Community pharmacists do not simply dispense pills. They are medication experts trained to offer health care services that enhance outcomes and lower costs for conditions like diabetes and hypertension – all while maintaining the highest standards for patient safety. In fact, all schools of pharmacy provide didactic training including evidence-based clinical decision making, therapeutic treatment planning, and diagnosing and prescribing medications. Pharmacists are among the most accessible care providers in the community, offering an important point of care, particularly in underserved communities.
Pharmacists provide additional care team value through services like:
- Medication Management: prescribing, dosing, and stopping medications; ordering labs for monitoring; and improving medication adherence.
- Chronic Disease Management: particularly for diabetes, cholesterol, hypertension, maternal health, and behavioral health.
- Acute Treatment: test-to-treat services for respiratory diseases such as influenza, COVID-19, strep and addressing minor ailments. This is especially helpful in serving patients seeking care outside of normal business hours.
- Preventive Care: including tobacco cessation, immunization, STI prevention, HIV testing, and prevention.
- Care Management: addressing transitions of care, gaps in care, screenings, and referrals.
At Surescripts, we have a unique view of healthcare trends through our stakeholders and how care is delivered across our network. We can see the impact of primary care shortages and how pharmacists can serve as key members of a collaborative care team, particularly in rural areas.
To further support the integration of pharmacist services into the care team, we need payment models to support reimbursement for patient care services at the pharmacy. Many states already reimburse pharmacists for these services and additional test-to-treat services through Medicaid and commercial health insurance. It is time to expand this policy to America’s seniors.
Pharmacists also need access to interoperable healthcare data to better provide quality, safe, and cost-effective care. In November 2023, the ONC HITAC Pharmacy Interoperability & Emerging Therapeutics Task Force delivered a set of 34 recommendations to the Health Information Technology Advisory Council (HITAC) with the overarching objective “…to support interoperability between pharmacy constituents, and the exchange of information necessary for medication management, patient safety and consumer engagement” for public health-related and care coordination use cases.
To build on these recommendations, collaboration from public and private sector stakeholders will be a critical requirement. The Sequoia Project is leading this effort, establishing the Pharmacy Workgroup as part of the organization’s flagship Interoperability Matters initiative. The Workgroup’s goals include:
- Overcoming technical challenges for pharmacists to engage in clinical interoperability with other care team members
- Identifying and operationalizing the information pharmacists need to access and share with other providers and payers, and
- Characterizing the benefits of pharmacy interoperability for all stakeholders.
Better healthcare requires a team-based approach that utilizes strategic reimbursement models, care providers practicing at the top of their license, and interoperable, actionable health information. Federal legislation to address the reimbursement issue and interoperability efforts like the Pharmacy Workgroup will help us get there.
Deanne Primozic is a strategy and policy executive creating opportunities at the intersection of tech, policy, and market intelligence. Leveraging her years of experience and insights, she translates complex policy and regulation into simple strategies for sustained success, then scales those strategies into effective campaigns of influence. Deanne is the VP of Policy & Federal Affairs at Surescripts. Connect with Deanne here.
