Claire Dawson
Hospital outpatient pharmacies are pharmacy services provided by hospitals to outpatients. Outpatients can access medication at discharge, enabling them to leave the hospital with medication in hand. In some cases, hospital outpatient pharmacies offer 24-hour access, medication delivery, and extended hours outside the typical 9-5 window. However, it is important to note that hospital outpatient pharmacies may have different dispensing laws and requirements, and not all medications can be supplied. For example, medicines for self-limiting conditions or minor ailments that are available over the counter from a local pharmacy are typically not supplied by hospital outpatient pharmacies.
| Characteristics | Values |
|---|---|
| Hospital outpatient pharmacies | Can provide medication at discharge, enabling patients to leave the hospital with medication in hand |
| Hospital outpatient pharmacies | Can access the same medication record within the health system that a physician uses |
| Hospital outpatient pharmacies | Offer hours outside of the typical 9-5 window, in some cases adding 24-hour access via tele-pharmacy and mobile technology |
| Hospital outpatient pharmacies | Offer medication delivery to the bedside, home, or workplace, as well as to locations near urgent care centers and physician practices |
| Hospital outpatient pharmacies | Are entering the retail pharmacy market in response to a lack of traditional retail pharmacies and home delivery companies that can compound prescriptions for the pediatric population |
| Hospital outpatient pharmacies | Are developing their own retail pharmacy services due to drug manufacturers eroding access to the 340B Drug Pricing Program |
| Hospital outpatient pharmacies | Are regulated by the Department of Public Health in Massachusetts |
| Hospital outpatient pharmacies | Are not allowed to dispense medications to a patient's home in some states, such as Florida |
| Hospital outpatient pharmacies | Must comply with outpatient labeling requirements when dispensing to inpatients |
| Hospital outpatient pharmacies | Must ensure that medications are only released to outpatients by a full pharmacist, who must also provide counselling |
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What You'll Learn
Hospitals entering the retail pharmacy market
The retail pharmacy market is evolving, with hospitals and health systems entering the space. This expansion is driven by a few key factors. Firstly, hospitals are seeking to insulate themselves from restrictive distribution actions and maintain independence from contract pharmacy relationships. Drug manufacturers have been limiting hospitals' access to certain pharmaceutical products, pushing hospitals to establish their own retail pharmacies.
Another significant factor is the dramatic increase in the specialty pharmacy business. The number of drugs in this category has grown by 73% in the last decade, now accounting for about half of total drug costs. This trend is expected to continue, with more specialty drugs entering the market. As a result, 80% of hospitals with 600 or more beds have a specialty pharmacy, and smaller hospitals are also recognizing the opportunities in this sector.
The rise of children's hospitals opening retail pharmacy locations is another notable development. These hospitals are entering the market to address the lack of traditional retail pharmacies and home delivery companies that can compound prescriptions for pediatric patients. Strict compounding and handling requirements must be met when adjusting adult doses of medicine for children, and hospitals are better equipped to handle these complexities.
The COVID-19 pandemic has also accelerated the transformation of the retail pharmacy market. Retail pharmacies played a crucial role in administering vaccines and providing testing services, increasing their trust and value among consumers. They have expanded their services to include immunizations, health screenings, chronic disease management, and even basic diagnostic services. This shift towards decentralized, consumer-focused care has been further enhanced by the growing popularity of telepharmacy, which allows licensed pharmacists to serve patients remotely, improving medication adherence and patient monitoring.
While some hospitals have closed their retail pharmacies, it appears to be more of a realignment to meet the evolving needs of health systems in a post-pandemic environment. Hospitals are recognizing the benefits of developing their own outpatient pharmacies to enhance the integrated patient experience.
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Outpatient pharmacy meeting health systems' needs
Outpatient pharmacy services are enhancing the patient experience and meeting the needs of health systems in a post-pandemic healthcare environment. While some health systems have chosen to sell to or partner with retail pharmacy chains, others are developing their own outpatient pharmacies.
Hospital outpatient pharmacies can access the same medication record within the health system as a physician, which is important for holistic patient care. They can also provide medication at discharge, allowing patients to leave the hospital with medication in hand, rather than having to wait for a delivery. Many health systems offer home delivery services, often through more personal avenues that are cost-prohibitive for large retailers. These services use couriers aligned with the health system, who can hand off the medicine directly to the patient.
Hospitals are entering the retail pharmacy market due to a lack of traditional pharmacies and home delivery companies that can compound prescriptions for the pediatric population. Hospitals have more access to their patient populations through their outpatient pharmacies, and these pharmacies are expanding their hours beyond the typical 9-5 window. Some offer 24-hour access via tele-pharmacy and mobile technology, as well as medication delivery to the bedside, home, or workplace.
In some cases, inpatient pharmacies cannot dispense medications to a patient's home, and there may be restrictions on the types of medications that can be dispensed. For example, in Massachusetts, hospital pharmacies are regulated by the Department of Public Health. Even within a healthcare system, if pharmacies are in different states, they are likely to have different dispensing laws. In Wisconsin, a pharmacy can be licensed as a single entity, allowing all types of dispensing from a single pharmacy if labeling and record-keeping requirements are met.
To ensure patient safety, it is important that all prescriptions, both new and refills, are counselled by a full pharmacist. This means that the pharmacist ensures the patient understands the medication and how to take it appropriately.
