Many Americans, about a quarter of the total population, live in rural areas. As a result, it is difficult for them to access medical care. As technology has improved, however, more in rural areas are being serviced through telemedicine, which is the use of technology to carry out clinical practice.
Telemedicine and Controlled Substances
Telemedicine is particularly significant in the area of pharmacy as it relates to the prescribing and dispensing of medications. One particular area of concern, however, is the prescribing of controlled substances via telemedicine because there is no face-to-face consultation between the patient and the medical professional.
The Controlled Substances Act labels a drug as a controlled substance if there are tight restrictions for its use, including a prescription, because of the possibility of abuse.
In the past, most states required a healthcare provider meet in person with a patient before the provider could prescribe a medication that qualified as a controlled substance. Now, however, with advances in technology, states are allowing video conferences to take the place of face-to-face contact. Some states that allow video meetings in lieu of personal contact include Delaware, Florida, Michigan, New Hampshire, Ohio and West Virginia.
But there are still restrictions placed on providers for video meetings. For example, providers can issue prescriptions only within their scope of practice, there must be a valid medical necessity for the medication, and they cannot prescribe opioids or benzodiazepines.
Another problem with telemedicine is the requirement that providers be licensed in the state where the patient lives. One way to handle the problem is to license providers in more than one state. The nursing profession already has an arrangement like this through their Nurse Licensure Compact. This allows nurses to practice in their home state as well as any other state that has signed the compact.
While telemedicine does present challenges for pharmacy care, it also delivers many advantages. It will enable pharmacists to have more contact with patients and caregivers, including follow-up contact to help patients adhere to their medication routines. It also has the potential to increase access to care for many underserved populations.
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