Good & Bad of Transitioning from Dispenser to Health Service Provider
On April 5 of this year, Ohio gave provider status to pharmacists in its state. Many other states (such as Tennessee back in 2017) have adopted legislation allowing pharmacists to perform more and more of the services historically reserved for the more traditional healthcare providers.
This trend of pharmacies going from mere medication dispensers to full health centers is not just a U.S. phenomenon.
A study found that the Portuguese population is responding with tremendous satisfaction to the shift of its pharmacies towards services traditionally belonging to other healthcare providers. The rapid expansion of services in places like the UK and Denmark have actually outpaced public awareness creating need for better marketing of pharmacy services.
This trend did not exist 50 years ago. The high attention on healthcare in recent decades has made politicians aware of what pharmacies already know. Pharmacies’ positions in the American economy and society makes them well adapted to answer many of the increasing needs of the healthcare system.
Incentives to Become Healthcare Centers
A pharmacy in Ohio found success removing many products, like greeting cards and candy; instead, they utilized floor space for a “healthcare solutions” center. They chose half a dozen medical services to specialize in and provided pharmacy-to-patient consulting to achieve the most good in these areas for their customers. Success resulted.
Stories like these abound in the U.S. Pharmacies once felt like just another location to go and buy things. Instead of grocery shopping for food, customers were just shopping for medication.
Today, Pharmacies know they can offer far more than medication dispensing. Pharmacists have the education and experience to provide effective medical guidance to consumers.
A University of North Carolina professor identified the four factors, which caused this inevitable social shift to better utilize pharmacists:
- Pharmacists best perform drug acquisition, distribution, and control to achieve cost-effective patient results.
- Pharmacists have the most patient interaction of the members of a health service network, giving them the most opportunities to optimize patient outcomes.
- Pharmacists are the final safeguard to make sure patients are receiving adequate education on their drugs to ensure safe use.
- Pharmacists are well trained and educated, perfectly capable of delivering quality drug therapy.
Pharmacies can take advantage of these opportunities in a multitude of ways:
- Behavioral coaching
- Chronic disease management (e.g. diabetes)
- Comprehensive medication reviews
- Medication adherence
- Medication synchronization
- Medication therapy management
- Prevention and wellness education
- Smoking cessation
These serve communities and consumers through convenient access to healthcare beyond medication dispensation. In an increasingly digitalized market, new services also help pharmacies remain relevant and profitable.
There is a lot of positive hype, and rightfully so, about this transition towards more personal healthcare services at pharmacies.
However, every business, pharmacies included, needs to be aware of the challenges which often accompany opportunity. It is only by awareness of potential pitfalls that we can avoid them.
For instance, pharmacies are not merely incentivized now to adopt a broader array of healthcare services. The market may compel them to forsake the dispenser mindset. Forecasts for 2019 foresee PBMs driving down reimbursement rates in their networks, expecting pharmacies to make up for it with the new revenue channels which come with providing new services.
As pharmacy brands shift more and more to becoming healthcare providers, here are three challenges which many pharmacies are already beginning to encounter.
Limited Access to Patient Info
If pharmacists are to provide more and more healthcare services, they will need to know more and more about their patients. As opportunities open to perform further patient therapy, pharmacists will need fuller accounts of their patients’ medical histories.
That information is not readily accessible. Information sharing has not yet caught up with pharmacy practice.
As a business, a pharmacy needs to leave its patients satisfied with their healthcare services. Nothing is more dissatisfying than care coming to a standstill, because a pharmacy does not have the information access allowed to traditional healthcare centers where the patient received his past care.
An even worse disaster threatens should pharmacists make medical recommendations based on insufficient data.
In order to avoid both dissatisfaction and lawsuits, performing honest assessments of pharmacist data access becomes essential.
While acquiring information can be a challenge, it turns out that protecting the patient data pharmacies do have can be a challenge.
Pharmacies, generally speaking, have open layouts. They lack the privacy afforded by segmented doctor’s offices. As more abundant, sensitive information enters the consulting practices of pharmacies, measures need to be put in place to properly protect patients.
One pharmacy, trying to increase the personal care provided to customers, moved the pharmacist’s desk to the front counter. While helpful in theory, this new positioning caused 4 out of 5 stores to accidentally leave patient information in the open for any passerby to see.
HIPAA compliance is an important responsibility for pharmacies with serious consequences in the case of failure. A single thoughtless procedure can lead to lawsuits or fines counted in the millions.
As this industry applies creativity to expanding pharmacists’ roles, it must be equally thorough in foreseeing the possible dangers to breaking patient confidentiality.
A 1999 legal article notes how even that far back pharmacists were being accused of negligence for the poor drug outcomes of patients. At the time, many rulings sided with the pharmacists. However, the article notes that the legal justification for this ruling treats pharmacists as non-professionals.
Today, pharmacists have more rights as healthcare professionals than ever before. Unfortunately, that means higher expectations and standards.
Negligence lawsuits follow from unmet duties. A more recent book on pharmacy law discusses how courts have been divided on whether duties exist for pharmacists to:
- Warn patients about negative effects of their drugs
- Know a patient’s medical history
- Exercise control over refills of a customer
These services are the exact sorts of things which pharmacies seek to do today. Without denying the opportunities created, pharmacies need vigilance to remain aware of popular and legal expectations.
Because the criteria for negligence often relies on court precedent rather than legislative law, pharmacies need reliable resources to ensure they are not blindsided by a lawsuit that would not have born any weight years before.
Anytime we charge into the unknown, there are risks. New laws are being passed every year expanding pharmacists’ roles as healthcare providers.
A lot of good can be done for patients and consumers as pharmacists are so excellently qualified to provide accurate and convenient healthcare. However, leaders in the pharmacy world must perform proper due diligence to ensure their pharmacists do not pay the price of poorly thought-out policies and untested laws.