future of community pharmacy

Patients who want care on demand go to their pharmacists for point-of-care testing, immunizations and travel consults, or prescriptions for contraception, smoking cessation and HIV prevention. September 29, 2017 ... used the occasion to speak with Essential Insights contributor Michael Myser about opportunities and challenges for community pharmacies, and how pharmacy practice must evolve in our changing healthcare market. With advances in artificial intelligence and ‘fuzzy’ logic (an approach to computing based on ‘degrees of truth’), and in logistics and supply (e.g. This information provides a baseline for further investigation and challenges pharmacy employers and other stakeholders to generate discussion and solutions to reduce these incidents and experiences in the future. Many pharmacists who spend time filling prescriptions keep hearing of a future where their role will be more focused on the patient, not the product. “Also ensuring that they are building strong advocacy with their students so that as students want to move toward this future, they understand the legislative and regulatory framework of what they are allowed to do within their state and how to overcome any barriers.”. Fifty-three percent of licensed pharmacists have a Pharm.D. “I believe that community pharmacies are going to be the place where care is delivered, that access to the learned intermediary, someone who can assess, evaluate, prescribe when appropriate and even more importantly, refer when necessary.”. Dr. Sophia (Cothrel) Herbert is a Community Pharmacy Practice Development Fellow within the Community Leadership and Innovation in Practice Center at the University of Pittsburgh School of Pharmacy and works to support the transformation of community pharmacy practice. Since then, the only real hints regarding future developments from the NHS and Department of Health were in the letter sent out just before Christmas 2, which announced a £170m (6 per cent) cut in funding for community pharmacy in England. Now the director of product strategy and commercialization for Cardinal Health, and incoming president-elect of the American Pharmacists Association, Tice sees the changing healthcare landscape as an opportunity for community pharmacists to not only expand their businesses, but also practice at the top of their licenses. Long-term care for group homes, providing products and consultation services to ensure that patients are achieving optimization of medications. Looking ahead with the leading minds in healthcare. February 12, 2018 Improving Pharmacy Claims Reimbursement for Community Pharmacies January 16, 2018 Top Five Independent Pharmacy Trends for 2018 September 18, 2017 Leveraging Technology for Medication Adherence Find articles that are relevant to your field of interest. “It is important that community pharmacy gets on board with these campaigns. The Future of Community Pharmacy in England 1. “This change is positive for patients and the profession.”. The more members we have, the bigger voice we can have and the easier it is to make those changes happen. To adapt to the rapidly evolving value-based healthcare system, the community pharmacy practice model must be transformed into a place for patients to receive comprehensive medication-related care from pharmacists and the pharmacy team. 1The Future of Community Pharmacy: Building a Sustainable Industry The Future of Community Pharmacy in England The debate on building a sustainable industry is not a new one: The economics of community pharmacy are under pressure and the business model, particularly for independent pharmacists, is at a tipping point. Maybe more. The Future of Pharmacy. When a patient has five to 12 medicines they're taking each day, you can align these refills so the patient can consolidate their visits to pick these up. Picture pharmacists having routine interactions with patients to review, optimize and synchronize medications rather than just episodic or transactional meetings at the counter. Five forces will profoundly shape the future of community pharmacy: Squeeze on healthcare budgets. This shift indicates that pharmacists with a B.S. Dr. Randy McDonough left his position as a full professor at the University of Iowa 14 years ago to prove that clinical services could be provided to people in the community pharmacy setting. Community pharmacy teams will deliver consistent, high-quality care of patients with minor illnesses and support the public to live healthier lives. The future of pharmacy has been an ongoing discussion for some years. “We want to take a comprehensive approach of looking at how pharmacists can collaborate with primary care practices, from models that we know about and models that maybe we are less familiar with, but helping to disseminate that information to schools, identifying the needs for these collaborations and ways to build sustainable models,” said Dr. Gina Moore, assistant dean for clinical and professional affairs, associate professor, University of Colorado Skaggs School of Pharmacy, and chair of the committee. [email protected] We started with the concept of "pharmaceutical care" back in the 90s, where pharmacists implemented clinical programs around what is now called "medication therapy management" (MTM). As co-owner of Towncrest Pharmacy in Iowa City, McDonough helped create a clinical practice that runs on five gears, all separate but cohesive, each financially viable on its own: McDonough knew he would need to integrate all services. At the end of the 2019 legislative session, legislators eliminated the list. “The other component the task force has talked about is not trying to create a new or different way for pharmacists to get reimbursed,” Adams said, “but that we fit ourselves in with the way the rest of the healthcare system bills for services.”