More and more, we see patients needing access to more comprehensive services. Standing still no longer an option. 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 Community Pharmacy Future project was created in 2011 by Boots UK, LloydsPharmacy, Rowlands Pharmacy and Well (formerly The Co-operative Pharmacy). 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. ... intends to strengthen the image and reputation of pharmacy teams to attract a larger and wider pool of people to the future pharmacy workforce. The future of pharmacy has been an ongoing discussion for some years. Brad Tice has spent nearly 25 years of his career implementing clinical services within retail pharmacy settings. 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 The study will inherently set a baseline to measure how enhanced pharmacy services are influencing quality of care and access to care. “I always said if I ever was asked to go back to academia, I would be an even better professor than before, having lived this experience,” McDonough said. The normal 8–12 hour shift becomes a forgotten concept and as days turn to nights, and days blur together. Pharmacy Mentor trades under the UK-registered company, DIGITALPHARM LTD (Company No. “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. And, with specialty pharmacy fill volume growing each year, it’s reasonable for an independent pharmacy to consider adding this strategy to its services. “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. In 2019, 31 percent of pharmacists reported that they experienced incidents of discrimination, with the most common basis being age followed by gender. What can we train them to do if they don’t already have that level of training, and what’s appropriate there, in terms of scope? In its 2018 report, “The Next Transition in Community-Based Pharmacy Practice,” the American Pharmacists Association found that pharmacists are trained to perform certain tasks but often experience work settings that are not conducive to such practice. 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 profession of pharmacy is at a significant crossroads between its conventional drug-dispensing identity and a pioneering clinical role with health care provider status. This is unsustainable for those SuperPharmacists and we need more people, if we are to change this bleak future of community pharmacy. 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. 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 must change their mindset beyond just filling prescriptions and move to a patient-centered view where they are looking at all of the patient’s needs when they fill prescriptions. When it comes to professional fulfillment amongst full-time pharmacists in the community setting, those working in independent and hospital settings reported higher levels of fulfillment and lower levels of work exhaustion, compared to those working in community chain, mass merchandiser and supermarket work settings. The more members we have, the bigger voice we can have and the easier it is to make those changes happen. Students are certified in immunization administration and receive specialty training on pediatric immunization. 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. “We really believe that this is the base knowledge that’s required for an entry-level pharmacist.”. Tice: Pharmacists must move from a prescription focus to a patient focus. 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. Offering an immunization program is a good first start, in large part because there's already a business model around it and it's a pretty well accepted practice these days. Community pharmacy teams will deliver consistent, high-quality care of patients with minor illnesses and support the public to live healthier lives. He started a clinically oriented practice, became recognized as a pioneer in community practice transformation and recently joined Loma Linda University School of Pharmacy as a professor of practice management and innovation. View the complete survey results and executive summary. Despite rising demand and volumes, all indications are that the pharmacy settlement will remain flat in real terms. Once analyzed, MacLean believes the study will provide evidence that community pharmacists can contribute to caring for patients, compelling other states and pharmacies to replicate services and treat common ailments such as strep throat, urinary tract infections and severe headaches, including migraines. Some states are moving to give pharmacists greater prescriptive authority. August 20, 2019. The pharmacy profession continues to trend younger in its composition. In 2019, nearly half of practicing pharmacists—47.7 percent—are 40 years old or younger, compared to only 24.4 percent in 2009. 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. First, advancing pharmacy technician practice. Biological products are the fastest-growing class of therapeutic products in the United States, according to the FDA. The Future of Community Pharmacy in England 1. Biosimilars may become more accessible though community pharmacy practice. Herbert noted, “The idea behind the network is to engage community pharmacists who are willing and able to perform practice-based research in collaboration with patients and research partners. 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. “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.”. Some pharmacies are delegating the accuracy checking of the dispensing process to technicians. The upward trend continues for women in leadership roles; 58.8 percent of pharmacists in management positions in 2019 were women. “Data show that when they are delegated that task and given that authority, pharmacy technicians are actually more accurate than pharmacists because they tend to have fewer distractions,” Adams added. Tice: Probably the biggest change community pharmacies are facing is the establishment of performance provider networks and the narrowing of these networks, where health plans are giving their beneficiaries access to a more select network of pharmacies. This shift indicates that pharmacists with a B.S. Perhaps there are lessons to be learned from independent and hospital settings that are succeeding at meeting the needs of its personnel. “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. In this review, an attempt was madeto summarize and calculate the current scenario and future perspective of community pharmacy as well as community pharmacist … “What are the types of tasks pharmacy technicians can do? Long-term care for group homes, providing products and consultation services to ensure that patients are achieving optimization of medications. “This change is positive for patients and the profession.”. My thought is, how better to be prepared for an emergency situation than to have that be what your daily practice is? “We have something we call continuous medication monitoring, where we have created a software program to quickly assess a patient and make determinations of any drug-related problems during workflow,” McDonough said. As costs go down and research diversifies, pharmacogenomic screenings could be common in 10 years. “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. The video showcases the work that pharmacies already do, as well as describing the transformation that community pharmacies will need to undertake over the coming months and years. 