What does patient care from pharmacies look like during a pandemic and what role can the pharmacist play in delivering that care? This question, which many companies hadn’t even considered before early last year, now has become a daily guiding mantra for retail pharmacies. It also was the question put before a panel of executives at Drug Store News’ 22nd Industry Issues Summit, held virtually on Dec. 2. Panelists also addressed how to work alongside consumers’ increasing self-care focus.
The panel, “Great Expectations: How Retail Pharmacy is Executing Patient Care,” was moderated by Dave Wendland, vice president of strategic relations at Hamacher Resource Group. Panelists included Adam Keeth of Sam’s Club, Becky Dant of Costco, Summer Williams Kerley of Rite Aid, Leon Nevers of H-E-B, Bob Pessel of VMC Pharmacy Program and Buying Group, Orsula Knowlton of Tabula Rasa Healthcare, Colette Heimowitz of Simply Good Foods and Stacy Burch of BD Diabetes Care.
One element that has helped retailers evolve to meet the challenge of delivering patient care through the COVID-19 pandemic, Dant pointed out, is that pharmacists’ stock has been rising for several years.
“I think we saw, before COVID even came, that the U.S. is relying on pharmacists to provide services for other healthcare crises,” said Dant, who is Costco’s director of professional services, citing smoking cessation around vaping as an area where pharmacists shone pre-pandemic. “I think this was coming prior to that, where the government was recognizing that the pharmacies had the ability to do these things. I think we’re going to see increases in services that can be offered through pharmacies like contraception and the smoking cessation that I mentioned.”
Pharmacies as a Crucial Resource
Having an established reputation as a place to go during times of crisis has been crucial for the industry as a whole, and has particularly served San Antonio-based H-E-B, which, besides COVID-19, has helped its patients navigate various hurricanes in the past year — and the century that H-E-B has been in business.
“The good thing is the customers already turned to H-E-B in times of crisis and in times of need,” said Nevers, H-E-B’s director of business development, procurement and supply chain. “From an organizational standpoint, we were able to really bear down on some of the things that we’ve already been working on. Basically, from a history standpoint, we’ve been working on immunizations for a long time. It’s the history, actually ends up paying for itself.”
An element of a pandemic approach to patient care that Keeth discussed also was touched on by Dant and Nevers — namely, the importance of meeting patients where they need the touchpoint. On the retail side, that looks like grocery pickup and other omnichannel operations. On the healthcare side at Sam’s Club, that means taking clinical services — in particular COVID-19 testing — on the road to help business customers keep employees safe.
“We’ve rolled out delivery, curbside pickup and services like DoorDash, so we’re getting out there to the patients to help them be safe, but we’ve also recently launched an employer program where we actually go to an onsite location with a machine and we’ll do a bulk COVID test wherever they need it,” Keeth said, noting that Sam’s Club has an RV that it has deployed to businesses, where the retailer conducts COVID-19 testing with next-day results. “We’re really just trying to push the boundaries and meet the patient where they want to be and where they want their care.”
On the consumer side, this has included a partnership with telehealth provider 98.6, offering Sam’s Club members a subscription service in which, for a fee, patients can schedule unlimited telehealth visits with $1 co-pays and have any prescriptions sent to the Sam’s Club pharmacy.
It is important that independent operators have the training in place to properly execute clinical services, especially new and changing ones related to COVID-19, but also the staples of pharmacy. VMC Pharmacy Program and Buying Group — a subsidiary of Associated Wholesale Grocers — can help enable member pharmacies to position themselves best to their communities.
“We want our pharmacists, our pharmacy teams, our independent pharmacy teams to be providers of immunization, providers of anything at the point of care,” said Pessel, VMC Pharmacy Program’s vice president. “In terms of testing — flu, COVID, glucose — and everything that’s involved in that, we go find the programs and roll those programs out. We have different teaching ways to get those out, including webinars and education. We’ve found that there’s acceptance across the board when things are rolled out correctly and taught right.”
The significance of having a well-trained and well-rounded pharmacist has been central to Rite Aid’s ongoing RxEvolution, which is seeking to position pharmacists more centrally to help patients with clinical needs, as well as overall health and well-being
questions. Williams Kerley, the chain’s vice president of clinical services and business development, said that the company’s approach has included getting all of Rite Aid’s pharmacists certified as integrative pharmacy specialists to further increase their potential to be a resource for patients.