. She serves as the Pennsylvania Flip the Pharmacy Team Project Manager, also funded by the Community Pharmacy Foundation, and is a member of the leadership team for the ACT Pharmacy Collaborative under the mentorship of professors Kim Coley and Melissa McGivney. It’s December 2013 and NHS England has launched its Call to Action on community pharmacy by asking all those involved in healthcare their view on the future of the sector and the industry outlook. Take a look at our featured experts who are shaping the healthcare industry. Community-based pharmacy is evolving from a place of product distribution into a healthcare destination. These future directions will help to transform how pharmacy tackles the medication management needs of Ontarians for the purpose of improving health outcomes. In July 2019, the Academia-CPESN Transformation (ACT) Pharmacy Collaborative was formed as a nationwide forum where community pharmacy leaders and schools of pharmacy could come together to make the patient-centered vision of community pharmacy a reality. New CPCF: As many of you should be aware by now we have just had the announcement of the 5 year deal for Community Pharmacy and the proposed changes to the CPCF. The most common type of harassment reported by pharmacists was hearing demeaning comments related to race/ethnicity at 15.7 percent. “So there is nuance, and sometimes it’s unnerving for pharmacists to begin to think that way, but our board of pharmacy in Idaho has shifted all of our regulation to a standard of care model, which allows pharmacists to practice at the top of their education and training and not be restricted by their license.”. “More involved direct patient care is the future of pharmacy practice, and schools need to ensure that they are graduating practice-ready pharmacists who are prepared to move into that role. The future of community pharmacy practice in South Africa in the light of the proposed new qualification for pharmacists: implications and challenges. I look forward to helping more pharmacists provide quality patient care services and improve the health, wellness, and quality of life for those we serve. The University of Pittsburgh School of Pharmacy recently created a community pharmacy practice-based research network to support ongoing practice transformation in Pennsylvania. 345 5785 67. Please correct the errors and send your information again. Read how pharmacists will be the ones to bring about the therapeutic benefits. “What are the types of tasks pharmacy technicians can do? Some forward-thinking pharmacies are already enabling pharmacists to live in this awaited world, helping patients manage their medication experience and documenting interventions. View the complete survey results and executive summary. MacLean and Dr. Julie Akers, clinical associate professor of pharmacotherapy at WSU, are finalizing a study on the effectiveness of pharmacy treatments, comparing the care pharmacists provide for minor illnesses and self-limiting conditions to what is offered at more traditional settings, such as physician offices, urgent care centers or hospital emergency departments. Pharmacists make sure patients are on the right medications, are using them the right way, and achieving the desired results with those medications. But now there's this focus on value-based care rather than fee-for-service models, so health plans are contracting with fewer pharmacies — particularly those that can prove they are addressing quality measures, delivering care that's improving the lives of patients, and reducing the overall total cost of care. The study also revealed that pharmacy continues to be a female-dominated profession, with nearly two-thirds of the workforce comprised of women compared to only 46.4 percent in 2009. There's a need to get pharmacists credentialed to be in these provider networks so that health plans understand they're eligible, just like a physician. Only 15.9 percent of all discrimination incidents and 17.2 percent of all harassment incidents were reported to an employer. Tice: Pharmacists must move from a prescription focus to a patient focus. degree. There will continue to be a focus on stakeholder engagement in all network activities.”, For Herbert, community pharmacy means “patient access to care within their own communities. Schools are the thread running through all the recommendations, bringing people together, doing the research and engaging in advocacy to advance community-based practice. Future Directions for Pharmacy: Two summary themes of organizational change and better external relationships have emerged as the key future directives for pharmacy in the coming 5-10 years. The Idaho board looked at other boards of pharmacy, but also looked at medicine and nursing, examining how their licensees were regulated and found they regulate based on this concept of standard of care. PWC, formerly known as the Pharmacy Manpower Project, Inc., is a nonprofit corporation comprised of major national pharmacy professional and trade organizations. He optimized the use of his pharmacy technicians, who run dispensing and take care of the product from beginning to end while pharmacists counsel patients. New focus areas addressed in the 2019 survey included professional fulfillment, harassment and discrimination. Community pharmacy, also known as retail pharmacy, is the most common type of pharmacy that allows the public access to their medications and advice about their health. And, with specialty pharmacy fill volume growing each year, it’s reasonable for an independent pharmacy to consider adding this strategy to its services. Pharmacists will collaborate with primary care practices as part of an integrated healthcare team, making recommendations on one shared medical record, reinforcing patient care plans. Within her research initiatives with community partners, she mentors student pharmacists for research and quality improvement projects. Several colleges of pharmacy participated in a demonstration webinar hosted by PioneerRx, and 10 schools were selected to be part of a pilot workgroup. “The way Idaho has tackled this is really from the perspective of delegating, allowing pharmacists to delegate tasks to technicians as long as those tasks are appropriate for their education, training and experience.” An example would be immunization administration. He optimized technology and welcomed more robots into the pharmacy. “I have been