How Specialty Pharmacies Can Be Prepared When Disaster Strikes

Disaster preparedness—a necessity for specialty pharmacies and their service provid- ers, suppliers, and patients—goes well beyond stockpiling water and food supplies. The industry faces unique challenges during a disaster situation and its aftermath, according to representatives of Diplomat Pharmacy Inc, which is based in Flint, Michigan. They shared their message in a session held on the final day of Asembia’s Specialty Pharmacy Summit 2018.

“In our current environment, I think we can all agree, unfortunately, we’re experiencing a tremendous rise in domestic terrorism, cyberattacks, as well as natural disaster, all of which make disaster preparedness planning more essential to the successful recovery from these events,” Shannon Beltrand, MA, chief information security officer, said during the session, “Disaster Preparedness: Lessons Learned and Best Practices for Specialty Pharmacies.”

Hurricanes, floods, forest fires, and blizzards all created disaster situations for US communities in 2017, said Gary Rice, RPh, MS, MBA, CSP, executive vice president of operations for Diplomat. In some instances, such as hurricane recovery efforts in Puerto Rico, sustained challenges persist, underscoring the importance of long-range planning.

An effective disaster preparedness plan incorporates 3 elements, the presenters said: emergency response, disaster recovery, and business continuity. The highest priority is the lives and safety of patients and employees, followed by inventory and equipment that can be moved or rescued, and, finally, facilities.

In addition to threats to their own lives and safety, employees may face other challenges during or after a disaster. A specialty pharmacy business should consider whether a facility will be operting and if employees will be able to work, according to Rice. Prior to a disaster, he said, companies need to have human resource policies and procedures in place that address these situations, such as the amount of time off from work afforded to staff to take care of their homes and families. Finances might become an issue, as well. “Employees want to know certain things,” he said, “like ‘Am I going to get paid during a disaster?’”

Local geography should also be considered. Inaccessible roads or flooding can affect employees’ ability to get to work, as well as whether medications and supplies can be delivered. “How do we best support our patients? We have to get the product to them,” Rice said. In some cases, such as for patients living in temporary housing, it may be more efficient to provide medications through a doctor’s office or by mailing them to a post office box instead of an uninhabitable residence.

Patients and caregivers, too, should be educated on how they can best plan for an emergency. “We don’t want to alarm our patients, but we want them to be prepared,” Rice said. “Sometimes we don’t engage in those conversations early enough.”

Patient preparedness includes remembering all prescription and OTC medications and necessary medical supplies. A list of medications and a prescription card should be accessible in an emergency, and all medications should be kept together. Ordering prescriptions early can help prevent patients from running out of what they need in the midst of a disaster or aftermath.

Technology also plays an important role during disaster recovery. In the event of an emergency, specialty pharmacy providers should be able to access a data center with patient information, a call center that allows staff to communicate with patients, and a fulfillment area that can facilitate prescriptions.

Redundancy is key for pharmacies during long-term recovery efforts, Rice said. Backup licensed facilities and pharmacists, systems, and data access can help maintain service during an emergency and aftermath. The panelists recommended running through disaster scenarios with that staff members are prepared and to identify areas that need improvement.

“This is all about being prepared. It’s not just the planning but [also] doing those desktop scenarios and challenging your team so that they really understand some of those weather conditions,” Rice said.

A business continuity plan is essential for dealing with disasters, according to Beltrand. This entails assessing a business to understand its current state, planning based on business priorities and critical systems, testing the plan with simulations, evaluating any gaps in the process, and maintaining the program. “This is a cyclical process that you’re building on,” she said.

According to the presenters, Diplomat has learned from its own experiences with natural disasters, including recent weather events in Florida and Texas. As a hurricane approached, the company prepared by sending some inventory from Florida to Michigan, Rice said, but faced an unforeseen issue returning the inventory when the delivery route became inaccessible.

Through such experiences, Diplomat recognized that its process was effective in the short term but needed to expand capabilities for longer-term recoveries, Beltrand said. A new fulfillment and distribution center now provides data redundancy capabilities for servicing operations across the country.