Clinical Perspective

Retail Knowledge

A successful marriage of pharmacies and retail clinics requires strategies to enable care coordination

Much has been made recently about the shortage of primary care providers in the U.S. these days. The gap is wide and projected to grow as our population ages and primary care remains unglamorous among graduating medical students. In the midst of the urgent care clinic movement, top pharmacy retailers have begun a movement of onsite clinics that address primary care services in an effort to alleviate the burden of a lack of affordable, available primary care services.

These local pharmacy clinics offer a new access point to make primary care more convenient for patients. Further, many other pharmacies are beginning to offer a variety of clinical services, like immunizations as well as chronic disease and medication management services. Given that, statistically, approximately 92% of Americans live within five miles of a pharmacy, the opportunity to provide primary care services like immunizations and chronic-disease management represents an incredible opportunity to open up access and convenience for patients to get their needed maintenance care.

The challenge remains, however, in creating a true coordinated care site, rather than yet another fragmented silo of care. Convenient care must be balanced with coordinated care. Technology is part of that equation, as is localized relationship-building.

For any pharmacy to be successful in representing a new clinical care site, be it a clinic staffed by a nurse practitioner, a pharmacist behind the counter, or other personnel providing care in the confines of a pharmacy setting, communication is a must. Communication is crucial to coordination. While large chain pharmacies represent national expertise and scope, the individual providers must spend time building relationships in the community with other providers at a one-to-one level in order to gain the trust, fidelity, and, ultimately, regular communication that will benefit their mutual patients.

Communication can be enabled in a number of ways. Old-fashioned face-to-face communication certainly still has a role to play, and should be encouraged. Among pharmacists, as an example, independent pharmacists have traditionally been much more valued members of the provider community when they take time to get to know their provider peers locally. The same needs to occur for any clinic or pharmacy setting that seeks to provide coordinated care in the modern age. In addition, technology provides more means of communication now than ever before. This includes bi-directional communication, like HIPAA-compliant email. Beyond that, data exchange becomes crucial — and not just data exchange, but information exchange. It’s one thing to simply provide a service and send a report; to truly achieve coordination, that service report must contain not only relevant data points, but an adequate discussion of findings and treatment plan such that it can be effectively communicated to other providers.

Technology represents primarily a means to an end. Certainly technological capabilities are necessary to enable data exchange, information flows and analysis. However, those technologies are only as good as the thoughtful application of processes around the use of those technologies, which creates true patient-centric coordinated care.

Gaps in care, as they’ve come to be known, often occur due to lack of data, missing information, and—truly—gaps in communication. Pharmacy and its associated clinics represents an excellent opportunity to fill gaps in primary care and health maintenance through convenient, frequently visited sites, but must be careful not to create new fragmented care through ineffective communication with local providers.

Editor’s Note: The number of retail health clinics is projected to double to nearly 3,000 by the end of 2015, according to a report released by Accenture at the annual institute of America’s Health Insurance Plans held earlier this month in Las Vegas.

Summerpal Kahlon, M.D., is vice president of business development for RelayHealth Pharmacy Solutions, a business unit of McKesson Corp. Dr. Kahlon is focused on enhancing connectivity and communication between prescribers and pharmacy on behalf of patients and their medication needs. As an adult infectious diseases specialist, Dr. Kahlon has practiced in a variety of healthcare settings, with experience in general infectious diseases, HIV/AIDS care and travel and tropical medicine. Prior to joining RelayHealth, he also worked with EMR and telehealth systems, and he maintains an interest in optimizing the efficiency of the healthcare delivery system. Dr. Kahlon holds an M.D. from the University of Alabama School of Medicine, an M.S. in healthcare infomatics from the University of Central Florida, and a B.A. in economics from Case Western Reserve University.