At St. Anthony's, most of our patients live below the poverty level and can't afford to pay for healthcare. The clinic staff sees as many patients as possible, but we don't have enough resources to care for everyone. Sometimes we have to turn people away.
We couldn't afford a pharmacist, which left our already-stretched physicians and nurse practitioners to dispense medications and educate patients. Diabetic patients, especially newly diagnosed, require quite a large investment of time in order to counsel them with the best information about their medication protocols. This prescription drug counseling amounted to 16 hours each month that physicians couldn't spend directly treating patients. But now, thanks to a grant from the McKesson Foundation, clinic patients get better prescription drug counseling and quicker service, and have been shown to experience improved outcomes.
Medical Director
St. Anthony Free Medical Clinic
San Francisco, CA
Ana Valdes, MD
With grant money from the McKesson Foundation, we installed a computer and telemonitor in the clinic to provide a source for telemedicine. Using teleconferencing technology, patients access the telepharmacy for "virtual appointments" with offsite pharmacy interns from the UCSF School of Pharmacy. Supervised by licensed pharmacists, these pharmacy interns "tele-counsel" patients on medication therapy management.
The telepharmacy allows patients to receive detailed information about their medications as well as reinforcement of lifestyle changes that help them to participate in their diabetes management. With better education, we have seen that these patients are more likely to take their medicines and see improvements in their health. In addition, this system gives pharmacy students the hands-on clinical experience required to graduate, while freeing physicians to see 40 additional patients each month.
The telepharmacy project has been so successful that we have expanded it to other chronic diseases.
The McKesson Foundation also provided a separate grant to support our health disparities work, specifically for our diabetic patients. In another demonstration of how telemedicine can enhance services for those without access, this grant allows us to provide retinal (eye) screening exams for our patients. In collaboration with the Optometry School at UC Berkeley, we have trained our staff to use the retinal camera and to accurately photograph patients’ eyes for screening and diagnosis. Once the photo is taken, it is electronically sent to doctors at UC Berkeley, who then enter the photos into their database along with the diagnosis, recommendations, and follow-up – ultimately generating information that is populated into our patients' electronic medical records.
