As a trusted healthcare resource that also happens to be one of the most accessible and affordable in the community, pharmacists are well positioned to help consumers with their care management needs and guide them toward better outcomes.
This has become more evident recently:
- Since most healthcare challenges occur outside of the four walls of a clinic or hospital, there has been continued recognition of the short-comings surrounding methods to integrate observations of daily living into the care management process.
- With higher deductibles and co-pays, there is a growing consumer behavior to “take control” of one's own healthcare, exploring holistic dietary, lifestyle, and OTC products/services in order to avoid high costs and manage current healthcare needs.
- As medication and disease state management are key areas of focus for payers, the access community is demanding greater contributions by pharmacists to help mitigate growing healthcare spend while improving the quality of care.
For these reasons, we see an emerging trend: Community pharmacy is expanding its care management business and looking at patient engagement as a key step on the road to success.
Patient engagement in a transaction-based business
Pharmacy has always been able to respond to the changing market and increased demands on its business and practice, despite pressures to be profitable. However, its primarily transaction-based business model continues to be threatened by the ongoing squeeze from lower reimbursements, DIR retroactive assessments, and growth in operating costs. The good news is that pharmacy is in a unique position to evolve its business model, incorporating patient engagement products and services into its transaction-based business in a way that can consistently help consumers with their healthcare and medication management needs. And that can result in improved payer and patient outcomes.
While the industry focus for some time has been on pharmacy’s expanded clinical role, developing the financial model to achieve success continues to be challenging. Besides reasonable reimbursement for these products and services, there is the challenge of consistently guaranteeing the expectations of payers and consumers on scope, delivery, and cost-effective value of these programs. After all, evolving the traditional practice and business of pharmacy will take more than flipping a switch and assuming all is now in place.
So rather than biting off more than we can chew, maybe we start with patient engagement — a high-value, low-cost proposition that demonstrates the merit of the pharmacy contribution.
There is already a strong communication interaction between the consumer and the pharmacist. The next steps are to develop best practices for patient engagement services and get credit for this interaction:
- Start with creating a care management strategic business and practice plan with an initial roadmap focus on patient engagement. Business modeling and offerings will be different based on size of your operation and available resources.
- Involve the pharmacy staff in assessing the opportunity and resources available.
- Perform a gap analysis to identify opportunities and to understand current and potential tasks/activities needed to integrate patient engagement into the current workflow.
- Explore ways to drive consumer behavior and further personalize the relationship with the pharmacist.
Let’s take a closer look at some of these steps.
Gap analysis
- Partner with payers, caregivers, and other healthcare professionals to align expectations, roles and responsibilities, and respective deliverables. In other words, figure out what can be controlled and what can’t be controlled.
- Leverage current internal and external resources and enabling technologies to complement roles/responsibilities and delivery of consistent offerings and information. Where there are needs, you may need to seek out new resources or technologies.
- With many “best-in-class,” off-the-shelf technology tools and flexible interfaces, you will need to identify those features that achieve better outcomes while lowering overall costs in the patient engagement process (i.e., medication synchronization, refill reminders).
- Focus on education, looking for tools and methods to help increase consumers’ knowledge, confidence, and skills, as well as effectively communicating the value of consistent use of self-monitoring technology, like apps, wearables, etc.
- Develop a reporting platform that provides consistent, accurate data you can use to benefit both the consumer and healthcare provider.
- Build core attributes and flexibility into your patient engagement platform to accommodate many healthcare conditions and managing those medications and needs specific to those conditions.
- To address workflow implications, physical footprint, and to promote consistent delivery and follow-up, personalize patient engagement to target the right people, right information, and right delivery vehicles at the right time. Seek opportunities for two-way dialogue to identify patient information gaps, frame the content of the communication based on consumer language and level of understanding, and deliver information in a way that is meaningful, actionable, and understandable. Remember: the typical patient retains only 20-60% of everything they hear by the time they get home.
- Invest in and provide critical training and development of the staff to be more patient-centric, based on their roles and responsibilities.
Driving consumer behavior
- Educate consumers on and encourage them to incorporate healthier behaviors — such as exercise and dietary changes — into their routine.
- Drive loyalty by partnering with the consumer. Develop a work plan for each patient based on disease state, personalized toward achieving a proper understanding of their medication management requirements and lifestyle and wellness goals.
- Consistently promote the knowledge, experience, and accessibility of the pharmacy and pharmacist so consumers come to view the pharmacist as a healthcare resource, not just a dispenser.
Pharmacy has always had a strong patient interaction relationship, thus the opportunity is available for the pharmacist to actively engage in helping advocate and support education, counsel on lifestyle and dietary needs, and assist with disease state and medication management. As the consumer continues to embrace the role of the pharmacy and pharmacists in their care, it can generate additional revenue from sales and reimbursement, as well as differentiate the pharmacist and pharmacy’s services to draw more business overall.
David J. Fong, PharmD, is president of Dave Fong Rx Consulting, Inc. A former senior retail pharmacy executive for Fortune 100 and Fortune 500 companies, he is recognized as one of the U.S. and Canada’s business and professional healthcare leaders, leveraging his knowledge and experience working with pharmaceutical manufacturers, distributors, retailers, payers, and healthcare technology companies to bring value to the industry and the consumer.
