Pharmacy Innovation Continues, but Provider Status and Reimbursement Are Necessary

Pharmacy Times spoke with Lisa Smith, PharmD, MBA, senior director of clinical operations and strategy at Walmart Health and Wellness, at the National Association of Chain Drug Stores (NACDS) 2022 Total Store Expo. Although innovation in the pharmacy space is continuing nearly 3 years into the COVID-19 pandemic, Smith emphasized that provider status and reimbursement are both necessary to continue this innovation in the future.

Q: The COVID-19 pandemic led to a lot of innovation in care delivery. Can you give an overview of the kinds of innovation that you saw?

Lisa Smith, PharmD, MBA: Absolutely. I think for years before the pandemic, we had talked about omni-channel care, and you started to see delivery, curbside, those type of things. But [the pandemic] really propelled that type of omni-channel prescription delivery forward. So, we saw patients who needed to get their medications safely, they wanted to have the least amount of contact as possible and so we saw curbside delivery really taking shape. But I think also how and where we delivered services, all of us went outside the walls of the pharmacy into the communities that needed us most, whether that be testing or doing immunizations at skilled nursing facilities or in the communities and at faith-based organizations, I think we saw how and where pharmacy was delivered change. And I think that's something that'll continue beyond the pandemic.

Q: The pandemic also changed the ways that patients view health care and how they want to receive care. How has this impacted the pharmacy space?

Lisa Smith, PharmD, MBA: I think one of the absolutely amazing things about the pandemic is really the patients and communities seeing pharmacy as a first choice for care. I think we knew, the communities knew, that pharmacy was doing immunizations, but maybe it still wasn't the destination for health care in the community that I think it is now. And so, the patient awareness of the services, knowing that you can have an appointment or not, you can walk in, we’re open nights and weekends. I think that convenience is something that patients will continue to utilize once the pandemic is over. I think we also began to service pediatric patients in a new way, and so parents, it's a much different level of trust. I'm a parent myself in bringing your child to a provider. And I think what we did with 5- to 11-year-old COVID-19 vaccines, and now even the 6 months to 4-year-olds, it's just been really amazing to see patients continue to trust us with their whole family's care.

Q: Now that we are a couple years out from the height of the pandemic, have you seen that innovation change or evolve?

Lisa Smith, PharmD, MBA: I don't think it's slowed down; I think what pharmacy is doing is really doubling down on those innovations, and especially as it relates to scope of practice and authority. I think with innovation, we often think about just the technology associated with it. But our ways of working and the scope of practice for pharmacy has really changed. I think one of the things that has been great for me to see that I think is going to continue to propel us forward is the scope of practice with our technicians. For us to continue to innovate, pharmacists are going to have to do more and more clinical skills. So, utilizing those technicians to really fill in those gaps, them administering immunizations for us, increasingly being able to do more things in the pharmacy, is only going to let the pharmacists continue to innovate that practice more and more.

Q: At the same time as all of this innovation, pharmacists have been fighting for provider status and have made some important steps in that direction. How do increased abilities for pharmacists go hand-in-hand with innovation?

Lisa Smith, PharmD, MBA: Yeah, they absolutely do. I think first and foremost we have to innovate, to give pharmacists the time to perform those services. So, that's one thing that's really important. But I think with provider status, what we saw during the pandemic is that when pharmacists have not only the scope and authority to deliver the services, but a payment mechanism to be reimbursed for those skills and services that they're providing, really the sky is the limit of what the profession can do. So, I think as we talk about provider status, it's always important to think about the innovation that's going to free up their time, but then also how we quickly follow provider status with payment reform and making sure that pharmacists can be paid for those services, because that's the only way we're going to continue to innovate and move the profession forward.

Q: How can pharmacists and others continue this innovation and momentum?

Lisa Smith, PharmD, MBA: I think it's just advocacy. I think one of the things that I saw that I hope continues is really the entire pharmacy industry coming together and advocating for the exact same causes. So, whether that was traditional competitors in the chain drugstore space, chains and independent hospitals, there was a unity in pharmacy that I don't know that we had as much before. And so, I think pharmacy having one voice of where we need to go for scope for payment, and just moving the practice forward. I hope that that continuity that we were able to create during the pandemic continues.

Q: What do you see for the future of pharmacy innovation?

Lisa Smith, PharmD, MBA: I really see pharmacy becoming a hub of the community for health care so, you know, we're not going to be doing surgery at a community pharmacy, but I do know that pharmacy is within 5 miles of the majority of Americans. Like I said, we have convenient hours where parents, working parents, can access service on nights and weekends. So, I think we're going to continue to see people relying more and more on pharmacists for chronic disease state management, for medication therapy management, diagnostic services, and really taking some pressure off of a strained health care environment and really utilizing pharmacies for some of those services that they can do to free up capacity elsewhere. So, I really see patients utilizing pharmacy more and more.