Community Pharmacies Expand Digital, Remote Services During COVID-19

A nationwide cross-sectional survey of Finnish community pharmacy owners found that the early phase of the COVID-19 pandemic accelerated the adoption of digital and remote pharmacy services, with medicine pickup lockers and online pharmacy platforms showing the most pronounced growth. The study, conducted by researchers affiliated with the University of Helsinki and published in Exploratory Research in Clinical and Social Pharmacy, surveyed owners of private community pharmacies belonging to the Association of Finnish Pharmacies (AFP) between October and November 2020, asking them to report on service availability and use in December 2019, before the COVID-19 outbreak, and again approximately 10 months later.¹

The researchers used Rogers' Diffusion of Innovations theory as their guiding framework to classify pharmacy owners as early or late adopters and to examine how that classification related to the pace of digital transformation.¹

A National Look at Pharmacy Innovation During COVID-19

Finland's community pharmacy system is privately owned, with pharmacy owners required to hold a pharmacy license issued by the Finnish Medicines Agency. At the end of 2019, there were 819 pharmacy outlets in the country.¹

The survey instrument, developed by the research team and pretested for face validity, asked about the availability and use of 9 digital and remote services, including electronic identification for telephone transactions, prescription medicine reservation via smartphone application, electronic medication subscription service for health care organizations, medicine pickup lockers, video calls for prescription delivery, chat service, medication review by phone, and remote appointments with a pharmacist.¹

Responses were received from 175 of 619 AFP member pharmacies, a response rate of 28%. Of the respondents, 170 (97%) answered the question concerning their readiness to adopt new innovations, which was measured using a validated instrument based on Rogers' theory. The researchers classified innovators and early adopters together as "early adopters" (43%, n = 73) and grouped the early majority, late majority, laggards, and those who selected "cannot say" as "late adopters" (57%, n = 96) for subsequent analysis.¹

Remote Services Nearly Doubled in Some Categories

Before the COVID-19 outbreak, the most commonly offered remote service among Finnish community pharmacies was an electronic subscription service for health care organizations, available in 61% of responding pharmacies in December 2019, followed by online pharmacy services (25%), medicine pickup lockers (21%), and prescription medicine reservation via smartphone application (21%).¹

The most notable change over the 10-month observation period was the increase in pharmacies offering medicine pickup lockers, which rose from 21% in December 2019 to 39% in October 2020 (P < .001), representing an almost twofold increase in service provision. During the same period, the proportion of community pharmacies offering online pharmacy services increased from 25% to 34% (P < .001).¹

Electronic identification for telephone transactions, chat services, remote medication review by phone, remote physician consultations, and pharmacists' remote medication counseling services remained available in only a small number of pharmacies. Each of these services was offered by fewer than 5% of respondents in December 2019, and by October 2020, their availability remained below 9%.¹

Usage patterns followed a similar trajectory. Daily use of the electronic subscription service for organizations increased from 48% to 53% of pharmacies over the study period. Medicine pickup lockers saw the greatest relative increase in utilization. Daily use rose from 4% to 15%, and weekly use rose from 8% to 15%.¹

Daily use of online pharmacy services increased from 9% to 18%, while weekly use increased from 6% to 18%. National registry data corroborated the survey findings—while the Finnish Medicines Agency registered a mean of 9.8 new online community pharmacy services annually between 2011 and 2018, registrations jumped to 61 in 2019 and 90 in 2020, a 48% increase compared with the prior year.¹

Innovation Readiness Shaped the Pace of Adoption

The study's multivariable ordinal logistic regression model found that innovation readiness was significantly higher among pharmacy owners younger than 50 years compared with those aged 50 to 59 years (P = .009) and those aged 60 years or older (P = .039). Pharmacies with an annual prescription volume exceeding 100,000 were more likely to demonstrate higher innovation readiness than pharmacies dispensing fewer than 40,000 prescriptions annually (P = .016).¹

Across adopter categories, the distribution of respondents was skewed toward earlier categories: innovators made up 13% (n = 22), early adopters 30% (n = 51), early majority 40% (n = 67), late majority 15% (n = 25), and laggards 0% (n = 0), with 3% (n = 5) selecting "cannot say."¹

All 5 services tracked in the study were offered more frequently by pharmacies classified as early adopters than by those classified as late adopters at both survey time points, and early adopters offered a significantly broader range of digital services than late adopters by October 2020 (P < .01). The statistically significant Wilcoxon signed-rank test results further indicated that service implementation progressed beyond what could be inferred solely from comparing service availability in December 2019 and October 2020.¹

What It Means for Pharmacists

The Finnish findings echo a broader international pattern of accelerated telepharmacy adoption during the pandemic. A scoping review of 33 articles on telepharmacy implementation during COVID-19 found that the most commonly observed initiatives were virtual consultations, home delivery of medicines, and patient education, while limited access to technology and low digital literacy were identified as major barriers to implementation.²

The review also found that regulatory flexibility played a significant role in expanding telepharmacy access. In the United States, temporary relaxation of Health Insurance Portability and Accountability Act (HIPAA) requirements allowed pharmacies to use more accessible teleconferencing platforms that would otherwise have been noncompliant with privacy standards.²

A separate descriptive report from a Midwest US health system found that referrals for clinical pharmacist visits increased 178% between 2019 and 2022, while completed visits grew approximately 78% over the same period, with a significant positive relationship between time and the number of telepharmacy visits completed after the technology was extended to patients' homes in March 2020. The authors of that report concluded that continued use of telepharmacy is important to ensure that patients, particularly those in rural locations, retain access to clinical pharmacy services.³

For pharmacists, the Finnish data underscore that remote-service uptake was uneven even under pandemic pressure and that readiness to adopt new technology and operating models—not just necessity—helped determine which pharmacies expanded fastest. The study's authors noted that services supporting rational pharmacotherapy, such as remote medication reviews, remained uncommon in Finland even in remote form; by comparison, a Dutch study conducted in spring 2020 found that 44% of responding pharmacies (n = 215) conducted medication reviews, mainly by phone, while only 2% of Finnish pharmacies (n = 168) reported the same.¹

Study Limitations

The authors acknowledged several limitations. The response rate of 28% raises the possibility of non-response bias, and pharmacy owners classified as early adopters appeared to be overrepresented among respondents, potentially presenting a more favorable picture of innovativeness than exists among the broader population of Finnish community pharmacy owners. Because data were collected approximately 10 months into the study period, respondents were required to report retrospectively on services provided before and during the early stages of the pandemic, which may have introduced recall bias, and the self-administered survey format is susceptible to social desirability bias.¹

The authors concluded that the COVID-19 pandemic accelerated the adoption and implementation of digital and remote services in Finnish community pharmacies, facilitated by pharmacy owners' generally positive attitudes toward innovation, and that further research is needed to examine how the market for digital pharmacy services has evolved since the pandemic.¹

REFERENCES

1. Timonen P, Ojanperä K, Savela E, Airaksinen M. Diffusion of innovations of digital and remote services in Finnish community pharmacies during the early phase of the COVID-19 pandemic: A National Survey. Explor Res Clin Soc Pharm. 2026;23:100827. Published 2026 Jul 25. doi:10.1016/j.rcsop.2026.100827

2. Unni EJ, Patel K, Beazer IR, Hung M. Telepharmacy during COVID-19: A Scoping Review. Pharmacy (Basel). 2021;9(4):183. Published 2021 Nov 11. doi:10.3390/pharmacy9040183

3. 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 Technol. 2024;40(2):66-71. doi:10.1177/87551225231222426