As ‘face of neighborhood health care,’ America’s pharmacies offer new solutions
Patient access, lower costs, accountability and collaborative care: those are the watchwords that define the nation’s overextended web of health care in 2015. And community pharmacy — the true face of neighborhood health care — offers some timely solutions to all of them.
The U.S. health system is grappling with a daunting list of challenges as it lurches through a massive transformation to a more accountable, cost-effective and rational system of care. Among the most pressing of those challenges: the still-rising $2.5 trillion annual healthcare bill, which now consumes roughly 18% of the GDP; an acute and growing shortage of primary care physicians that makes it tougher for patients to gain access to health services on a timely basis; and the growing strain on federal and state health resources as aging boomers and newly insured Americans rapidly swell the ranks of Medicare and Medicaid.
Amid those hurdles, pharmacists remain the most underutilized network of health professionals in the United States. This despite the fact that the pharmacy profession has undergone a remarkable transformation over the past two decades, and is poised to offer new and innovative solutions to some of the nation’s most urgent healthcare issues.
It’s a glaring disconnect. Even as pharmacists dramatically expand their clinical and preventive-health expertise and provide more patient-care services that improve the health and wellbeing of Americans — while lowering the costs of care for public and private health plans — the healthcare delivery system and government policies have not yet adapted sufficiently to maximize pharmacy’s pro-patient impact.
Yet, pharmacy operators continue to pursue an expanded practice model, offering a more cost-effective alternative for a growing list of frontline health-and-wellness services. “We’re looking for anything we can do to expand our outreach into the community and supplement the primary healthcare providers,” said Dennis Wiesner, senior director of privacy, pharmacy and government affairs for San Antonio-based H-E-B and VP of the Texas State Board of Pharmacy.
“Pharmacists are helping to shape the healthcare delivery system of tomorrow — in partnership with doctors, nurses and others,” said Steve Anderson, president and CEO of the National Association of Chain Drug Stores. “This collaboration with other healthcare team members can lead to better health outcomes for the ultimate good of the patient. As one of the most trusted healthcare professionals, and arguably the most accessible healthcare professionals, pharmacists are uniquely positioned to provide services to patients, particularly among those in under-served communities where healthcare may not be readily available,” Anderson added.
Focusing on successful outcomes
The core of pharmacy practice remains the expert dispensing and management of prescription drugs — and the counseling and medication therapy management that pharmacists provide at tens of thousands of community pharmacies every day.
It’s a critical part of healthcare delivery. An estimated 82% of Americans use daily medications to manage their health, and 29% take five or more medications, according to the Centers for Disease Control and Prevention. Chain pharmacies alone, Anderson pointed out, “fill over 2.7 billion prescriptions yearly and help patients use medicines correctly and safely, while offering innovative services that improve patient health and healthcare affordability.”
For the nation’s health system as a whole, the move to allow pharmacists to provide state-approved health services to underserved Medicare beneficiaries couldn’t come at a better time. Pharmacists are tapping more of their full potential, meeting the needs of patients in new and exciting ways as they integrate services like immunizations, health screenings, medication therapy management, and diabetes management with the activities of other health providers in collaborative care models and accountable care organizations.
“Our product used to be dispensing pills safely and efficiently, but today our product is that and much more,” said Greg Wasson, recently retired president and CEO of Walgreens Boots Alliance. “Our product is an outcome — an improved health outcome — that only a face-to-face encounter with a community pharmacist can accomplish.”
It’s about telling pharmacy’s story and demonstrating the pharmacy profession’s value “one consultation, one vaccination, one medication synchronization, and one screening at a time,” Anderson noted. “The American public will be the beneficiaries of greater efforts to realize the potential of pharmacies as the ‘face of neighborhood health care.’”
Consider some recent examples:
Rite Aid’s Health Alliance leverages the combined expertise of community pharmacists and in-store care coaches in collaboration with physicians and local health systems. The goal: to provide “comprehensive care and support to individuals with chronic and polychronic health conditions,” said chairman and CEO John Standley, “while helping patients “achieve health improvement goals established by their physicians.”
Iowa-based supermarket and pharmacy chain Hy-Vee partnered with the University of Nebraska Medical Center and Ferris State University to offer customers a point-of-care test for influenza and strep. Trained pharmacists administered the tests and filled prescriptions, when needed, under physician-set protocols.
As a focus of its expanding pharmacy practice model, Walgreens Boots Alliance is moving pharmacists out from behind the counter to better counsel patients and expand clinical services, in line with its “Well Experience” store concept.
CVS Health continues to expand its Pharmacy Advisor program. “Pharmacy Advisor helps our PBM plan members with chronic conditions, such as diabetes and high blood pressure, by promoting medication adherence and closing gaps in care,” said CVS Caremark EVP and chief medical officer Troyen Brennan. “Our interventions can also include reaching out directly to their doctors or referring patients to disease management programs.”
Minnesota-based drug chain Thrifty White has enrolled thousands of patients to its synchronized monthly prescription refill system. By doing so, the chain is shifting those patients to appointment-based pharmacy care.
In Hawaii, pharmacists collaborate with inpatient hospital caregivers to provide a seamless transition for discharged patients back into the community. The program, called “Pharm2Pharm,” was created to prevent gaps in care, provide continuity in patients’ long-term treatment and wellness programs, and reduce hospital readmissions.
Teamwork: The new health paradigm
This dramatic evolution in pharmacy practice begins in pharmacy school, where six-year PharmD degree candidates undergo intensive training not only in chemistry, biology and the complex science of medication therapy but, more and more, in the hands-on care and management of patients and chronic disease.
“Pharmacy education focuses to prepare future pharmacists to provide medication-related care directly to patients where and when they need the care. The care is ... conducted in