“Our pharmacists are experts at traditional medicine, but we wanted to blend that with other options as well, such as alternative remedies and lifestyle modifications that can occur,” she said. “It was really to help support our customers’ mind, their body and their spirit as well — and really, as always, unlock the value of our pharmacists and put them at the forefront to become advocates for that fusion based on customer needs. It’s not to take away any of the traditional steps that we’ve done across retail pharmacy, but it’s to add that extra layer to help meet our customers’ needs.”
Heimowitz, vice president of nutrition education at Simply Good Foods, which markets the Atkins and Quest Nutrition brands, said that her company is a resource for other retailers that want to be a resource for a more holistic-minded consumer.
“Consumers are interested in nutrients that will support their mood, nutrients that will support better sleeping habits and nutrients that will support their energy, and we have those kinds of educational materials that we could share with any nutrition department,” she said. “We’re happy to do webinars for pharmacists when they do get into the alternative health arena.”
Technology also is a tool that can give pharmacists an assist when it comes to using their training to provide the best care to patients, according to Tabula Rasa Healthcare’s Knowlton, who is the company’s president, co-founder and chief marketing and business development officer. She said that the company has been developing technology meant to enable personalization of medication regimens, including ways to head off potential adverse drug interactions, among other efforts.
“We consider ourselves a supplier of technology and clinical services for community pharmacists throughout the United States, and one of the reasons why we started the company was really to elevate the awareness and to increase the value of pharmacists,” she said.
“We’re trying to make it easier to develop impactful interventions for patients and their community prescribers through visualization,” she said, highlighting the ability for her company’s software to show multiple medications and the potential adverse interactions in a single view.
Connecting with the Self-care Trend
Besides trying to provide patient care during a pandemic, pharmacy operators also must contend with the growing trend toward self-care, which only has accelerated as a result of COVID-19.
In a certain sense, a consensus emerged among panelists that, similar to offering multiple ways for consumers to buy groceries and necessities, the key to delivering information to inform self-care comes down to meeting patients where they are, which, unsurprisingly, increasingly means meeting them at home, while also being a resource to pharmacists for when the in-person consultation takes place.
Heimowitz also said that Simply Good Food’s pre-pandemic approach to being part of informed self-care regimens involved such in-person events as health fairs, book signings and lectures. Throughout the pandemic, these efforts have taken the form of webinars offering educational materials, as well as handout materials that pharmacies can offer to OTC shoppers looking to make better food and lifestyle choices.
“That’s what I think we can do from the perspective of nutrition and education, which I think is going to bring an offer to retailers’ materials as far as lifestyle changes, wellness recipes, meal plans, shopping lists, there’s so much we could do from the nutritional standpoint to educate the consumer,” she said, noting that making these resources available to patients via pharmacies could help reduce the number of obese patients or those with diabetes.
Burch, BD Diabetes Care’s vice president of marketing and commercial excellence, said that among patients with diabetes, there has been increased demand for digital tools, which she said studies have found can help improve diabetes management.
“We have the BD Diabetes Care app and it’s designed all around to help support positive self-care,” she said. At the same time, BD is continuing its partnerships with retailers to collaborate and bolster pharmacies as a resource. “I think the patients are leaning — more so even today than they have in the past — on their pharmacists playing a critical role in that point of care testing,” she said. “They’re playing a critical role and helping them with adherence, and they’re playing a critical role in helping to get them materials on self-care. And I think that’s what you’ll continue to see the focus on as we move through these challenging times.”
Costco’s Dant highlighted interoperable data as an improvement that would strengthen pharmacies’ abilities to be a patient-care resource. “What I’ve seen as we’ve investigated different abilities to offer virtual care, it’s just that data sharing — how do we make this easy to use in the pharmacist’s workflow, how do we make it easy for them to see the data that they need to connect with that patient and help care for them?”
When it comes to the future of patient care amid a rise in self-care, Rite Aid’s Williams Kerley said that retailers have an opportunity to be a resource for patients and continue to build demand for information by encouraging proactive self-care. She also said that 45% of those age 18 to 29 years old don’t have a primary care physician, and 28% of those age 30 to 49 years old don’t either. “The barrier right now is really just getting individuals to understand that they need to take care of themselves, and what needs to be in place to do that,” she said. “That’s why it’s so important right now, as we’ve all talked about, to bridge that gap and position pharmacists as the front line to help with education and that preventive component, because it’s easier to be proactive and focus on the preventive.”
For Tabula Rasa Healthcare’s Knowlton, success requires collaboration and relationships that keep patient outcomes. “The importance of the relationships is that they are essential and symbiotic partnerships,” she said. “We have common goals, we have common patients, we have common competitors. We need not to just survive, we need to thrive and to do that together.”