NCPA President Discusses 3 Ways to Ride the Pharmacy Surge Wave

It is no secret that the COVID-19 pandemic has presented many challenges for pharmacists.

In addition to an overwhelming list of daily responsibilities, pharmacists have been facing the clamor for COVID-19 vaccinations, treatment, and testing, especially in response to the Omicron variant. For example, the number of fully vaccinated Americans has steadily increased since summer 2021, with 65% of the population fully vaccinated.¹

As of March 4, 2022, 49.9% of booster-eligible individuals in the United States had not received their booster doses.² The continued testing and vaccination demand, coupled with never-ending to-do lists, staffing shortages, and technology gaps, a exacerbates spikes in patient volume and workload for pharmacy professionals.

The positive aspect of these challenging times is an abundance of new opportunities for pharmacies as clinical service providers. The pandemic proved that pharmacists are uniquely positioned to expand their expertise beyond the traditional scope of work of dispensing medications and make a dramatic impact within their local communities. With 90% of Americans living within 5 miles of a pharmacy,³ pharmacists have assumed a larger, more active role in consumer-driven healthcare and now play a vital role in removing barriers to patient care.

The public perception of pharmacists is changing. Patients view their pharmacists as trusted caregivers to support a range of health needs beyond medication dispensing. Consumer-driven health care, federal and state legislation, and population health needs have also contributed to the evolution in pharmacist roles.

I recently sat down with Michele Belcher, president of the National Community Pharmacists Association (NCPA) to hear her stance on the fundamental and growing role of pharmacists in consideration of the challenges that COVID-19 has presented. As NCPA president and owner of Grants Pass Pharmacy in Oregon, she offers a unique perspective on the present and future state of the pharmacy profession. Running her family-owned and -operated pharmacy, Belcher understands the critical role that independent community pharmacies play in caring for patients across their region. Her candid and insightful points support an emerging theme: Now is the time to turn the pharmacy profession’s COVID-19 challenges into positive long-term change.

3 Ways to Support Community Pharmacies
Significant change in the pharmacy space can be accomplished through 3 essential efforts: implement technology to coordinate care and save time, initiate clinical services to generate alternative revenue streams, and shift the pharmacy mindset to proactive from reactive workflow models.

• Implement technology solutions to address staff burnout and shortages and save time. Among the factors that contribute to staff burnout, the largest driver is inadequate staffing to meet patient volume. Patient surges from large retail pharmacies, such as CVS and Walgreens, which have temporarily closed because of staffing shortages has caused a ripple effect, especially for independent community pharmacies traditionally located in more rural communities. The impact is felt at Grants Pass Pharmacy, according to Belcher. The pharmacy’s volume of new patients has increased up to 850% more per day, because of closed pharmacies in the area.⁴ Given the additional workflow burden to set up new patients coupled with the increased prescription volume, it is critical to assess staffing levels and prioritize workload distribution to reduce burnout. Implementation of tech solutions allows pharmacy teams to maximize staff efficiency and streamline processes. Pharmacists deserve to be armed with tech solutions designed with their unique practice models in mind while also connecting them to the entire health care ecosystem. Shared population health management platforms with specific medication management and pharmacy clinical services workflows allow pharmacists to play a larger role in the care coordination equation. The ability to coordinate patient care efficiently requires systems that connect pharmacists to other clinicians and payers. Best practice platforms include workflows allowing providers to integrate with multiple clinical sources to absorb data, enabling a comprehensive and efficient process to individually assess each patient’s clinical risk factors and medications. Tech solutions allowing documentation with automation alongside the ability to seamlessly check eligibility and bill for medical services at the point of care will revolutionize patient care value and pharmacy team satisfaction. Using advanced technologies, pharmacists become more efficient, while making more informed, smarter patient care decisions.
• Initiate new clinical services to generate revenue streams.
  Assisted by technology, pharmacy teams should next consider adding new clinical services and revenue streams. Pharmacists play a vital role in patient care beyond medication management. Pharmacists are critical for population health initiatives, disease management and caring for under-served and high-risk communities. Now is the time to capitalize on this wave. For example, there is an increased demand for pharmacists to provide patient care services. Pharmacists as caregivers include patient visits on public health items, such as assessments for indicated adult and pediatric services, hormonal contraceptives, and tobacco cessation. Chronic disease management for asthma diabetes, and hypertension are also evolving opportunities for pharmacy professionals. Pharmacists are regularly providing cognitive services, which should be compensated, and with appropriate tech solutions and payor arrangements will be via medical billing or unique value-based care payment arrangements. Offering clinical services as billable-care visits presents a creative and unique way for pharmacists to generate revenue streams while supporting the over-burdened health care system. For these ideas and efforts to come to fruition, the health care system must recognize pharmacists as providers, both federally and locally, and provide the necessary credentialing and enrollment tools. Herein lies an important opportunity for pharmacy leaders at the community, regional, state, and national levels to ensure proper reimbursements for clinical services. Equipping pharmacists with electronic health record technology that allows them to perform and bill for all medical services performed is fundamental for opening the door to new revenue streams for patient services.
• Shift to a proactive versus reactive mindset. Finally, proactive versus reactive processes for items, such as medication dispensing and pharmacy consultations, help free up the pharmacy team members to provide other clinical services. For example, implement medication synchronization strategies by shifting to an appointment-based model where patients schedule times to pick up all medications and receive valuable pharmacist consultations during these monthly meetings. This accomplishes an increased efficiency in workflow by having all prescriptions filled at once, while allowing a focused opportunity for the pharmacist provider to engage and document billable patient assessment encounters. However, it is important to note that before making any drastic changes to pharmacy services, patient convenience and satisfaction must be considered. An appointment-based model may work for some patients, whereas others prefer the convenience and flexibility of stopping by the pharmacy at the patient’s convenience. Implementing the right processes and technology to manage both approaches is ideal.

Conclusion
The time is ripe for the health care industry to fully leverage pharmacists’ expertise, knowledge, skillsets, and trust across their communities to support the overburdened health care system. Advanced technology and maximized opportunities for reimbursable services should lead to the hiring of more staff members, reducing burnout and improving job satisfaction. It is equally important to remain adaptive and open to the reprioritization of tasks and shifting staff responsibilities to alleviate staff burnout and ensure that all team members are practicing at the top of their licenses.

Belcher concluded with an important reminder: Offer pharmacy technician leadership training that improves professional satisfaction and develops leaders who will help the organization meet its goals. And never forget to motivate the team through breaking down goals into manageable and small tasks, incentives, positive praise, and regular communication.

References

1. See how vaccinations are going in your county and state. The New York Times. Updated March 9, 2022. Accessed March 10, 2022. https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html
2. In focus: COVID-19 community levels. CDC. March 4, 2022. Accessed March 10, 2022. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
3. Get to know your pharmacist. CDC. Updated January 4, 2021. Accessed March 10, 2022. https://www.cdc.gov/heartdisease/pharmacist.htm#:~:text=With%20nearly%209%20in%2010,help%20you%20manage%20your%20health.
4. Chast N. ‘Major inconvenience’: C. Oregonians voice frustration over pharmacy closures, transfers, wait times. News Channel 21. October 14, 2021. Accessed March 10, 2022. https://ktvz.com/news/2021/10/14/major-inconvenience-sisters-resident-frustrated-over-pharmacy-transfer-prescription-wait-times/