Abstract
Telepharmacy is another service system that helps to enhance the efficiency of the health service system under the situation of the Covid-19 epidemic. It can also support the government's public health policy and create a new alternative service model to support a new way of medicine. Methodology: This research has a participatory action research which aims to design a new normal hospital telepharmacy service system, Pharmacy that is a joint service unit with a hospital and a single pharmacy in the region 7 health district and pushes it to be a policy of the region 7 health district. To study the effectiveness of telepharmacy services in hospitals and drugstores. Evaluate the cost-effectiveness of telepharmacy services from a provider-client perspective. Study the satisfaction and opinions of the service recipients and providers and synthesize policy recommendations for the development of telepharmacy systems. Results: A platform has been developed to be used to provide remote health services under the name telehealthregion7 which can be used in all fields of health professions at https://www.telehealthregion7.com/ which is a web application and has designed a long-distance health service system in the normal era, the new way of hospitals and drugstores can be divided into 4 systems, namely, the telepharmacy service system in the hospital, telepharmacy service system in Primary care cluster, telepharmacy service system in Pharmacy and telepharmacy service system for COVID Patient Care Home Isolation. Results of service from February 2021 to December 2021. The total number of medical personnel registered on the platform is 332, including 240 pharmacists, 35 doctors, 43 nurses and 14 other medical personnel. Medical personnel who are provided services through the platform A total of 235 people, representing 70.78% of those registered, were divided into 152 pharmacists (63.33%), 33 doctors (94.29%), 40 nurses (93.02%) and 10 other medical personnel. (71.43 %). The total number of registered service recipients was 1392. The number of service recipients who had access to the service via the platform was 801 (57.54%). The total number of visits to the service was 2040, representing an average of 2.55 times per person. The service can cover all the region 7 health district, including: Khon Kaen Hospital Mahasarakham Hospital, Kalasin Hospital, Roi Et Hospital and Srinagarind Hospital and outside the region 7 health district, including Ratchaburi and Kabinburi hospitals. In terms of the effectiveness of the telepharmacy service system of the hospital. The total number of service recipients was 297, the number of visits was 604 times. The clinical symptoms after receiving the service were not different or improved, totaling 294 people, representing 98.99%. The number of problems that pharmacists found was a total of 323 problems and pharmacists were able to resolve 262 problems or 81.11%. For the effectiveness of smoking cessation services by telepharmacy service system. The total number of service recipients was 167, the number of people who successfully quit smoking for at least 1 month, at least 2 months, at least 3 months, at least 4 months and at least 6 months were 118 (70.66%), 64 (38.32%), 36 (21.56%), 14 (8.38%), 3 (1.80%), respectively. Overall satisfaction scores of recipients and providers in the hospital sector were at the most satisfied level, 4.81±0.42 and 4.61±0.50 (full score 5), respectively. Overall satisfaction scores of recipients and providers in the pharmacy sector were at the most satisfactory level of 4.37±0.64 and 4.4±0.50 (5 full scores), respectively. The total cost per time of telemedicine service at the hospital was 95.58 baht. The cost-effectiveness at which the patient's condition stabilized or improved was 196.36 baht per patient. The cost-effectiveness in resolving the problem successfully was 220.34 baht per problem. The results of the cost-effectiveness assessment of telepharmacy services by pharmacy was found that the total cost per person of complete A1-A5 service with A1-A4, A4F and A5 service 5 times was 631.55 baht. The total cost per 1 month, 2 months, 3 months of successful smoking cessation was 298 baht. 549.44 baht and 976.78 baht, respectively. % Cost saving of travel expenses, food and accommodation, Opportunity loss and total cost of service recipients are as follows: 65.37±4.50, 60.22±18.36, 10.39±24.34 and 54.75±17.99, respectively. Conclusion: Telepharmacy is an efficient service. The service recipient is most satisfied because it benefits the service recipient. Help facilitate patients without having to travel to hospitals and drugstores to receive medicines. Increasing the quality of pharmaceutical services. Reduce the length of time patients stay in hospitals and drugstores. Reduce the cost of traveling to hospitals and drugstores and create a system to encourage people to stay home, reducing the risk and reducing the chance of infection during the epidemic situation. Therefore, the country's policy should encourage telepharmacy services in both hospitals and drugstores.
