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What does the future hold for pharmacists and pharmacy technology? To find out, I asked one of our resident pharmacists, Larry King, who directs product safety and performance at Surescripts.
October is American Pharmacists Month. What better way to celebrate pharmacists than to ask one where he believes pharmacy is heading?
I watched as King took his crystal ball down from the shelf. Here’s what he told me.
The perception of pharmacists has shifted in the public sphere and within the medical community at large. COVID-19 increased the scope of practice for pharmacists, and this allowed for services like test-to-treat and immunizations. But the end of the pandemic has not meant the end of the increased scope of practice, driven by the ongoing need and desire for these services, and many states have introduced legislation to support pharmacists’ increased scope of practice. The role will continue to evolve.
Direct patient care like test-to-treat is one side of the coin. The other is deeper clinical interaction, largely driven by the shortage of primary care providers. This deeper clinical interaction may include, for example, the comprehensive medication review, or CMR, where the pharmacist evaluates the patient for the possibility of adverse drug interactions, the correct strength of medications, the right regimen, etc. Deeper interaction could also include things like nutrition. Consider a patient who has been diagnosed with diabetes. What grocery items are in the shopping cart? What items should be in the cart?
Doctors and pharmacists often work together under collaborative practice agreements. These agreements allow pharmacists to change the patient’s dosing or add medications to the patient’s regimen, in partnership with the doctor, of course. But the pharmacist acts with the doctor’s permission. I think we’ll see more of this. Pharmacists will have more autonomy. Smoking cessation is a big one. Pharmacists can get patients started on smoking cessation treatment without the intervention of a primary care provider. The same holds true for many other disease states, including diabetes and high blood pressure.
Manual tasks (phone calls, faxes and paperwork) have characterized so much of pharmacy practice. That’s changing as pharmacy technology evolves. E-Prescribing was the first real push into pharmacy technology—a game-changer that brought significant advances to patient safety. E-Prescribing includes automated data like drug description, quantity and patient directions. Now, the focus is to inform the execution of clinical services with relevant, automated information like diagnosis codes, lab information and clinical notes from other providers the patient has seen. Relevant information means fewer manual tasks for pharmacists.
As pharmacy technology gets more autonomous, experienced pharmacy techs can take more work off pharmacists’ plates. It’s not really a new concept, but now there’s momentum. Technicians can be empowered to do quality assurance work. They can look for typos and flag conflicting patient directions. They can confirm whether the bottle has the correct medication and proper number of tablets. And as the role of pharmacy technicians shifts, this will help to shift the role of pharmacists toward deeper clinical interaction.
Patient care and safety comes first in healthcare. But at the end of the day, pharmacy is still a business. There must be a viable revenue model aligned with the evolution of pharmacy roles. As pharmacists step up to fill gaps in care, reimbursement is key. Policymakers will introduce bills that increase scope of practice (as they have done in Virginia), grant some aspects of provider status to pharmacists, reclassify medications that allow for pharmacist-originated prescriptions, and allow for payment from the patient benefit plan.
Imagine walking up to the pharmacy counter and the pharmacist writes, fills and dispenses your medication—all without having to visit your doctor. You couldn’t get this specific medication over the counter, without a prescription, but it didn’t require a doctor’s order. This could be blood pressure medication. Cholesterol medication. It could be medication for smoking cessation. It could include some diabetes medications. Perhaps also antibiotics. This is the logical progression of the test-to-treat services that began during the pandemic, and the logical outcome of provider status.
Go deeper: Learn more about how care teams are evolving to fill primary care gaps—and the role of pharmacists in making this happen.