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. These pharmacies are sharing their innovative models and schools are studying the impact, providing a window into the future of community-based pharmacy practice. It’s anticipated that their attention will shift from dispensing to providing convenient clinical care. Clinical collaboration - and the capability of allowing pharmacists, doctors and patients to communicate effectively in real-time - is expected to be a larger part of pharmacy practice as the model evolves. Ross Ferguson. “The combined efforts of the ACT Pharmacy Collaborative, Flip the Pharmacy and CPESN are driving community pharmacy practice toward a patient-centered care model, and the combination of these forces and efforts will bring us closer to that vision of community pharmacies providing optimal patient care.”. Schools are the thread running through all the recommendations, bringing people together, doing the research and engaging in advocacy to advance community-based practice. This underscores the important and expanding role pharmacists are playing in public health, especially in the ongoing opioid crisis. AACP hosted a webinar on June 10 regarding CPESN, the ACT Pharmacy Collaborative and the Flip the Pharmacy initiative. Each prescription fill/refill provides an opportunity to more meaningfully engage the patient. 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. The future of community pharmacy practice in South Africa in the light of the proposed new qualification for pharmacists: implications and challenges. For many, it’s difficult not to feel pessimistic. These changes enabled McDonough and his team to provide 2,000 to 3,000 clinical interventions a month. The Council of Deans formed a task force to find opportunities to improve community-based practice and give viable recommendations to AACP and member institutions to pursue such possibilities and make them realities. During her fellowship, Herbert has worked on several projects involving student pharmacist participation through the ACT Pharmacy Collaborative such as the National Day of Service, Patient Case Challenge, CPESN/ACT Student Scholar program and CPESN/ACT Student Match program, which facilitates student experiences at community pharmacies across the country in light of the COVID-19 pandemic. Same with point-of-care testing: the pharmacist would decide to do the test but the technician could administer it. Pharmacy schools can incorporate the Pharmacist e-Care Plan standard into curricula to prepare student pharmacists to provide enhanced patient care services in the community. Five forces will profoundly shape the future of community pharmacy: Squeeze on healthcare budgets. 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). 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. Employers, such as large pharmacy chains and others, should consider how they can boost fulfillment and lower exhaustion amongst their employees, which will lead to retaining a strong workforce. Dickson said “there is a future for community pharmacy in various forms… it has to be about plugging into primary care and being a part of that… My view is that it’s more about primary care than it is about selling shampoo and combs.” Utilising vital skills To view a full catalog of products that Cardinal Health offers, please use our ordering website. Its mission is to serve the public and the pharmacy profession by developing data regarding the size and demography of the pharmacy workforce and conducting and supporting research in related areas. The University of Pittsburgh School of Pharmacy recently created a community pharmacy practice-based research network to support ongoing practice transformation in Pennsylvania. 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. Some forward-thinking pharmacies are already enabling pharmacists to live in this awaited world, helping patients manage their medication experience and documenting interventions. 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. More information about biosimilars can be found through these websites: Americans have access to more than 62,000 community pharmacy locations for medication therapy management, immunizations and walk-in patient consultations. 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. Do they need their A1C (blood glucose) checked? It may take a little education (patients don’t always know what training pharmacists have had or what services are being offered) but once they know, Akers has not seen any hesitation in a patient’s willingness to be seen by a pharmacist. “We must share our success stories, not just within pharmacy, but with other audiences, including physicians, professional organizations and the public,” Moore said. Essential Insights contributor, healthcare writer. This is likely due to the recent growth in pharmacy graduates combined with the retirement of older pharmacists. Beyond teaching students how to run a contemporary practice, McDonough continues his role in the Community Pharmacy Enhanced Services Network and serves as director of practice transformation for Flip the Pharmacy, an initiative intended to scale the innovations that have been made in community pharmacy. Idaho has been the trailblazer for independent prescriptive authority. 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. We at the National community pharmacists Association (NCPA) are focused on an envisioned future where the pharmacy benefit is broadly recognized for the value it brings to health care. “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. Do they need a flu shot? 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. 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. Looking for other medical products we carry? Pharmacy Mentor is the ultimate pharmacy marketing solution. 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. Specialty pharmacy fills represent around 24 percent of total revenue for community pharmacies, reported Drug Channels Institute. Two, we need to get to work on the infrastructure to help pharmacists implement these practice changes. Community-based pharmacy is evolving from a place of product distribution into a healthcare destination. October is American Pharmacists Month, and Tice 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. Students learn how to screen for HIV, strep and influenza, practicing throat and nasal swabs on themselves or a team member before going through a rubric-graded assessment, ensuring they can collect the sample without it being contaminated. 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). Fifty-three percent of licensed pharmacists have a Pharm.D. “We all need to think about community pharmacy not as a place where product distribution occurs but where healthcare occurs.”