Enabling patient-facing care: Pharmacists at the top of their licenses
Pharmacists still are waiting for the handcuffs to come off. That’s the consensus of industry leaders who are frustrated with the challenges of getting reimbursements for a wider range of services these professionals can perform. It’s a topic at the center of enabling patient care in community-based pharmacy.
“We talk about pharmacists being able to practice at the top of their license,” said CVS Health executive vice president of retail pharmacy and supply chain Kevin Hourican.
“What’s disappointing is that the regulations sometimes significantly lag [with] what the customers actually want.”
He pointed to point-of-care testing as a key area where pharmacists could rise to their full potential.
“A patient could come to a 24-hour pharmacy when a doctor isn’t available to have tests completed. There would be prescriber authority to be able to write for antibiotics, for example, for a positive strep throat test.”
Further, pharmacists could play bigger roles in helping patients determine if they need cholesterol medications, or hypertension medications, he said.
“We believe the pharmacist can play an even more important role in this space,” he said, especially given the convenient locations for patients.
Hourican emphasized that the industry is collaborating to make progress on this goal.
“We are working with many industry partners and NACDS to help advance forward improvements to select regulations, so we can serve the communities and our patients more appropriately.”
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Overcoming barriers to patient-facing care
There is no shortage of hurdles when it comes to achieving patient-facing care. Here are some key challenges and how the industry is trying to address them.
Long wait times: The biggest reason for dissatisfaction with a pharmacy is long wait times, said Oscar Cateriano, director of dispensing U.S. Retail, at BD.
“This should not be happening, and collectively BD is working with retailers to help solve this,” he added, citing third-party research that his company supported. One way to address the challenge of wait times is to “bifurcate” strategies by becoming more efficient with prescriptions for certain patients in order to open more time for those who need individualized pharmacist services, said Kevin Hourican, CVS Health executive vice president of retail pharmacy and supply chain.
Provider status: The industry needs to have pharmacists get reimbursed for services other than just dispensing medications. “That’s one of the biggest barriers holding us back as an industry,” said Rick Gates, Walgreens group vice president of pharmacy. “Provider status is going to give us a reimbursement mechanism for additional healthcare services.”
Technician staffing ratios: States mandate different ratios for the number of technicians per pharmacist. The lack of uniformity makes it hard to standardize across the country. “We have pharmacists doing technician labor in select states, because in those states the ratios don’t allow for them to be doing purely pharmacist work,” Hourican said. “We believe passionately that this needs to be changed. We can improve access to health care with legislative reform.”
Electronic health records: Pharmacists need more access to patient records in real time. “As intimate as we get with the patient, it would be great to have even more connectivity with the providers they have, at the time of point of sale when we’re really engaging with the patient,” Thrifty White COO Tim Weippert said.
Changing ecosystem: Industry disruption has led more dollars to flow out of hospitals and has produced changes in the traditional ranks of healthcare providers. This is a challenge, but also an opportunity for pharmacists to expand their levels of care by adapting to these fast-paced changes. Technology “is the great enabler” for connecting pharmacists to the wider ecosystem centered on the patient, said Doyle Jensen, executive vice president of global business development at Innovation.