most excited about facilitating student connections and experiences through these initiatives, especially the CPESN/ACT Student Scholar program that will allow selected students to interact with and learn from community leaders and CPESN practices in an impactful way,” she said. This year’s survey also addressed new workforce factors, including professional fulfillment, harassment and discrimination. Pharmacy chiefs have published their vision for the future of community pharmacy in the UK, laying out a new roadmap to radically enhance and expand personalised care, support and wellbeing services provided by the sector. The task force chair, Dr. Jennifer Adams, associate dean for academic affairs, director of interprofessional education, clinical associate professor at Idaho State University College of Pharmacy, said the task force will structure recommendations in three separate areas. After that, medication synchronization is a core service pharmacies should think about. However, what of our role in the future? These pharmacies are sharing their innovative models and schools are studying the impact, providing a window into the future of community-based pharmacy practice. In the pharmacy profession, we are not that much different. “We realized innovations were occurring but not on a large scale,” McDonough said, “so we thought, how can we take that innovation and implement it across a large number of sites? The future of community pharmacy. Schools should take the time to fully assess their curriculum, making sure it is robust enough to where they are going to have pharmacists who are confident and ready to go start these services,” Akers said. “Our university has been closely involved with our board of pharmacy and our state association and we have navigated relationships with legislators to advance scope of practice,” Adams said. The Pharmacist e-Care Plan standard is one of the many ways to transform community pharmacy practice. Some examples of enhanced services include clinical medication synchronization, medication reconciliation, comprehensive medication management, durable medical equipment evaluation and support, point-of-care testing, travel immunizations and travel medication consultations. The advances in technology of all kinds, and their impact on the profession, are a serious concern. “We must share our success stories, not just within pharmacy, but with other audiences, including physicians, professional organizations and the public,” Moore said. This underscores the important and expanding role pharmacists are playing in public health, especially in the ongoing opioid crisis. We set out, and achieved our aim, to design pathways for pharmacy services that will give patients and carers the practical support they need for getting the best outcomes from medicines that have been prescribed for long-term conditions. As costs go down and research diversifies, pharmacogenomic screenings could be common in 10 years. There is a successful future for community pharmacies that strive to meet the medication and other health needs of their patients, within their own communities where they live, work and play,” she said. “One advantage to that is that during a public health emergency like COVID-19, a pharmacy can say, ‘You know what, we are going to do our best to take care of everyone who we want to keep out of urgent care centers and hospital emergency rooms because we want to relieve the burden on the healthcare system, so now we are going to treat acute sinusitis and uncomplicated urinary tract infections,’” Adams said. 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These dynamics create exciting tension for pharmacy companies and pharmacists as they debate how to win in today’s market while planning, adapting, and investing for the future. “If I am already doing these things and I am already taking care of patients at this level, it’s not such a stressful shift for me in an emergency.”. They have participated in biweekly meetings since late 2019 to learn about the PioneerRx pharmacy management software system, create patient use cases to utilize with the e-Care Plan standard and work with the software system to implement in their laboratory curricula. Pharmacists are trained for six or seven years on appropriate medication use, but they do so much more than just counting pills, putting them in a bottle, and handing them across the counter. and Graduate Programs Tuition and Fees, Survey of Vacant Budgeted and Lost Faculty Positions, American Journal of Pharmaceutical Education, https://www.fda.gov/drugs/therapeutic-biologics-applications-bla/biosimilars, Read how authorizing pharmacists to prescribe. Perhaps there are lessons to be learned from independent and hospital settings that are succeeding at meeting the needs of its personnel. By Athena Ponushis and Nidhi Gandhi, Pharm.D. “Community pharmacists who are providing these clinical services really are needed because they can make communitywide interventions that affect patients in a positive way, not just with drug therapy but by evaluating social determinants of health, connecting patients with agencies that can help them achieve their goals,” McDonough said. Some states are moving to give pharmacists greater prescriptive authority. Most notably, in 2019, 72 percent of pharmacists reported offering naloxone dispensing in a community setting. More and more, we see patients needing access to more comprehensive services. “What I find interesting is that prior to this course, our students have completed their over-the-counter self-care pharmacotherapy course, and in that course it’s over-the-counter or refer because the patient needs a prescription. When these innovations are combined with the growing influence of consumers focused on their well-being, the future of pharmacy will be radically different. We have been talking about clinical pharmacy and pharmacist services for 20-25 years now. Biological products are the fastest-growing class of therapeutic products in the United States, according to the FDA. Other days are dedicated to immunizations. Nidhi Gandhi is the Academic Leadership and Education Fellow