DSN webinar: Panelists weigh in on pharmacists' expanded role as providers

Drug Store News held a webinar on Aug. 22, sponsored by OmniSYS, entitled "Healthcare Equity and Access Demands Pharmacists as Providers."

The webinar, moderated by David Pope, chief pharmacy officer at OmniSYS, XiFin Pharmacy, featured Marc Watkins, chief medical officer at Kroger Health, Ilisa Bernstein, senior vice president of pharmacy practice and government affairs at the American Pharmacists Association, Kevin Ban, chief medical officer of Walgreens Boots Alliance and Kyu Rhee, former CMO of CVS, Health and Human Services and IBM, and the new CEO of the National Association of Community Health Centers.

Pope opened the discussion, posing the question, What were some of the outstanding contributions that pharmacists made during the pandemic and what can we learn from those as we consider expanding the pharmacist’s role?

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Bernstein responded, stating that pharmacists stepped up to the plate and hit it out of the ball park. She also noted that for over 20 years, immunization training has been in the curriculum at schools of pharmacy, and that with the PREP Act, the federal government was able to unleash pharmacy teams to treat and immunize. "It’s astounding what pharmacists and pharmacy teams provided around the country, particularly in underserved areas of the country as well. Pharmacists are essential front line providers. They are key members of the healthcare team and are trained as medication experts. We can’t let that expertise sit on the shelf. We need to change the dynamics to unleash the power of pharmacists," Bernstein said.

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Watkins added that even prior to 20 years ago, the scope of the skillset of pharmacists was known. "Through the pandemic what we saw that was the most impactful, was the degrees of access Americans had to pharmacists. Many of the traditional healthcare locations may have been shuttered during the pandemic. Many of the community based and retail pharmacies remained open. They were frontline, being available and accessible when Americans needed them the most. We can’t roll back accessibility. Accessibility is the largest determinant of health," he said. 

Pope went on to ask Watkins and Ban, how do you as a physician, see the pharmacist role post COVID?

Watkins noted that as patients become more familiar with pharmacists, who have been the most accessible healthcare providers worldwide and in the United States, "As we saw during the pandemic, they’ve established meaningful relationships with patients. It establishes trust and allows patients and pharmacists to develop this framework to discuss their health in a meaningful way."

Watkins urged that pharmacists need to continue to practice at the top of their license, engage in active advocacy for their profession and be engaged. "As we move away from the fee for service model and look to value based care models, we’ll see the value of the pharmacist will remain. That creates opportunity for them to be engaged, especially post COVID and how can they impact the lives of their patients directly through their ability to deploy interventions, counseling and be involved where states permit to have provider status so they can impact health at scale."

Ban offered his views of the pharmacist's role amid the pandemic, stating, “There were three things. First, we had regulatory support. We had reimbursement support. When you have those two things you can do a lot. The third element was urgency, around getting tested and vaccinated. We need to build on this now. We have urgency, now we have to look at what we did collectively to drive care to medically underserved areas and beyond and how can we take that farther," he said.

Next, Bernstein addressed the topic of whether pharmacists are prepared for infectious disease and chronic disease care, pointing out that often pharmacists are dong residencies or post grad training to get additional expertise in different areas. "We need to unleash that ability, not just through experiences and opportunities, but proving the authority, the ability for pharmacists to practice at the top of their knowledge skills and license," she said.

Pope also asked panelists what trends they're seeing in their current landscape that are driving us toward an expanded role for pharmacists.

Ban said, "We are beginning to see that people are becoming shoppers even in health care. A lot of us have taken on high deductible insurance. Then there's the physician shortage. According to the Kaiser Family Foundation, over 8,000 communities are medically underserved from a primary care perspective. That represents about 100 million Americans, about 30% of the population. We need around 16,000-17,000 new providers and that won’t happen. We need to change how we think about resources. We have resources, pharmacists. It’s beginning to sound cliché. They are highly trained, trusted and immediately available except they're spending most of their time counting by 5s. You go into a pharmacy and they seem too busy. We need to change that. We’re trying to wick away the work that doesn’t need to happen by pharmacists with things like centrally filling medications so they can provide high value services. It comes back to regulatory support and reimbursement and urgency. We need to solve problems in new ways."

Next Rhee addressed the trends that he is seeing in the marketplace that are driving the role of pharmacists. 

"Simply put, pharmacists deliver high quality heath care and they are essential parts of the healthcare team," Rhee said, adding, "That system needs to be safe, timely, effective, efficient, equitable and patient centered. I recognized that pharmacies and pharmacists have delivered high quality care during the pandemic and beyond. We often think from an inpatient and outpatient perspective that we saw how safe and essential it was for our health system. One of the urgency issues is health equity. We need to focus on health inequities. How can we address it to leverage the talent, skills and expertise of everyone on the healthcare team, including pharmacists?"

Bernstein took the discussion one step further, noting that patients are seeing that pharmacies are collocating clinics in sites. "You’re seeing how pharmacists are stepping into primary care opportunities, that there’s an integrated approach," Bernstein said, adding, "Pharmacists are working closely in these collocated clinics and are being embedded in primacy care practices as well. The problem is reimbursement strategies and payment schemes are not supportive for paying pharmacists for services. We need to get over that barrier so pharmacists can provide more care," she said, noting that as far as the legislative environment and its ability to support pharmacists as providers, there's tremendous momentum on the federal and state level.  

To view the webinar, visit here.