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Outpatient pharmacy access to medication records
Outpatient pharmacies play a crucial role in enhancing the patient experience and integrating care delivery. They offer extended hours, medication delivery services, and convenient locations near urgent care centers and physician practices. These services improve patient compliance with medications and provide easy access to adjustments and refills. Additionally, outpatient pharmacies within hospitals can compound prescriptions for the pediatric population, adjusting adult doses to meet the specific needs of children.
To ensure patient safety and effective counselling, hospital outpatient pharmacies must adhere to specific requirements when releasing medications. Compliance Officers are responsible for conducting hospital pharmacy practice reviews to ensure that registrants fully understand the requirements for patient counselling and medication release. According to the College of Pharmacists of British Columbia, all new and refill prescriptions must be counselled by a full pharmacist, who documents the counselling session. Simply asking if the patient has any questions is not sufficient.
Pharmacists have a responsibility to ensure that patients understand their medications and know how to take them appropriately. This includes discussing potential side effects and providing patient information leaflets. By playing an active role in patient counselling, pharmacists can help limit prescription fraud and improve overall patient care.
In some cases, inpatient pharmacies may also dispense medications to outpatients, especially in scenarios requiring high-acuity patient care and frequent medication changes. However, certain states, such as Florida, have regulations prohibiting inpatient pharmacies from delivering medications to patients' homes, except in urgent situations. Overall, outpatient pharmacy access to medication records facilitates a more efficient and patient-centric healthcare system.
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Outpatient medication at discharge
In a study conducted at Holtz Children's Hospital, it was found that only 49% of patients filled their prescriptions at an onsite outpatient pharmacy, with the remaining patients filling their prescriptions elsewhere. To improve prescription delivery, the hospital implemented a bedside delivery service, which increased the percentage of pediatric patients leaving with their prescriptions from 2% to 85% over 18 months. This service allowed pharmacy technicians to deliver medications directly to patients' bedsides before discharge, ensuring that patients had their prescriptions in hand.
To further enhance prescription delivery, hospitals can adopt electronic prescribing, which has been shown to significantly reduce medication errors. For example, a computer-generated process can ensure uniform recording of diagnoses, procedures, and complications, reducing the risk of transcription errors. Additionally, medication reconciliation processes are crucial in preventing adverse drug events and medication errors, especially during transitions between care settings. These processes involve creating a complete and accurate list of a patient's current medications and comparing them to medication orders.
It is important for patients to understand that medicines must be taken as directed, and any concerns about side effects or medication effectiveness should be discussed with a healthcare professional. Patients should also be aware that outpatient pharmacies in hospitals typically supply medicines intended to treat the condition for which the patient was referred. For other existing problems or minor ailments, patients may need to obtain medicines from their GP or local pharmacy.
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Pharmacy services to outpatients
Medication Dispensing
Hospital outpatient pharmacies provide a convenient option for patients to obtain their prescribed medications. These pharmacies can access the same medication records as physicians within the health system, enabling a holistic view of the patient's care. Outpatient pharmacies offer extended hours, with some even providing 24-hour access through tele-pharmacy and mobile technology. This accessibility enhances patient compliance with medication regimens. Additionally, these pharmacies can provide medication delivery directly to patients' homes, workplaces, or locations near urgent care centers.
Medication Counselling
Pharmacists play a crucial role in counselling patients about their medications. It is mandatory for a full pharmacist to provide counselling for every new and refill prescription, ensuring that patients understand their medication regimens. During counselling, pharmacists address any questions or concerns patients may have, explain how to take the medication appropriately, and discuss potential side effects. This personalized guidance optimizes the therapeutic benefits of the medications and promotes adherence to treatment plans.
Vaccine Management
Hospital outpatient pharmacies also collaborate with Hospital-at-Home programs to manage vaccinations. They develop and implement policies for the storage, transportation, administration, and waste management of vaccines, ensuring their integrity and proper handling. This integration ensures that patients receive timely and effective vaccination services in the comfort of their homes.
Compliance and Regulation
Compliance Officers are responsible for conducting hospital pharmacy practice reviews to ensure adherence to regulations. They verify that medications are released to outpatients only by full pharmacists and that proper counselling is provided. Compliance Officers also address instances where pharmacy technicians or assistants offer inadequate counselling, such as simply asking if the patient has questions for the pharmacist. By enforcing these standards, Compliance Officers uphold the quality and safety of pharmacy services provided to outpatients.
Integration with Healthcare System
Hospital outpatient pharmacies are integrated into the healthcare system, allowing for seamless coordination with physicians and other healthcare providers. This integration enables physicians to make adjustments to medications and fill prescriptions conveniently. Additionally, outpatient pharmacies within the healthcare system can offer cost-effective home delivery services, utilizing couriers aligned with the health system to hand off medications directly to patients. This integration enhances the overall patient experience and ensures that their health needs are met efficiently.
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Frequently asked questions
It depends on the hospital and the state. In some cases, hospital outpatient pharmacies can accept outside prescriptions, but in other cases, they may only provide medication to outpatients at discharge or as part of a specific program. Additionally, some states have different dispensing laws, so it's important to check with your local hospital outpatient pharmacy to confirm.
The process may vary depending on the hospital and your specific situation. Typically, a pharmacist will review the prescription and counsel you on the medication before dispensing it. This includes ensuring that you understand how to take the medication appropriately and addressing any questions or concerns you may have.
Yes, many hospital outpatient pharmacies offer home delivery services. These deliveries are often made by a courier aligned with the health system, ensuring that your medication is handed off directly to you. Some pharmacies also provide medication delivery to locations such as your workplace or urgent care centers for added convenience.
