The Covid-19 situation has created an opportunity for Pharmacy to push out its Medication Delivery Service (MDS) in full force. This service which used to be running on a small scale, is now offered as a full-fledged service.

“We initiated the service in 2010 because of long waiting time to collect medication. It started on a small scale and we only approached patients to take up the service when they arrived at pharmacy,” said Aileen Chua, Pharmacist.

As the primary liaison person for this service, Aileen facilitates the communication between various parties in the MDS chain – from NHCS Pharmacy, Business Office and ALPS to the delivery vendor from Keppel Logistics as well as other healthcare institutions.

Teamwork is key in the MDS chain. Pictured left to right: Pharmacist, Debra Chua, dispenses the medication, and ensures correct medication and right quantity before wrapping them up; Pharmacy Assistant, Shirley Chong, wraps the medications for delivery; and Senior Pharmacy Technician, Seline Tan, prepares the medication parcels for collection.
 
Impact from the pandemic

“There was a huge surge in delivery requests when Covid-19 struck because many patients deferred their appointments,” shared Aileen. “Patients were afraid to visit healthcare institutions for fear of catching the virus. More telehealth and remote care services were implemented during this period, and that has caused further demand for MDS as well.”

Prior to the pandemic, there were certain requirements before a patient can opt for medication delivery, for instance, patient’s medication prescription must include drugs that are in NHCS formulary medication (meaning drugs that are part of NHCS Pharmacy’s existing inventory). Non-formulary medications are typically fulfilled by other pharmacies such as SGH Pharmacy.

“During the Covid-19 period, we received numerous patients’ requests for all medications, even non-formulary ones listed on their prescriptions, to be delivered,” shared Aileen. “We had to seek help from SGH MDS to prepare the medications for us. Similarly, it applies to SGH whose patients requested for medications that are only available in NHCS.” She added that NHCS also extends this service for our heart patients seen at SKH.

 
Here, the delivery staff scans the medications to be collected from Pharmacy and delivered for the day.
 
Communication between Pharmacy and the delivery vendor is key to meet delivery demands. To ensure that patients get the medication on time, Pharmacy needs to carefully plan and pace the number of deliveries for each delivery period, and more importantly to update the vendor. Aileen said, “We keep our vendor updated regularly so that they could plan and ramp up their service accordingly. When there appeared to be too many deliveries for a certain delivery period, we would work around to arrange alternate delivery times with the patients.” 

Coping with strange…demands

“We encountered patients who asked if we could deliver medications prescribed by doctors from other healthcare institutions,” Aileen recalls with a smile.

Fellow Pharmacist, Ang Soon Xin who works closely with Aileen to manage MDS, said, “There were also cases of patients discharged from NHCS and were asked to follow up at the polyclinics but because of the pandemic, refused to do so. When their medications ran out, they came to us and requested NHCS to deliver medications from a prescription that had already been fully dispensed.”

Even though these were some challenging situations that Aileen and Soon Xin faced, they were appreciative of the great teamwork with other departments in helping to resolve such issues. “The administrative staff who oversees repeat prescriptions at the clinic helped put in requests to the doctors for top-up prescriptions. Some of our fellow Pharmacy colleagues also assisted to clarify with doctors on extension of prescriptions.”

Next: Tackling the cold

When asked about the upcoming plans for MDS, Aileen shared that NHCS Pharmacy will be throttling full steam ahead with delivery of cold chain items - medications that need to be kept at a low temperature.

“Cold chain medications can be costly. When we were previously considering implementing cold chain deliveries, we were concerned about breakages and possible monetary loss. However, we recognise that cold chain delivery will offer more convenience to our patients and enable NHCS to harmonise our service with other healthcare institutions,” said Teo Siew Chong, Assistant Director, Pharmacy.

 
A group shot of the Pharmacy team (taken during safer, Covid-free times) responsible for delivering medications safely and timely to our patients.
 
To further enhance the MDS, Pharmacy will also start recruiting patients into the initiative at the clinic level, effectively reducing the number of patients waiting physically at Pharmacy.

Aileen quips, “At the end of the day, hearing our patients express their gratitude towards our service is all that matters. Some understand our predicament and even wish us well!”