Enabling Pharmacy Transformation Through Greater Interoperability

I was recently asked how the profession of pharmacy has changed over the past five years. The more I sat with this question, the more it struck me just how much has shifted—and how hopeful it makes me for where we're headed.

Five years ago, I was working at the American Pharmacists Association in its practice and government affairs department. My team was laser-focused on helping pharmacists respond to the pandemic. One of the ways we did that was through a weekly webinar series covering the latest developments. On September 17, 2020, we covered news that felt seismic at the time: the Department of Health and Human Services had issued an emergency authorization allowing pharmacists in all 50 states to prescribe and administer certain childhood vaccinations—and the COVID-19 vaccine, when it became available later that year.

This was unprecedented because scope of practice for healthcare providers, including pharmacists, is regulated at the state level. Suddenly, pharmacists everywhere could respond to the pandemic in the same way—making care more accessible across the entire country. And they delivered. Pharmacists and their teams were responsible for administering more than half of all COVID-19 vaccines in the United States. That authority continues through 2029, and today patients are increasingly choosing to receive their routine vaccines at the pharmacy.

Where pharmacists stand today

In 2020, just seven states required compensation for any approved pharmacy-provided care services. Fast forward to today, and the contrast is remarkable. More than half of states require broad compensation for pharmacy services, and 43 states require compensation for at least one care service at the pharmacy. And last year alone saw scores of additional bills introduced to expand scope of pharmacy practice and payment, with dozens signed into law.

Support is building in Congress as well. The Main Street Pharmacy Access Act (formerly known as the Ensuring Community Access to Pharmacy Services (ECAPS) Act) has a strong bipartisan backing. If passed, it would give seniors easier access to testing and treatment for respiratory illnesses from their local pharmacy—and reimburse pharmacists for delivering this care.

We talk a lot at Surescripts about the three things pharmacists need to deliver care at the top of their license: policy, payment and technology. The COVID-19 vaccine effort was a proof point for that framework. Pharmacists had the right policy—a consistent scope of practice aligned with their training nationwide. CMS ensured reimbursement was in place for administering the vaccine. And the technology was largely there, from immunization registry access to the clinical direct messaging services pharmacies began leveraging through Surescripts to notify other providers when a vaccine was administered.

What excites me most about where we are today is the shift toward implementing a standard of care regulatory approach. Historically, expanding what pharmacists can do has happened service-by-service—a sometimes slow process that's unique to pharmacy. Other healthcare professionals are regulated through a more flexible standard of care framework that relies on professional judgment and standards for patient care and safety.

This approach is now increasingly being applied to pharmacy. Three states have standard-of-care frameworks in place today—Idaho, Alaska and Iowa—and pharmacy leaders are mobilizing to ensure more states are on their way. This shift has really taken shape over the past five years and has the potential to be especially powerful in rural communities, where pharmacists are often the most accessible healthcare provider. In fact, several states are already including pharmacies in their Rural Health Transformation Program plans.

Connecting pharmacies to the care team

Policy and payment wins are accelerating. Now we need to accelerate the technology to match—and that starts with interoperability.

As pharmacists take on a greater role in patient care, they need to be able to access and afford care management systems that allow them to exchange, document and store clinical information—and bill for services. In some cases, pharmacy management systems are evolving to offer new capabilities. In others, pharmacies are developing or seeking entirely new systems. Regardless of the path, pharmacists need the ability to access and share information with payers and other providers as full members of the care team.

That's why Surescripts is sponsoring a Pharmacy Workgroup through the Sequoia Project's Interoperability Matters Program. Together, we're working to better understand and communicate the information exchange needs pharmacists have, and to align those evolving technology needs with the interoperability landscape that other providers already operate in.

We're also investing in new ways to connect pharmacies to clinical information exchange, through their care management systems. With Surescripts Health Information Network Interconnect, pharmacies gain a direct pathway to tap into the broader interoperability ecosystem. And we continue to focus on making it faster and simpler to fill prescriptions—freeing up the time and staff pharmacies need to deliver more expansive care.

A future built on connection

I'm confident that the standard-of-care map will look dramatically different five years from now. More states will adopt flexible frameworks. More pharmacists will be compensated fairly for the care they provide. And the technology will be there to support them—not as an afterthought, but as a foundation.

When all of these pieces come together—the right policy, fair payment and robust technology—pharmacists step into a future as members of a highly connected care team, and patients can access exceptional care wherever they seek it. That's the future we're building toward, and we're building it now.