. 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. Take a look at our featured experts who are shaping the healthcare industry. That’s what was most important: getting all of our faculty to recognize that we truly believe as a program that this is the future of pharmacy,” Akers noted. 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. Imagine pharmacogenomic screenings being commonplace, as pharmacists look at genetics to predict drug response and tailor treatments. Most notably, in 2019, 72 percent of pharmacists reported offering naloxone dispensing in a community setting. 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 year’s survey also addressed new workforce factors, including professional fulfillment, harassment and discrimination. At WSU, student pharmacists take an intensive, weeklong, point-of-care and clinical services course at the beginning of their second year. What needs to be reserved for pharmacists?” Adams asked. 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. “My thought is, how better to be prepared for an emergency situation than to have that be what your daily practice is?” Adams pointed out. This study is the fifth in a series of surveys conducted by the Midwest Pharmacy Workforce Research Consortium, which has been commissioned by the Pharmacy Workforce Center, Inc. (PWC) since 2000. APhA has more details on provider status legislative efforts on their website.]. In the pharmacy profession, we are not that much different. 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. 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. All rights reserved. Results released in April from the 2019 National Pharmacist Workforce Study (NPWS) indicate that the profession’s demographics continue to rapidly change, with notable gains in racial and gender diversification. Plus, the advantage of medication synchronization is that it also provides an opportunity to create an appointment-based model where pharmacists not only review medications, but engage with the patient and offer other services. Learn more about how Cardinal Health is improving healthcare. Tice: The goal of provider status is to enable the pharmacist to practice at the top of his or her license. It’s now up to a pharmacist or pharmacy to determine what fits into those categories. At the end of the 2019 legislative session, legislators eliminated the list. Community pharmacy sessions The future of community pharmacy. 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 legacy Cardinal.com Medical Ordering site has been replaced with Cardinal Health Market. “We began this course after getting approval from our full faculty to move it forward as required curriculum for all of our graduates. 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. “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? Several states have passed emergency regulations during this crisis, allowing pharmacists to do more, like extend refills. Download the brochure An area for clinical services including medication therapy management, comprehensive medication reviews, point-of-care services, immunizations and the like. 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. The future of community pharmacy in cancer care Community pharmacy plays an essential role in the care of patients with cancer, with contact throughout the pathway from prevention and treatment to living with and beyond cancer. 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. Picture pharmacists having routine interactions with patients to review, optimize and synchronize medications rather than just episodic or transactional meetings at the counter. The Pharmacist e-Care Plan standard is one of the many ways to transform community pharmacy practice. “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. Second, advancing the scope of pharmacy practice. I officially become president-elect in March 2018 and first and foremost, we need achieve provider status for pharmacists at the federal level (getting recognition for the patient care services provided by pharmacists so they can be reimbursed by programs like Medicare Part D). 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. Compounding, while documenting care and keeping providers informed. To learn more, visit flipthepharmacy.com. Community-based pharmacy is evolving from a place of product distribution into a healthcare destination. 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. degree are likely retiring or moving out of practice and into different roles, which could mean more career opportunities for new pharmacy graduates. Patients continue to have access to important pharmacists’ services in a variety of settings. Biosimilars, which are defined as biological products that are highly similar to and have no clinically meaningful differences from existing FDA-approved reference products, can offer additional treatment options when patients are prescribed a biological product, potentially lowering healthcare costs. 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. Ross Ferguson / 1st Mar 2015. To understand the impact of COVID-19 on community pharmacies and the future of community pharmacy practice post-COVID-19 we did a survey in Kenya. So it’s always comical when we’re doing these patient cases that the students’ automatic response is, ‘We have to refer because that’s what we’ve learned before.’ It’s changing that mindset for them, realizing that as an advanced care practitioner pharmacist, you can handle some of these minor illnesses and conditions with prescriptive authority,” Akers said. 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. 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. Pharmacists in Idaho can prescribe based on four parameters: when no new diagnosis is required, when a CLIA-waived test can guide diagnosis, when a condition is minor and self-limiting or in an emergency. 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. Tice: There is an opportunity to make real practice change in the pharmacy, and find new revenue streams beyond dispensing medications. Pharmacists make sure patients are on the right medications, are using them the right way, and achieving the desired results with those medications. Pharmacists must have good support staff if they are going to take on new roles, so elevating pharmacy technicians is crucial. A durable medical equipment area, working with patients and sending notes to prescribers to keep them informed of a patient’s progress over time. 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. PSNC, as the community pharmacy negotiator, has developed a video animation explaining how community pharmacies will fit into the NHS of the future. Since the bombshell of a funding cut to pharmacies in England was first outlined at the end of last year, the sector has been preparing for the worst. 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. 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 bigger voice we can have and the Flip the pharmacy be the ones bring... 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