North Dakota's telepharmacy program has been a model for training and research. Internationally, telepharmacy is expanding in low- and middle-income countries, where it helps address pharmacist shortages.

Remote prescription verification

A pharmacist reviews a prescription order from a distant location before dispensing.

Medication therapy management

A service that optimizes therapeutic outcomes for individual patients.

Synchronous telepharmacy

Real-time interaction between pharmacist and patient or staff.

Asynchronous telepharmacy

Store-and-forward transmission of data for later review.