Providing patient care in a career in community pharmacy
The COVID-19 pandemic has changed the way the public seeks health care. For example, he highlighted the value of community pharmacies as a place where healthcare professionals can provide vaccinations, tests and medication-related care, in addition to triage or other health services.
The practice of community pharmacy is undergoing a critical transformation that will change the way pharmacy professionals and the public perceive the role of the community pharmacist. Many factors coincide to build a community pharmacy for an exciting development that will continue to grow in the years to come.
The healthcare business model is changing rapidly as communities need their local pharmacies to fill gaps in care. During this time, pharmaceutical technology has developed to enable community pharmacists to better document patient care and outcomes.
The COVID-19 pandemic has created new opportunities for pharmacists in community pharmacies to provide care and express value to other members of the healthcare system in the United States. Community pharmacists, pharmacy professors and pharmacy students are all participating in the transformation of the practice, making it an exciting time to explore community pharmacy as a career.
Declining margins on drug dispensing is a well-known subject in community pharmacy. Although the gross margins of pharmacies have declined in recent years, the provision of additional patient care services has increased significantly.1 This provides additional revenue to community pharmacies while allowing the pharmacy team to focus on providing patient care over time.2
There is also a growing shortage of primary care physicians in the United States, which is expected to more than double between 2017 and 2032.2 This shortage increases the need for community pharmacists to take on primary care and chronic disease management roles.3
Pharmacists are trained as clinicians and their integration into chronic disease management efforts has a positive impact on clinical outcomes and return on investment.3 There are critical gaps in healthcare that community pharmacists can fill with their accessibility and skills.4
The provision of improved patient care services has grown dramatically over the past 2 decades, including the milestones of Medicare Part D Drug Treatment Management (MTMP) programs in 2006, allocation in all 50 states for pharmacists to be vaccinated by 2015, and the growing recognition of pharmacists as healthcare providers in 18 states, with other states having pending legislation.4.5
It is important to note that community pharmacists are increasingly paid for the care they provide to patients. This is happening with opportunities such as MTMPs and payer programs negotiated through clinically integrated pharmacy networks, such as the Community Pharmacy Enhanced Services Network (CPESN) USA and their state affiliates.6.7
Many of these new and expanding payer programs use the Pharmacist eCare Plan technology standard for documentation of care.7.8 The eCare plan is a community pharmacy electronic health record that enables more robust documentation of care provided over time beyond prescription and supports adjudication of payment for services.8
The COVID-19 pandemic has accelerated the transformation of community pharmacy practice and further expanded the delivery of patient care services. One example is the ability of pharmacy students across the country to immunize the public with the COVID-19 vaccine, when in many states restrictions prevented it less than a year ago.9
Additionally, community pharmacies have been able to offer COVID-19 testing, other point-of-care testing and essential services, while many other health care destinations have been forced to close during shutdowns. All of these changes have meant that patients and other providers have different views on the role of community pharmacists. Patients have always placed great trust in their pharmacists, but their vision of what pharmacists can offer is growing.ten
It is an exciting time in the world of community pharmacy practice. Community pharmacists are paid more than ever for patient care, and new doors are opening every day for pharmacists to have a positive impact on the health of their patients.6.11 CPESN USA now includes more than 3,000 pharmacies nationwide, all of which are united to provide enhanced patient care services.
The growth of patient care programs and workflow transformation come with challenges, and the Flip the Pharmacy program has made great strides in supporting pharmacies in their change efforts.12 As pharmacies have come together to work for transformation, colleges and schools of pharmacy have also come together to mobilize efforts to transform community pharmacy practice.
In 2019, the Academia-CPESN Transformation (ACT) Pharmacy Collaborative formed as a learning and action collaboration between colleges, schools of pharmacy, and clinically integrated networks of community pharmacy.13 The goal of the collaboration is to support the transformation of community pharmacy practice from a product-based model of care to a community pharmacy care delivery model.
To date, the ACT Pharmacy Collaborative has 93 member colleges and schools of pharmacy, each with an ACT Champion representative who serves as a liaison for the college / school efforts surrounding the transformation of community pharmacy practice.13
ACT Champions and their teams strive to advance community practice and promote it as a promising career for pharmacy students through education, research, and connection to community pharmacy practices. The network of faculty, staff and students that have formed through the ACT Pharmacy Collaborative has fostered meaningful connections and opportunities to become involved in transforming the practice of community pharmacy.
Students are powerful agents of change; one student adds great value to community pharmacies as they transform their practices. Don’t be afraid to do your part to support the transformation of the practice of community pharmacy and take your first steps on the exciting career path of the practice of community pharmacy.
Sophia Herbert, PharmD, is a researcher in the development of the practice of community pharmacy at the Faculty of Pharmacy, University of Pittsburgh.
- Michos L, Holmes E, Lewis R, et al. NCPA 2017 Compendium. Opportunities
for community pharmacy in a changing market. National Association of Community Pharmacists. Accessed August 30, 2021. https://www.ncpa.co/pdf/digest/2017/2017-digest-lr.pdf
- Dall T, Reynolds R, Chakrabarti R, et al. The complexities of physician supply and demand: Projections from 2019 to 2034. Washington, DC: HIS Markit Ltd. Accessed August 30, 2021. https://www.aamc.org/media/54681/ download
- Smith M, Bates DW, Bodenheimer TS. Pharmacists are part of a responsible care organization and integrated care teams. Health Aff (Millwood). 2013; 32 (11): 1963-1970. doi: 10.1377 / hlthaff.2013.0542
- Somma McGiveney MA, Pope DD, Trygstad T. Unrealized Potential and Unrecognized Value: The Practice of Community Pharmacy is Reinventing Itself – Join the Movement. JACCP. 2019; 2 (4): 330-334. doi: 10.1002 / jac5.1147
- 2021 State supplier status mid-year legislative update. National Alliance of State Pharmacy Associations. June 24, 2021. Accessed August 30, 2021. https://naspa.us/resource/2021-state-provider-status-mid-year-legislative-update/
- Network of enhanced community pharmacy services. Accessed August 30, 2021. https://www.cpesn.com
- NCPA Innovation Center Releases Assessment of Trends in Improved Services and Medication Support with Value-Based Payment Models in Medicaid. Network of enhanced community pharmacy services. Accessed August 30, 2021. https://www.cpesn.com/report
- Online care plan initiative for pharmacists. Accessed August 30, 2021. https: // www. ecareplaninitiative.com
- Fifth Amendment to the Declaration under the Public Preparedness and Emergency Preparedness Act for Medical Countermeasures against COVID-19. Public health emergency. Accessed August 30, 2021. https://www.phe.gov/ Preparedness / legal / prepact / Pages / COVID-Amendment5.aspx
- Murphy J. Public views pharmacists as trusted professionals with high levels of virtue. Pharmacy time®. April 18, 2020. Accessed August 30, 2021.
- Information on the Pennsylvania Pharmacist Care Network. Pennsylvania Pharmacists Association. Accessed August 30, 2021. https://www.papharmacists.com/page/PPCN_Information
- Kondic AMS, Trygstad T, McDonough R, Osterhaus M. Scaling Community Pharmacy Transformation with the ‘Flip the Pharmacy’ Delivery Model: Program Origins. Innov Pharm. 2020; 11 (3): 10.24926 / iip.v11i3.3399. doi: 10.24926 / iip.v11i3.3399
- Collaboration University-CPESN Transformation Pharmacy. Accessed August 31, 2021. https://www.actforpharmacy.com/