2020 will forever be remembered for the devastating impact of the COVID-19 pandemic. On a personal level, relationships and daily routines changed to accommodate new concerns and norms of daily lives. On a professional level, the role of pharmacists as a trusted health care professional came again into focus as the unexpected demands of COVID-19 tested the health care system’s capacity to manage patients.
As the U.S. slowly reopens, testing and contact tracing remains a priority as an important safety measure to limit viral spread until a vaccine becomes widely available. To execute testing on a large scale, availability of kits is only part of the consideration. The U.S. health care paradigm needs to shift to both proactively identify at-risk communities and address care capacity concerns, for which pharmacy can provide a solution. Now is the time to consider the vital role pharmacists can serve in addressing access barriers to COVID-19 health services and information.
Understanding the pandemic and population
To ensure that communities have adequate COVID-19 resources, including testing, health care organizations need information on populations, health care practitioners and diagnoses. A number of resources are now available, including free access to LexisNexis Risk Solutions Healthcare COVID-19 Resource Center data set. By leveraging LexisNexis’ vast amount of data, health care professionals can visualize at-risk populations and potential care capacity challenges via the interactive map.
Health care organizations, pharmacies and professionals can answer critical questions:
- Which communities are most at-risk for poorer health outcomes due to COVID-19?
- Which communities are in most need of critical care resources to help combat its impact in their region?
By understanding the scarcity of resources and at-risk populations in specific neighborhoods, providers can determine who would most benefit from testing and how knowledge and resources can be disseminated most effectively for improved clinical outcomes. These insights enable improved testing and treatment decisions by providers, including pharmacists.
Enabling care provision by skilled pharmacists
Eliminating barriers to testing remains key. Pharmacy offers thousands of community sites, already established and strategically placed across the country. To fulfill the demands of testing and with the support of federal and state agencies, pharmacists have been granted the authority to order and administer COVID-19 tests.
Pharmacy chains will require a streamlined, effective and manageable method to address the challenges associated with pharmacists ordering and administering tests. The multilayered approach needs to include the following:
- Enabling a connected interface between the pharmacist and their employer for the real-time exchange of information.
- Prefilling of required provider information for ordering and billing of the COVID-19 test (with information such as individual NPI number, state license, address, phone and fax number).
- Credentialing of the applicant to ensure testing criteria have been met.
- Registration and verification of the applicant with their insurance payer.
- Timely validation of the provider and applicant’s information to meet mandatory reporting requirements.
Data challenges for third-party payers to maintain an accurate payer directory may include:
- Knowing the pharmacist’s individual NPI number and address information.
- Verifying the pharmacist’s state license number and current status.
- Linking the pharmacist to her organization affiliation.
- Ongoing timely alerts and notifications regarding any changes.
Achieving these objectives can be greatly simplified by implementing a solution that uses existing provider data to pre-populate pharmacist data as well as manage the ongoing maintenance and alerts relating to the population. Furthermore, the credentialing, formatting and registration process can be streamlined with the help of a technology partner with established connectors into the payers’ provider intake platform.
Providing safe, accessible community services
Retail pharmacies need to consider infrastructure when implementing COVID-19 testing. Remote and drive-thru COVID-19 testing sites can be established across the U.S. to meet demand; however, “pop-up” environments bring the challenges of maintaining real-time patient data access and security via a workflow utilizing tablets, laptops and other portable devices.
Cybersecurity, already a major concern for health care organizations during the pandemic, will become a critical consideration when setting up testing sites. Patient data has to be protected via secure remote login and frictionless fraud protection for mobile channels based on multifactor authentication, a method using two or more identity verification steps. Additional security solutions can help distinguish fraudsters from genuine patients in real time and across all digital touchpoints.
As remote testing sites perform services nationwide — further dispersing patient data across the health care landscape — care coordination will become more important than ever. Providers need to ensure they are dealing with the right person for the right transaction. For each unique patient, using a universal patient identifier across pharmacy operations helps centralize records and maintain accuracy of demographic information for a more efficient and consistent delivery of care. With technology that links and clusters records to confirm a unique identity across dispersed platforms, pharmacists can quickly and easily validate patient information. This workflow enables a safe and stable testing process in a dynamic environment.
Amid the COVID-19 crisis, there is an opportunity for retail pharmacies to leverage the advanced training of pharmacists to address the health care needs of their communities. There are technology solutions that can take advantage of existing infrastructure to achieve efficiencies and streamline the involved and resource-intensive process of COVID-19 testing. The net result will benefit both pharmacies by expanding their community services and patients in need of those services.
Jill Regan is director of relationship management at LexisNexis Solutions — Health Care.