at AACP, The Future of Community Pharmacy: Direct Patient Care, © 2020 American Association of Colleges of Pharmacy, Successful Academic Pharmacy Collaborations, Assessment & Accreditation Management System, Pharmacy Faculty Demographics and Salaries, Student Applications, Enrollments and Degrees Conferred, Pharm.D. More involved direct patient care is the future of pharmacy practice, and schools need to ensure that they are graduating practice-ready pharmacists who are prepared to move into that role. A full description of the Collaborative and how colleges/schools can be involved can be found in the “Blueprint for Building a National Partnership Collaborative” on the ACT Pharmacy Collaborative’s centralized website (www.actforpharmacy.com). As the healthcare market evolves to a value-based care model that pays for quality and performance, his experience sheds light on how community pharmacies can thrive amidst these changes. The Community Pharmacy Future project was created in 2011 by Boots UK, LloydsPharmacy, Rowlands Pharmacy and Well (formerly The Co-operative Pharmacy). This is likely due to the recent growth in pharmacy graduates combined with the retirement of older pharmacists. The consequences of suboptimal medication use are astounding -- from hospitalizations, to readmissions, to even death. Students are certified in immunization administration and receive specialty training on pediatric immunization. Idaho was successful in adding pharmacists to the list of nonphysician providers in its Medicaid basic plan this year, enabling pharmacists to bill for services based on scope of practice, with no restricted services. The normal 8–12 hour shift becomes a forgotten concept and as days turn to nights, and days blur together. Some pharmacies are delegating the accuracy checking of the dispensing process to technicians. Community-based pharmacy is evolving from a place of product distribution into a healthcare destination. The Collaborative, with support from AACP, has three main drivers: to unite, mobilize and amplify community pharmacy practice transformation with colleges/schools and community pharmacy partners nationwide. So goes the perceived evolution of community-based pharmacists, from performing clinical interventions to becoming initial clinicians, ushering in a time when community pharmacies are considered essential to the healthcare landscape. They have open practice laboratory sessions and breakout sessions where they learn how to run a travel consultation, interact with a patient and do the paperwork. Brad Tice has spent nearly 25 years of his career implementing clinical services within retail pharmacy settings. The percentage of non-white licensed pharmacists increased by 46 percent, from 14.9 percent in 2014 to 21.8 percent in 2019, with the percentage of black pharmacists more than doubling, from 2.3 percent to 4.9 percent. IMAGINE a scenario in which the Scottish Government is no longer prepared to pay for community pharmacies to dispense and supply medicines, but instead prescriptions were dispensed in Health Board hubs. ©2021 Cardinal Health. It was important to think laterally and to align ambitions for the profession with those for a patient-centred NHS in order to take pharmacy forward, said Mr PETER CURPHEY (Council member, Royal Pharmaceutical Society). First, advancing pharmacy technician practice. For many, it’s difficult not to feel pessimistic. As well as playing an enhanced role in chronic disease management and the delivery of broader health solutions, the community pharmacy of the future will increasingly become a preferred location for the treatment of minor ailments, vaccinations, preventive health, health checks and risk assessments, selfcare and the tackling of health and lifestyle issues. 11444197) VAT Reg No. Adams believes a groundswell from state Medicaid programs will lead the effort of reimbursement, showing that when you pay pharmacists for services, outcomes improve and costs go down. Even if you manage to source a pair of rose-tinted glasses, the future of community pharmacy doesn’t look particularly promising at the moment. In 2019, nearly half of practicing pharmacists—47.7 percent—are 40 years old or younger, compared to only 24.4 percent in 2009. Learn more about how Cardinal Health is improving healthcare. The Future of Community Pharmacy in England is our latest publication in our Tipping Point series which examines the different trends shaping the delivery of healthcare in the 21st century. The goal of this collaborative is to support the transformation of community-based pharmacy practice from a product-based care model to a community-based pharmacy care delivery model, focusing on the enhanced services that support people who are taking medications to help them reach their health goals. Rather than re-create the material the state pharmacy association had created for continuing education for practicing pharmacists, faculty collaborated with the association, giving students access to online modules that they complete over the summer before school begins. Until recently, health plans wanted to have broad coverage with as many pharmacies as possible. Determining if it’s the right immunization for that patient at that time would be the responsibility of the pharmacist, but the actual administration could be done by a technician. “We are training our student pharmacists for the future and this is the future we see,” said Linda Garrelts MacLean, interim dean, clinical professor of pharmacotherapy at Washington State University College of Pharmacy and Pharmaceutical Sciences. Students spend the entire first day of class going condition by condition, reviewing key guidelines through patient cases, deciding whether to use prescriptive authority, refer to a more advanced care setting or recognize that over-the-counter self-care products are appropriate for that case. The study found that new roles abound for community pharmacists in this “new patient-centered, medication experience era,” but stressed the difference between professional identity and commercial identity. 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