New Program Model Allows Pharmacies to be a Primary Care Option for Rural Communities

Pharmacy Times interviewed Joe Duarte, co-founder and president of ContinuumMD, on pharmacies that are providing virtual and in-person primary care options for rural communities.

Alana Hippensteele: Hi, I'm Alana Hippensteele with Pharmacy Times. Joining me is Joe Duarte, co-founder and president of ContinuumMD, who is here to discuss how pharmacies are starting to provide primary care options for rural communities.

Joe, how did you get started in this field, and what was your background before getting involved in pharmacy?

Joe Duarte: Prior to being in the health space, I was a professional fighter, I was a former world champion. One of the things is that I’ve been passionate about is, growing up without insurance, I wanted to help create accessibility to it—make it accessible, and affordable for people—and figuring out what those challenges are and be able to use the technological tools that we have created to make that happen by partnering with pharmacies and local providers while using our national doctor network, as well.

Alana Hippensteele: When did going to a pharmacy as a primary care option start to occur for patients in rural communities?

Joe Duarte: I think, if you look back in terms of the history of it, Minute Clinic started in 2000—I believe it was 2000—in 2000, like 22 years ago, and that might be the oldest working model. Now, they have over 1100 locations in 33 states, and I think that it kind of shows that that type of care is viable, it's needed, and it's efficient. So, you see this with CVS’s clinics as well. You're starting to see this more in terms of those big pharmacies offering these services; however, they're far less personable. This is where I really kind of leaned towards looking at the independent pharmacies, the community pharmacies, as a strategic partner to create these health care hubs and align myself with.

Alana Hippensteele: When the pharmacy connects patients with a licensed medical provider in a telemedicine setting, are the providers nurse practitioners, pharmacists, physicians or another type of health care professional? And this is a part of that model that you were talking about for Minute Clinic, and then ContinuumMD.

Joe Duarte: So, based on the services that are needed, that will determine the type of provider that will be appointed to that. That's all built into our software. It maps to providers that are licensed for that particular use case. We use everything from MDs, DOs, NPs, RNs, PAs. There are various providers that we use to be based on the need of the patient.

Alana Hippensteele: Is it possible for patients across the country to use pharmacies as a primary care option, or are there only certain states where this is currently possible?

Joe Duarte: Beautiful thing about technology is it's made this possible in every state. With our platform that we have, all states are viable for providing primary health care. It directly connects. The health care hub is connected to primary care providers, and they can offer our services right out of the pharmacy. It's beautiful in the sense of it ties into local providers, as well as a backup national doctor network that we have, to make sure that those scripts are turned around in a timely manner, patients are not lapsing in their medications, and making sure that they get the care they need, when they need it and where they need it. We realize that time is—nowadays, it's really difficult for a person to take time out to go to a doctor, to sit in a waiting room, to be seen by the doctor for 5 to 10 minutes just to renew a script or get a new one. This pathway really allows that pharmacy to be the heart of community health care.

Alana Hippensteele: Would this telemedicine service facilitated by the pharmacy only be possible for certain disease states? I would imagine the same level of patient care might be trickier with specialty pharmacy, for example, which would be dealing with areas like oncology and HIV. Is that an area where the pharmacy might not be able to be the primary site coordinating care for patients?

Joe Duarte: Yes, certain disease states are best suited, obviously, for in-person visit. However, many common conditions are treated via telemedicine. One of the things that you’ll notice is, with the advancement and innovation of technology, we're able to not only treat more disease states but manage them as well. Remote patient monitoring has really become a holistic approach and a way for providers to stay ahead of the problems that are causing patients to avoid emergency room visits and urgent care visits and things of that nature.

And also, I think 1 of the things that we're seeing is that when you make something accessible, patients are able to improve their adherence rates. We're seeing this in every place that we work in. I'm a perfect, perfect example. I'm a perfect example. I moved to Texas last August. My primary care appointment was canceled 2 weeks ago, and the next available appointment is July 19. Fortunately for me, having a company like this, I put myself on the schedule, and I get my script renewed that I need, and it makes it easier and closes that gap. That’s essentially what we’re doing. We want to offer to pharmacies in every state so that they can give their patients the best care.

Alana Hippensteele: What do you see as the future of the pharmacy’s role in rural communities with perhaps limited access to health care services?

Joe Duarte:A key asset to closing that gap is obviously working collaboratively for improving patient care. There's a lot of gaps when it comes to script renewals. Maybe patients are in between doctors, maybe they misjudged and are out of a medication that they need. But all of these things come back to making things very accessible, especially in rural communities where you might have 88 providers for 10,000 people, a population of 10,000 or more. Accessibility is always a challenge. And I think as providers, they want to serve the community the best, they want to improve as much of the health care as they possibly can, but they are bottlenecked because of the process that a brick-and-mortar facility operates in. The nice part about the Continuum Healthcare Hub is that you kind of have a hybrid model where a patient can go into the facility to see the physician, and on that refills, refill it through the platform. That's a beautiful thing, because it alleviates visits at a doctor's office to allow more patients, increase that doctor's ability to see more patients or a new patient, and that current patient is able to just get the refills, or any new scripts done via telemedicine. It's a beautiful thing in a sense where a doctor can both be a telehealth provider if he's a local physician, but also at the same time see patients in his office and alleviate some gaps. There's a lot of opportunity that I see just in the community that I'm in and then talking with the pharmacies that I've been speaking with in the different networks.

Alana Hippensteele: Any closing thoughts?

Joe Duarte: I grew up on an island and it's difficult for people to not only take time off and get the care they need, but I think one of the things that we don't think about a lot of times is how this impacts everything from the type of quality of life that we're getting. I think that's my closing thoughts: how can we improve quality of life and get people what they need when they need it. Like I said, our goal is to restore the independent pharmacies, the community pharmacies as the cornerstone of community health care. That's the goal, our mission of our company.