Expert: Independent Pharmacies “Layered On” New Patient Services During the Pandemic

In an interview with Pharmacy Times, Debbie Weitzman, president of pharmaceutical distribution at Cardinal Health, discussed how independent retail pharmacies quickly adjusted during the pandemic in order to offer patient services and expand care. She also discussed highlights from the Cardinal Health Retail Business Conference, happening July 13 through 16 in Las Vegas, Nevada.

Aislinn Antrim: Hi, I'm Aislinn Antrim with Pharmacy Times. I'm here with Debbie Weitzman, president of pharmaceutical distribution at Cardinal Health, to discuss the future of pharmacy, what's coming next, and how that's being explored at the RBC conference this week. So, how have retail independent pharmacies really pivoted over the last 3 years to serve patients and what parts of these changes do you think will stay the same long-term?

Debbie Weitzman: Well, if we go all the way back to the beginning of the pandemic, really, independent pharmacies never closed the door. [They were] really one of the only retail entities of any kind that, within days or, you know, maybe a week, they really all figured it out quickly. Those that didn't have already a drive thru, I saw some incredibly creative alternatives to the drive thru, like curbside pickup, people put up signs that had, text to get the delivery at your door. And that was really just for picking up scripts and basic stuff. And then it transitioned into testing and having drive thru testing or curbside testing, then, of course, was followed by vaccinations. So really, it's not even like pivot, right? Because it's just been like one after another after another layering on all the different services in ways that community pharmacies stepped up to meet the needs of patients. So, they really worked very tirelessly, they faced all the same challenges as any business would have, which was keeping their own employees safe and themselves safe, as well as dealing with any work shortages, if people did get sick and they had to have coverage. So, it’s been a really extraordinarily taxing time for pharmacists. But you know, they never wavered, they really stepped up in a big way.

And what's been great is that this story has emerged about the value of pharmacy in the community and things that pharmacy associations and pharmacists and companies like ourselves have been saying, literally for years, if not decades, which is that, you know, we need to let pharmacists practice at the top of their license. And we need to recognize the value of the pharmacist and the pharmacy as part of the care team. The moment has come where that recognition has really come to fruition. We're seeing it legislatively, where initially it was the PREP Act and the emergency measures that were taken to empower pharmacists to provide all the services directly to respond to the pandemic. And now we're seeing a continuation of that momentum to keep making those things permanent, and adding more capabilities or enabling pharmacists to use their skills to now move into that space of doing more provider-type activities. So, I think it's fantastic that they were rewarded, that pharmacists were rewarded and recognized for all of the extraordinary work that they did during the pandemic. And, you know, we all have to even try to figure out, like, when people say the pandemic is over, it's not really over, right? It just keeps evolving and morphing into the next phase. So now, I think we're we are in more of what they call the endemic stage or the steady state. And then you're seeing pharmacists just continue the services that they did on an emergency basis on a regular basis. And it's one of the big themes we have here this week during our RBC, which is how can pharmacists just really keep that momentum going and keep layering on more and more services now that this recognition is in place of what they're capable of doing?

Aislinn Antrim: Absolutely. I love how you say layering on because that's really what it is. Can you speak to the ways that the health care industry is evolving to meet changing consumer needs and preferences?

Debbie Weitzman: Yeah, I think we talked about it this morning in one of our sessions, that really where consumers’ minds are now is omni-channel. There's no one solution for any customer and the very same customer who likes to buy online, sometimes they want to shop in the store, and sometimes they want to buy online [and] pick up in store, you know? We have all these different models now that meld together, you know, digital services with brick-and-mortar physical services. So, we're talking a lot about the ability to provide the different opportunities to consumers to address their health care needs in the fashion that's most relevant to them. And that could even mean different methodology for different parts of their health care. So, you know, you might be really comfortable with a tele-visit with a doctor for one thing, but really want a face to face for another type of condition. And I think pharmacists are also embracing that. They're bringing introducing more technology into their store so that they can have an online presence, make shopping online an option. I mean, a lot of them have already had some limited digital services, like, you know, an app for refill, those types of things. And again, the idea of layering on, they need to take that technology to the next level and make sure people can shop online for their store, they need to be able to do consults and things like that, perhaps over a video chat. So, this kind of melding together of the physical space and the digital space is something that we're really pushing our pharmacy customers to, to embrace and just sort of step by step take, take a little step in the direction of a new technology advance, until they really get comfortable with it.

I mean, you have the whole spectrum, right? You have some pharmacies that really have very little offerings in that space, and you have some that are on the other opposite end of the spectrum with very sophisticated different opportunities for patients to engage with them digitally. So, we're just trying to make sure everybody gets on that curve. And you know, wherever they're comfortable with, they keep pushing themselves to make sure they keep up because it's been proven that it's not really just newfangled young people, you know, [who are] tech savvy. It's really everybody. You know, we have Nielsen research that shows that people 65 and older, 50% of them are shopping online. So, it's really the whole spectrum now. That is also a result of the pandemic. When everybody was shut in their homes for a long time, pretty much everybody was forced to figure out how to use technology to get the goods and services that they needed. So, we've had this giant leap forward in the use of technology and day to day life and I think that is a really game changing event for health care and the delivery of health care services.

