Clinical Services: Enhancing Pharmacy Care

Pharmacists are uniquely positioned to supplement the care provided by primary care physicians (PCPs) and specialists. They see their patients frequently, often on a monthly or even weekly basis, which allows them to play a crucial role in healthcare. In today's healthcare environment, where the majority of treatments involve medication, pharmacists are the experts. Their involvement is vital in managing medication adherence, addressing adverse drug reactions and expanding patient access to care in the form of immunizations or other patient-centered clinical services.  Expanding the role of the pharmacist and pharmacy team leads to better patient outcomes.

Engaging directly with patients not only improves satisfaction for many pharmacists but also presents an opportunity to generate additional revenue independent of Pharmacy Benefit Manager (PBM) reimbursement. By developing their own programs, pharmacists can leverage the market to determine their worth rather than relying on arbitrary insurance determinations.

Common Pitfalls in Implementing Clinical Services

Despite the potential benefits, many pharmacies struggle with implementing clinical services effectively. Pharmacy staff often feel overwhelmed or under-trained, preventing them from starting new initiatives. Without investing in operational efficiency, such as medication synchronization (MedSync) and addressing common workflow pitfalls, they may lack the time to implement these programs successfully.

Another issue is the failure to maximize pharmacist and staff efficiency when administering these programs, resulting in suboptimal returns on investment. Pharmacies often attempt to implement generic programs instead of tailoring them to their unique situations, missing out on opportunities for growth and innovation.  There is not a one-size-fits-all approach to pharmacy care, and the best programs are usually a combination of broad service ideas (e.g. caring for patients with diabetes) mixed with an approach that is tailored to your patients (e.g. you dispense a lot of CGMs so you create a service to help patients set-up, track and evaluate their readings).

Additionally, pharmacies often take a reactive approach to developing clinical services.  They wait for a payer to come along (such as Outcomes) to dictate what services they can offer and how much they will get paid.  Some of the best clinical programs are offered to patients completely outside of insurance reimbursement.  This allows the pharmacy to set the price and get paid immediately instead of waiting for third-party reimbursement.

Lastly, pharmacies often attempt to implement clinical services as an area that is limited to just a small part of the staff.  While this can be a good strategy at the start, getting all staff members involved and having specific responsibilities for pharmacists, technicians and other staff will help to distribute workload, maximize efficiency and increase the financial returns.

Strategies for Success

Successful pharmacies improve operational efficiency and staff training either before or alongside the development of clinical services.  This means implementing and maximizing MedSync as the default mechanism for managing refills and ensuring that staff training is sufficient in all areas of the dispensing process.  Pharmacies with a robust MedSync program, can utilize the monthly Sync Calls to market or implement their clinical services.

Highly successful pharmacies assess the market for services in their area, addressing the needs of patients or local providers, and they price their services accordingly, whether utilizing a third-party payer or a cash-based model. Participation in Clinically Integrated Networks, such as CPESN and associated State networks, helps drive programs and generate additional clinical services revenue.  Participating in these types of contracts also typically comes with training as part of the program, so this is a great way get some initial experience with a lot of extra support.  The best pharmacies also look for ways to involve the entire staff in the implementation of programs, not just the pharmacists.  It is also best to have one or two staff members who are the “champions” for the program – they know the program inside and out and can help to troubleshoot problems, train new staff and evaluate the effectiveness of the program itself.

Investment in staff training is crucial. Sending staff to continuing education (CE) sessions or conferences to learn new skills or incentivizing them to get certified in areas like diabetes education (CDE) or immunizations can make services more marketable and efficient. Effective marketing ensures that patients and providers are aware of the services offered and understand how they can help achieve healthcare goals. Continuous improvement and expansion of services are key to long-term success.

It is perfectly OK to start small and develop the foundations for your service in your pharmacy, but don’t be afraid to scale up rapidly to reach as many patients as possible. [not sure of the transition here but I think this is an important thing to mention]

How PEAK Pharmacy Solutions Can Assist

At PEAK Pharmacy Solutions, we help pharmacies identify existing opportunities and guide them in getting started with clinical services. We analyze the market environment to pinpoint where new services might be introduced and identify the key components needed for development. Our team assists in training staff and provides direct implementation support including tracking outcomes and return on investment (ROI).

By partnering with us, pharmacies can enhance their business operations, improve profitability, and ultimately deliver superior patient care. Let us help you unlock the potential of clinical services and achieve peak performance in your pharmacy.