Enabling patient-facing care

If the future of health care can be summed up in one word, that word might be “connected.” To thrive in a fast-reforming healthcare system that demands better patient outcomes at a lower cost, pharmacies, physicians, hospitals, health systems, outpatient clinicians and diagnosticians are going to have to connect much more effectively, both with one another and with the patients they serve.

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No pharmacy provider is better positioned for this new paradigm than Walgreens. Nine months into its merger with European drug store and wholesale powerhouse Alliance Boots to become the world’s premier pharmacy-led health and well-being enterprise, Walgreens is on a mission to help topple, once and for all, the traditional fee-for-service, silo-based model of healthcare delivery, and replace it with an integrated, hub-and-spoke model of care that puts patients at the center of the wheel — and providers like Walgreens acting as spokes in a connected continuum of care.



Exclusive interviews with top pharmacy and health leaders at Walgreens reveal a bold strategic vision for the nation’s top pharmacy retailer: to play a critical role in the reinvention of the nation’s healthcare system. Walgreens, they asserted, is doing its part to make that happen by working with its healthcare partners to create a unified, team-based system of community care that keeps the patient at the center of every healthcare intervention, from his or her first contact with a primary care doctor, pharmacist or clinician, through the hospital intake and outpatient process, and back into the community.



“The mindset and orientation of our health care strategy,” said Richard Ashworth, Walgreens president of pharmacy and retail operations, “is to leverage the assets that Walgreens brings — including our locational advantage and our core pharmacy capabilities — and to put those together with our other healthcare providers and services in the community ... in partnerships with local health systems.”



Ashworth called those partnerships “one of the strategic pillars for our healthcare strategy.” And hospital-based health systems, he added, are “the crux of where care is really delivered, which is in the community, by hospitals and health systems and physicians.”



Walgreens, Ashworth told DSN, is positioning itself to extend and complete that continuum of patient care beyond the hospital or physician practice setting. He calls the company’s strategy a “move into something we’re calling a collaborative services model.”



“This means we take the assets and infrastructure and frequent interactions with patients we have and work together with the local health system to better coordinate care,” Ashworth explained.



Building up and aligning capabilities



To that end, the company is mobilizing its vast and still-growing arsenal of pharmacy-, clinic-and technology-based resources in an aggressive campaign to position the company as an accessible, cost-effective and community-based solution to many of the nation’s healthcare woes. Wal-greens is also working hard to align itself seamlessly with hospital systems, physician groups and other health providers in a new, team-based model of coordinated community care.



“Walgreens is trying to be a more integrated part of the healthcare ecosystem,” noted Brad Fluegel, chief healthcare commercial market development officer. “Across the spectrum, we’re trying to figure out how to help stitch together various parts of the healthcare system to deliver a better experience for the patients.”

“A lot of what we’ve been doing as we talk with health systems, health plans and others is making sure that we can connect our process and our data with theirs, so that we can help improve adherence rates, close gaps in care that patients might be experiencing, and use our digital health tools to create incentives for patients and consumers to take better care of themselves and remain adherent,” Fluegel added. “It’s a whole host of things like that to help take care of that patient.”



Preceding that effort was a massive campaign by Walgreens to build up its own health delivery capabilities, either through internal development of its pharmacy care and retail clinic resources, acquisition of outside companies in areas like specialty pharmacy, or through alliances with companies like MDLive and Theranos, the latter a groundbreaking developer of rapid on-site lab testing services.



Walgreens pharmacy and healthcare leaders are working overtime to fully develop and leverage the company’s disease management services, adherence and immunization programs, diagnostic capabilities, consumer-driven engagement services, retail clinics and patient data resources — and to align those capabilities with other providers to create a closely integrated, community-based and patient-focused healthcare team. The company also continues to reconfigure its stores to accommodate that sweeping health strategy, with private patient consultation rooms adjacent to the pharmacy now open in some 2,000 Walgreens stores and more on the way.



As a result, Walgreens now has the means to meet patients where they live, work or shop, delivering care and patient support across a whole spectrum of access points, including Walgreens retail pharmacies and Healthcare Clinics, Walgreens-operated hospital outpatient pharmacies, employer-based Walgreens pharmacies and walk-in clinics, and telehealth links with doctors and pharmacists delivered through the Walgreens website and mobile app.



A continuum of care



Walgreens’ campaign to align itself more closely with other health providers in a continuum of care is playing out across the country, in a variety of settings. One focal point is WellTransitions, a pharmacist-led, transition-of-care program in which Walgreens collaborates with hospital systems to extend patients’ pharmacy care and support beyond the discharge process as they transition back into the home and community. The program, launched in 2012, begins in the hospital, where Walgreens pharmacists help patients better understand their prescription medication therapy. Post-discharge, those patients continue to receive follow-up care from participating local Walgreens pharmacies.



“WellTransitions helps to address the growing need for coordination of community pharmacy care that can help improve patient adherence to medications, while also helping hospitals reduce preventable readmissions,” explained Bobby Clark, Walgreens senior director of health outcomes and clinical research.

The program has shown remarkable results. Recent company research showed that hospital patients who participated in WellTransitions were 46% less likely to experience an unplanned hospital readmission within 30 days of discharge.

“We help patients as they transition out of the hospital back into either a tertiary setting or back home. The program has demonstrated the ability to significantly reduce preventable readmissions,” said Ashworth.



“Some of our hospitals provide consultations through an iPad, so the tech will come up to the patient’s room to