Aislinn Antrim Absolutely. Can you share more about how pharmacies can prepare for this evolution and kind of take those steps, as you mentioned?

Debbie Weitzman: There's a ton of suppliers and vendors out there, you know, willing to do things. There's a lot of very specialized areas, we're offering a lot of services around buying online and setting up your own website. The PMS system, you know, the vendors who provide PMS systems to the stores, they also have suites of services. I do recommend to our customers that they try to find, as a starting point, somebody they're already close to, somebody they're already worked with. That's why for us, it's a real priority to develop some of those services, because we already have this trusted advisory relationship with our customers. And we have the staff to kind of coach them through things. So, it's always easiest when you have a sort of out-of-the-box solution, and you don't have to invent it yourself. I think there's a lot of opportunities to do that.

You have to pick the area that's right for your business, whether that's clinical consulting—and we have a solution for that, you could go heavily into the clinical areas—or if you want to push the front end of store, then you need an online shopping tool. So I think each owner of a pharmacy has to decide, evaluate their business, where their opportunities are, understand their community and what the needs are, the demands are there, and pick one service, one new thing to get started. You don't want to launch 3, 4, or 5 new things all at the same time and overwhelm yourself or your staff, you want to kind of pick 1 thing, do it well, and then, you know, continue, as we said before layering on.

Aislinn Antrim Perfect. So, talking more about the RBC conference, what are some highlights for you?

Debbie Weitzman: Well, we just had our opening session, it was very exciting and actually a little bit emotional. We had a really heavy emphasis on community impact. We really wanted to thank all of our participants and our pharmacy owners for the incredible work they've done in their communities, you know, not only because of the pandemic or during the pandemic, but they always do that, right? That's what they're really all about. And they're all sort of uniquely independent, they respond to the needs of their community. So, in doing that, you know, making that an emphasis this year, we had 2 outstanding speakers. One is one of our pharmacy owners, one of our customers who has a very personal story about a health challenge of a family member of his and a foundation that he supports as result to try to get more research for this particular disease. And then we had our guest speaker who was very inspirational. He's got a fantastic story. His name is Jon Dorenbos, he is a magician, an ex-NFL football player, and an inspirational speaker who mixes his own personal story and the challenges he's faced along with magic tricks, which are incredibly impressive and fascinating. So, it really resonated with everybody, you know, his story, his energy. Yeah, his message was fantastic. And, you know, we had a few executives up there on stage to try and continue the message of congratulating and acknowledging all the fantastic work that our customers do and giving them a little background on the things they will be seeing over the next couple of days on our show floor.

Aislinn Antrim: Wonderful. More pharmacists are continuing to operate at the very top of their license, so can you discuss the push for provider status?

Debbie Weitzman: I think that we talked about a little bit already. Every day, we're getting a little bit closer. The decision to let pharmacists prescribe COVID treatment is critical, it's a recognition of the need to keep moving in that direction. So, I think one of the big challenges we face is that it's still a decision that's going to be made by pharmacy boards at the state level. But the overarching goal should be to make it at the federal level. And, you know, there's a number of different trade associations working hard on that. So, I think it's just something that the industry has to keep pushing for, and now there's a lot of momentum in that direction. And I think all of the ecosystem challenges around labor shortages, you know, doctor, primary physician shortages, but think about not only as a primary physician shortage, but just think about running doctor's offices, everybody's having trouble with front office staff, billing staff. So, if you've already got this incredible infrastructure in place through the pharmacy, then it's going to be such a big need and such a big demand. I think we're moving in the right direction—I can't say when or if it's going to become a federal law, but I think that we're going to keep kind of knocking down the barriers and move in that direction.

Aislinn Antrim: As we start looking to the future, maybe not after COVID but living with COVID, do you see more changes in pharmacist roles in patient care?

Debbie Weitzman: I do, I feel like there's a really interesting partnership that is evolving. We work a lot with payers for our outcomes business, and our outcomes business makes a huge network out of all the pharmacies. So virtually every independent pharmacist is part of the outcomes network. And we've now established kind of this constant dialogue, both with payers as well as manufacturers, about leveraging that network to push patient care and the direction that they need to do so. Whereas, you know, the original premise of founding that network was just really focused on star ratings. Now, we've been able to do sort of micro programs and very targeted programs based on disease state, based on geography, based on a specific goal that a payer or manufacturer might want to achieve. And it's been, you know, proven to be a very cost-effective way to get patients to act a particular way. So, you know, it could be adherence, it could be understanding, like just an educational piece. It could be pushing out information that they need. So, what we what we love about this is that it also is like a virtuous circle, you're helping pharmacists get the information they need, it's a paid engagement for them. So, it is helping to insert them into the care team. And, you know, it's great for their business, it's great for patient care, it's great for the relationship between the pharmacist and the patient. So, like I said, it’s this sort of virtuous circle on just the overall health of the patient.