Pharmacists have the opportunity to make an impact on community health during the first global pandemic in most of our lifetimes.
We've been saying for years that we are the 'most accessible' healthcare provider and sometimes the ONLY healthcare provider in medically underserved communities.
What counts as a "medically underserved" community?
Medically underserved is defined as "areas or populations designated by Health Resources & Services Administration (HRSA) as having too few primary care providers, high infant mortality, high poverty or a high elderly population."
This HRSA map shows the many areas of the country defined as medically underserved.
Earlier this month I wrote about how pharmacists can impact cost savings for patients, payers, and providers and I still believe that pharmacies are being under-utilized, but that is changing rapidly.
As many of our family and friends are being asked to work from home or not at all until further notice, pharmacists are actually being called into action to serve our community members during this time of uncertainty.
I wanted to quickly share some ideas for how community pharmacists can step FORWARD and SHOW the value of pharmacist-led services.
For more ideas about pharmacist-led clinical services that impact patient care, register for our upcoming ONLINE Elevate Pharmacy Virtual Summit.
Here are a few ideas for how pharmacies can help to educate patients and alleviate some societal pressures to be hyper-vigilant about community health.
Post signage on the door that encourages people that are high risk (over the age of 60, those with a fever or symptoms or anyone who may be immune-compromised) to avoid coming inside the pharmacy.
Also, encourage calling prescriptions ahead of time and reserve the "waiting" area only for those with acute needs.
Sharing flyers, posters, bag stuffers and educational materials on social media like how to protect yourself, is an easy step to implement immediately.
I would love to see independent pharmacy owners reaching out to local health departments, hospitals, and primary care clinics to offer to serve on committees or disaster response teams.
The more we are seen as a partner in the healthcare system, the stronger we can foster an organized, inter-professional response.
IMPLEMENT SOCIAL DISTANCING MEASURES
Offer patients alternative pickup methods like drive-through, home delivery or curbside pickup to limit person to person contact.
Avoiding sharing pens or passing around debit cards or other publicly used inanimate objectives if possible.
NO EMPTY REFILL BOTTLES. This has always been a pet peeve of mine, but my staff knows not to accept any empty medicine bottles from the patient's home.
If your dispensing or clinical services platform allows, provide telehealth consults with the pharmacist so that people can receive counseling or be referred to other healthcare providers.
PROVIDING POINT OF CARE TESTING SERVICES
This may be one of the more controversial ideas, but I do feel pharmacists who can provide testing services to help identify the need for screening and advanced testing.
At the very least, pharmacies should share online screening tools with patients.
UAMS Health created an online screening tool for patients, that I would encourage pharmacies to share with their patients.
Pharmacists can offer patients point of care testing for the traditional flu virus as well as strep testing to help rule out other viruses and illnesses to help lessen the burden of primary care and emergency rooms.
Of course, the pharmacist should have personal protective equipment to offer these types of services and be appropriately credentialled and CLIA certified.
SUPPLYING CHRONIC AND ACUTE MEDICATIONS
In the state of Arkansas, the legislation allows for emergency refills. Emergency refills for 30-day supplies, when appropriate can help patients with chronic conditions continue to stay healthy.
Know your state's exemptions and legislation regarding emergency refill authorizations.
We must assure patients they will have access to their medications and the pharmacy will be there to support them through the pandemic.
I went back and forth on whether I'd dispense a 90 day supply and for most patients, I would say that at this time it is unnecessary. I am concerned about the impact on the global drug supply chain and I think it would be more prudent to limit refills to 30-day supplies in the interest of public health.
Providing people with OTC product recommendations will be important as ever, but pharmacies should consider limiting the quantities sold per person on a case by case basis to limit another "toilet paper-like" run on medications.
Of course, 90-day supplies and OTC product sales would be at the pharmacy's discretion and made on a case by case basis.
We should be thinking about policies and procedures to put in place now in case the crisis stretches on for months.
As this recent article on the drug supply chain mentions, "Worry itself can lead to behavioral changes and risk."
Either way, we need to assure patients we will be there to provide patient care, help them get their medications and/or make recommendations on alternative medication therapies and ensure patient compliance to chronic medications.
THE ECONOMIC IMPACT
One of the things that concerns me most about the pandemic is the global impact on the economy.
Our patients, particularly the elderly and patients with limited financial means, will be especially impacted by the crisis.
We must be aware of the financial pressure this will put on our patients.
Pharmacists are compassionate and capable.
We are here to support our patients and to help calm their fears.
The Ohio Department of Health put out a COVID-19 readiness checklist for pharmacies that is will help pharmacists to put measures in place to ensure the safety of our staff members.
What are some things you are doing to impact population health in your community?
The American Pharmacists Association annual meeting scheduled for March 20-23rd has been cancelled due to travel and gathering restriction recommendations.
If you are a pharmacist looking for new ideas about how to serve your patients in innovative ways join the 2020 Elevate Pharmacy Virtual Summit on April 8-12th.
It is a free, online virtual pharmacy conference for pharmacist-entrepreneurs and those in consulting practices.
You can register for free using your email address at ElevatePharmacySummit.com
About Blair Thielemier, PharmD