Chronic care patient management is simultaneously one of the most challenging and opportunity-filled areas of pharmacy.
The challenges, reflected in such conditions as diabetes, are highly complex and require collaboration among stakeholders across the healthcare system, according to participants in an executive panel at the Drug Store News Industry Issues Summit in New York in late November.
At the same time, panelists from retailers to solutions providers emphasized opportunities for improvement centered on education, personalization and prevention. Technology can help play supportive roles in these areas, they said.
“There are many preventable chronic conditions for which we must do a better job harnessing knowledge,” said Dave Wendland, the panel moderator and vice president of strategic relations at Hamacher Resource Group. “We need to project that knowledge to consumers in a way that they will not only take advantage or take notice of it, but make lifestyle changes.”
Retailers Emphasize Customer Education, Information Access
Retailer panelists emphasized the crucial need to act decisively on chronic care issues, including focusing on education.
“From a diabetes standpoint, there are huge needs in south Texas,” said panelist Leon Nevers, director of business development and procurement at H-E-B. “We have great food, but we also have quite a challenge with being able to work that food off and understand how to manage your disease state.”
Nevers said leveraging solutions on both the pharmacy and food sides of the retail operation are crucial to success.
“We started with our blood glucose testing by offering free health screenings in all pharmacies, and helped patients understand how the numbers impact their lives,” he said. “I’m also very encouraged to see H-E-B as a grocery chain really embracing other opportunities to educate the consumer, such as with nutrition labels that are easy to understand.”
Panelist Becky Dant, director of professional services at Costco, said pharmacists are uniquely positioned to educate patients on chronic conditions.
“I think a pharmacist is a great person to carry that message and get buy in from their customers,” she said. “As we all know, patients with chronic conditions come into the pharmacy a lot, so there’s a lot of touchpoints there. And there are a lot of opportunities for us to ask them, ‘How are you doing with your food intake? How are you doing with your exercise?’ Pharmacists can hand out information on how patients can incorporate these into their lives more easily. I think they’re a great touchpoint for that. And how do we make it fun for the patients?”
Dant said Costco has helped support pharmacists through step-wise approaches to program rollouts that ease employees into new efforts.
“We want the pharmacist to feel comfortable with the material, comfortable offering those services to the patients, and feel confident offering them,” she said. “So we’ve given them some time to absorb it.”
Moreover, the ability to access information easily is a crucial component of providing care, Dant said.
“I think accessibility to information is huge, both for the pharmacist and the patient,” she said. “It allows pharmacists to be more involved in the care of the patient, and for the patient to be more knowledgeable and ask questions of their pharmacist or their care provider.”
Summer Williams Kerley, a retailer panelist and Rite Aid’s vice president of clinical services and business development, said pharmacist education of patients can extend to help with apps and connected health devices.
“There are so many different wearables and apps available to every consumer,” she said. “It’s about encouraging the consumer to find the app or wearable or device that works for them. Our pharmacists are there to help the patients understand the importance of finding what works for them, and helping them stay engaged with that through conversations during patient visits.”
Pharmacists Need Tools for Success
Addressing chronic care challenges requires providing more tools to pharmacists to help them manage patients, said panelist Crystal Lennartz, vice president of pharmacy performance at Health Mart Atlas, which is part of McKesson.
“One of the things we’ve focused on has been positioning the pharmacist as a coach,” she said. “We’ve been providing to our network of pharmacies motivational interview training, knowing that each patient is unique, and they’re going to have their own specific barriers to care, whether that’s adherence or a gap in care. And we’re also using artificial intelligence in the training to simulate for the pharmacist how the patient may react to both the pharmacist and the technician. It’s a chance for them to get a do-over, without a live patient in front of them.”
Stacy Burch, vice president of marketing and commercial excellence at BD, said an important goal is to help drive
pharmacist-patient conversations as early as possible in a condition like diabetes.
“The onset of diabetes can start way before a patient gets diagnosed, in most instances,” she said. “So how can you start those conversations with the pharmacist early on? That would start the dialogue to change how people are eating, to change the things that they’re doing. We are working to help educate the pharmacist about having those earlier conversations, so that patients come in and seek guidance earlier, and hopefully gain stronger control of their disease. This ultimately leads to better adherence and better outcomes for a healthier lifestyle.”
Another panelist emphasizing consumer-centric strategies was Shannon Huneke, senior director of strategic partnerships and alliances at United Healthcare National Accounts.
“It’s really about putting the consumer at the heart of everything we do,” she said. “By virtue of the combination of the United Healthcare benefits business and the Optum Health Services business, we’re able to address every segment of the health ecosystem in every way. This includes the consumer, the provider, the government, the employer and the community — and the systems that support them. One way we live this mission is by taking technology, data and analytics, and predictive modeling, and [marry] them with the vast amounts of consumer insights and expertise of retailers and partners. We ultimately try to seamlessly bring that together to create a much more relevant, simple consumer experience.”
Progress Requires Personalized Solutions for Patients’ Needs
Several panelists said that achieving progress in chronic care requires the use of individual solutions to match the different needs of patients.
“We’re really personalizing to what they want,” said Costco’s Dant. “We’re expanding our ability to reach patients in the ways that they want through expanded use of our mobile app. We have texting services that help us interface with those patients, whether it’s through refill reminders or educational pieces. We still have traditional telephone outreach. We are really looking at what does this patient need? Is it extra counseling? Is it just that they need refill reminders? They are able to opt in and opt out of those services as they see fit, to take some ownership of that care.”
Rite Aid’s Kerley said her company builds services around individual locations and patient needs. “As we build services and programs, they have to be very individualized and tailored to those patients’ needs.”
United’s Huneke said technology can help support individual approaches for consumers. “It’s ultimately about driving a much more personalized experience,” she said. “How do we do that? Technology is important. It’s also about driving value and lowering costs, and certainly increasing quality. We have a program called Motion where we’re incentivizing our consumers to make better choices. Because at the end of the