Telehealth session features novel pharmacist role

November 6, 2006

Advances in telehealth could enable senior citizens to remain living independently longer without the need for full-time care. That was one of the primary messages presented at Partners Telemedicine's Connected Health-Empowering Care Through Communication Technologies, a two-day symposium held recently at Harvard Medical School in Boston. An innovative role for the pharmacist was highlighted in one presentation as a key component to making this connection between technology and quality health care.

In the breakout session, Connected Health Pipeline: Preview of Developing Products and Services, Stever Aubrey, CEO of Dovetail Health in Needham, Mass., described the services provided by his company. Dovetail Health utilizes a team of healthcare experts who, enabled by technology, help senior citizens maintain their independence and remain living at home for as long as possible, deferring the need and expense of moving into an assisted-living facility.

The company's health plan begins with a thorough in-home assessment. The pharmacist visits the home and evaluates the patient's medications. "There are often a lot of myths and misconceptions on the part of the patient about their medications. We provide patient education, including which medications are the most important, what signs to look for, and what to do if patients forget their medication," explained Leslie Hoyt, MSW, chief care officer for Dovetail.

"We can use the technology device to beep and send a message saying, 'Good morning Ethel. It's time to take your medications, and please push this button to let me know that you've done so,'" described Hoyt. "We'll get a red flag if she doesn't take them."

Following the initial visit, the pharmacist develops a medication management plan with input from the client and the caregivers to ensure that the medication is taken as directed. According to Aubrey, the Dovetail pharmacist informs the patient what they've discovered. "We say, 'Here are some points we'd like you to bring to the attention of your physician.' We then call the doctor and send a letter asking if there is anything we should know about the patient who has signed up for our services."

"The difference here is that it's not a one-time counseling. It's establishing a relationship with a client, along with the client's family and physicians and taking a step back to determine what the best plan is for a particular patient," Hoyt pointed out. "We don't want the wrong medication, a missed dose, or another mistake to be the reason a person can't remain independent and living at home."

Aubrey admits that one of the biggest challenges is getting patients to the point at which they'll accept the technology in their homes. "It's important to let patients interact with the technology so they can become comfortable with it."

"We believe that technology can't work on its own," Aubrey said. "A pharmacist who knows each client and understands his or her unique health condition is critical for transforming the data into important knowledge regarding each client's personal situation. The pharmacists we hire are people who are passionate about geriatric medicine, counseling, and using the newer technologies."

As for the technology end of things, although the company is currently using the Philips' PTS system for in-home monitoring, it will soon be transitioning to Philips' Motiva Interactive Healthcare Platform, which utilizes broadband television, along with vital-sign measurement devices to connect patients to their medical support system.

Among other things, Motiva will provide educational material as video-on-demand, timely reminders to take medications, motivational messages about lifestyle choices, and health-related surveys that test for patient comprehension and compliance.

For more information on Dovetail Health, pharmacists can visit http://www.dovetailhealth.com/.