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Pharmacies can be at the front of a new care model

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There is a gap in our nation’s health care system. Pharmacies need to act now if they want to prove they are the right ones to fill it.

Todd Huseby

One of the long-standing gaps in the American health care system is a lack of accessible, efficient and cost-effective services for individuals in need of a routine screening or ad hoc support for “minor” health issues.

Often, we brush off these health annoyances, willing to ignore them as not “big enough” to warrant a time-consuming (and potentially expensive) visit to a doctor. They may be novel conditions causing issues for the first time or chronic conditions requiring ongoing monitoring. Today we will focus on the role of the pharmacy in screening for acute minor ailments.

Such situations may seem mundane, but they represent an important and often overlooked category of daily health care. Improving the access, affordability and patient benefit of these services would be singularly beneficial for patients, communities and health care providers alike.

Today, there are approximately 60,000 points of care in community pharmacies nationwide, each with highly trained pharmacists and, increasingly, connections to clinics and primary care providers. This team of providers could be at the forefront of our future care model, ready to quickly and cost-effectively triage patients in an integrated and affordable way and thus grow its support of community members.

Rodey Wing

There is work for this new “team” to do to build the solution and demonstrate its value to patients and payors alike. Pharmacists need the tools to supercharge their role in order to deliver the greatest impact, and the marketplace is already crowded with physical and increasingly new digital solutions jockeying for position. If pharmacies don’t start to lay the groundwork for this future, others will fill the void.

A rapidly emerging need

As COVID-19 transformed almost every aspect of our lives, visits to our health care providers were no exception. Telehealth and virtual engagement options exploded, creating new virtual access points and rapidly expanding utilization across the population, providing a victory for patients seeking greater convenience. In this time of turmoil, technology has opened our eyes to what is possible, making it easier for many patients to get care, while transforming how care is provided. In this new technology-enabled environment, services can also bring new efficiencies for providers through shorter, video-streamed consultations and quicker turnarounds.

This upside in convenience can result in often overlooked consequences. For those without access to virtual visits, it can add new barriers that make it more difficult to see a provider in-person or discourage patients from making an appointment for seemingly minor, ad hoc health questions that don’t, by themselves, appear to merit the inconvenience or the expense of a formal appointment.

Kate Maheu

New start-ups are seeing this opportunity and stepping up to fill it. A few prominent examples include Him & Hers (providing care visits for middle-aged and older adults), Hinge Health (digital-based solutions for patients with musculoskeletal issues), and Tomorrow Health (an e-commerce platform providing home-based health care solutions).

This is the tip of the iceberg: Digital solutions are quickly and affordably creating a solution targeted to a specific population and testing it out for acceptance. As providers come under increasing pressure, the opportunity for players to fill care gaps across the health sector will only grow, further lowering barriers to entry and making it easier for new players to enter.

Why pharmacists?

Pharmacists have demonstrated that with the right training they’re well suited to plug these gaps. In the U.S., they’ve shown they’re ready and willing to take on increased responsibilities for health care. They are, in addition, the most ubiquitous and accessible health care professionals in many communities, particularly for those in lower-income urban and rural settings with the greatest need for accessible care.

We see the power of this role in Canada, where the local pharmacist can discuss everyday health conditions with customers; appropriately trained pharmacists can even prescribe medications for certain acute conditions, such as allergies and urinary tract infections.

Just imagine: Instead of taking time off work for a costly doctor’s visit that simply confirms your seasonal allergies, you could go to the pharmacy around the corner, share your symptoms with the pharmacist on call, and head back to work with prescription in hand — all from a single stopover on your lunch break.

Sarah Scolnic

The value of such an experience could be extrapolated across the health care system, with supercharged pharmacists and a community care team leading the way through the approximately 60,000 points of care in communities across America. This new care model won’t form itself, of course. It will require pharmacist capacity; easy-to-use and accessible digital engagement tools; and advanced technology to accelerate the efficiency of current pharmacy activities. Together, these actions could free up pharmacists (and suitably trained technicians) and prepare them to supercharge their role as part of a local, integrated care team.

Such a community care model, with the pharmacy at the core, would be a cost-effective way to relieve pressure on providers, enabling them to spend more time with patients on the ailments and conditions requiring more extensive evaluation. This model transforms the pharmacy from a medication dispenser into a community resource that conveniently and affordably boosts access to quality care for all.

We are already seeing some examples of pharmacies attempting to elevate their role and focus on care delivery. One way they are doing this is through sharing locations and functions with providers, such as doctors’ offices. Another is by strengthening relationships with customers; at least one start-up, AspenRx, has emerged to facilitate personal connections between pharmacist and patient, with easy-to-use digital work flows.

It is likely that such efforts will continue — and accelerate — as pressure on payors continues to push them to search for the lowest-cost option to provide the highest level of care for patients. In many communities nationwide, that represents an opportunity for pharmacies to take on a bigger role.

Now is the time

These changes will not happen overnight. It will take time to create public awareness and operational capabilities. It will take time to help communities see the value of the community care model and embrace the supercharged role of a pharmacist. That is why it is so important that pharmacies start now. If pharmacies don’t embrace this expanded role and build the foundations for it, the opportunity will slip away.

COVID-19 has shown communities the value of their local pharmacy. Patients are interacting more with their local pharmacy team than ever before. The “corner drug store” is increasingly regarded as a viable site for nonemergency medical care and preventative health care delivery needs. Now it’s up to pharmacies to build on this momentum.

Pharmacies have financial incentives to do so. Reimbursements for typical work are in steep decline, and pharmacies need to compensate. As noted above, start-ups are working to get in the game. Pharmacies would be well advised to act quickly to take advantage of their unique status in the market and their ability to meet the evolving needs of the public.

Conclusion

Pharmacies can be a critical point of care for acute health issues. They are a familiar feature of neighborhood life, from densely populated cities to suburban strip malls to rural town centers.

In addition to having access to a wide range of health care products and medications, they offer the considerable expertise of an on-site pharmacist and the potential to partner with additional on-site medical expertise. For common ailments, your neighborhood pharmacist can be a first line of support, saving you a trip to the doctor by performing routine screenings.

With approximately 60,000 pharmacies in the United States, it’s time for each of these points of care to deliver greater value in supporting the health of its community, ensuring consistent access to high-quality, convenient health care services across America. Economic and technological factors have primed pharmacies to assert themselves and take on this more varied, supercharged role in each point of care. If they don’t grasp the opportunity, someone else almost certainly will.

Todd Huseby and Rodey Wing are partners specializing in the health care industry at Kearney, a global management consulting partnership. Kate Maheu is a principal at Kearney, and Sarah Scolnic is a manager at Kearney; both specialize in pharmacy and health care provider operations. They can be contacted at todd.huseby@kearney.com, rodey.wing@kearney.com, kate.maheu@kearney.com, and sarah.scolnic@kearney.com.


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