In this interview, Farah Madhat, Pharm.D., MA, executive vice president of PrescribeWellness, a Tabula Rasa HealthCare (TRHC) solution, and Robert Alesiani, Pharm.D., BCGP, chief pharmacotherapy officer at TRHC, converse with ComputerTalk’s Will Lockwood about the tools community pharmacies are deploying to support the unprecedented efforts to roll out COVID-19 vaccines. From patient scheduling and intake to second-dose management, reporting, and community education, learn about how pharmacists are making it all work.
Farah Madhat, Pharm.D., MA: Tabula Rasa HealthCare and PrescribeWellness are committed to helping community pharmacies understand just how to obtain vaccines and manage the vaccination process. Our priority has been to ensure our independent and chain pharmacy partners have the latest information on how vaccine doses are being allocated to immunizers. There are both federal and state programs, and they have different methods of distribution and reporting requirements for pharmacies.
ComputerTalk: So, there are different channels and processes that pharmacies need to understand in order to ensure that they are going to have access to vaccine doses for their patients.
Madhat: Correct. And a really critical area for pharmacies to understand is reporting. They will have to be able to report according to the specs of different agencies. For example, reporting to the CDC [Centers for Disease Control and Prevention] is a little different than reporting to states. It’s imperative that pharmacies have technology that supports all the various reporting requirements and have established best practices for these efforts.
ComputerTalk: And what about a pharmacy’s patients? Many people are really eager, even anxious, to schedule a vaccination as soon as possible once they become eligible.
Madhat: Yes. Pharmacies’ phones are ringing off the hook, certainly, because obviously their patients want to ask all the questions they have, and they trust their local community pharmacies to be able to answer. So again, phones are ringing off the hook while pharmacies are doing their best to vaccinate at a rapid pace. It’s an environment in which organization and workflow are keys for the success of this unprecedented vaccination effort.
ComputerTalk: And what are the tools pharmacists are using to communicate with patients and manage the process? For example, how are they identifying vaccine-eligible patients and then engaging with them? And how are they managing registration and data collection tasks?
Madhat: Pharmacies using the PrescribeWellness platform have the tools to address all of these needs. Pharmacists are able to identify qualifying patients and then initiate outbound communications to them.
We wanted to ensure that pharmacies don’t have crowded vaccine administration work areas. We launched a contact-free patient intake and scheduling tool. Patients receive an email or text message that links to a prescreening criteria form where they enter basic demographics, report any COVID exposure or symptoms, and more. They can also access a fact sheet for the vaccine as well. After patients submit the form, the pharmacy can electronically communicate readily back to the patient and confirm an appointment or reschedule as necessary.
ComputerTalk: All this is happening remotely so that there’s proper attention given to social distancing, and once the patient does come in for the vaccine, all the information is in the system and it’s a much quicker process, right?
Madhat: That’s right. PrescribeWellness also provides pharmacies a QR code that they can display on the door or front window which, when scanned, provides the same prescreening form and fact sheet. Patients can then easily complete the form in their car.
ComputerTalk: We’re talking about collecting patient screening information, and that takes us back to the topic of reporting to the CDC or state immunization information systems (IIS), right?
Madhat: Yes, and we ensure that pharmacies have all the current data reporting requirements and capabilities. Historically, this has meant connecting with the IIS, which are the immunization information systems you mentioned. People also refer to them as state immunization registries. Not all pharmacies were previously required to connect with state IIS, but states are saying now that pharmacies absolutely need this connectivity so that they can report COVID vaccination data effectively. And, pharmacies also now need to be able to connect and report to CDC if they’re procuring their vaccinations from it, which carries distinct requirements. State agencies and CDC have expanded their datasets, meaning that they are requiring community pharmacies to document and report more information than in the past. For example, the pharmacy must document and report patient race and ethnicity for first doses.
ComputerTalk: So the documentation and reporting requirements have expanded above and beyond what a pharmacy may have been doing before?
Madhat: Correct. From a workflow perspective for both community pharmacies and for our company we continue to adapt to ever-evolving data requirements as vaccinations are being made more widely available. We are staying agile and responding to regulatory changes as quickly as possible.
ComputerTalk: What other resources are pharmacies using to help manage the vaccination process workload?
Madhat: As I mentioned, pharmacies are experiencing a huge influx of calls. Many of them have found that they need resources to help field all of these calls, to help with scheduling, and to answer questions about COVID-19. PrescribeWellness provides call center services as support for community pharmacies.
ComputerTalk: We’ve been talking primarily about getting patients ready for the first vaccine dose, but then there’s the issue of ensuring they receive a second dose, right?
Madhat: That’s right. We send automated reminders for the second dose to patients. We base this on the NDC of the first dose they receive, and so we know if they need to come back and when. And our patient outreach campaigns involve a series of communications, to ensure that they do come in for that second dose, because it is so critical for the efficacy of the vaccines.
Reminder outreach benefits both pharmacies and patients. Patients receive help remembering that they need to come in for the second dose and pharmacies can plan their workload and their inventory efficiently by referencing their clinical calendar within the pharmacy.
This is all part of our PrescribeWellness platform, and it’s turnkey for pharmacies.
Robert Alesiani, Pharm.D., BCGP: I just wanted to touch on another topic quickly, and that’s the importance of pharmacists educating the community. There are still a lot of people who are questioning whether they want to get this vaccine or not. There also has been a lot of media coverage about viral mutations or variants and what that means. It’s important to note that viral mutation is not only common, but expected, and only occurs within a host. So, ideally, if a patient comes in contact with the virus and they’ve been vaccinated, their body will respond to that virus and will destroy or incapacitate it quickly before these mutations have an opportunity to occur. That’s why it’s so critical for people to be vaccinated. Patients need to be educated about this.
As long as the virus is still active in a community, it will continue to mutate perhaps into new variants resistant to our current vaccines. Then new vaccine formulations or “boosters” will be needed that are specific to these new strains (as we are seeing with the B.1.351 variant from South Africa, the United Kingdom B.1.1.7 and the P1 strain believed to have originated in Brazil). So, vaccination really needs to be a global effort, and everyone in every community, every state, across the United States and around the world, must consider immunization against COVID 19.
ComputerTalk: And what are your thoughts on how community pharmacies can best impact vaccine uptake among their patients?
Madhat: It’s going to be the relationship that they have with their communities, and the frequency with which they interact with their patients. That relationship has built trust, and this is really the time to recognize that. Pharmacies can ensure that they are being stewards of public health and helping to educate their patients, answer questions, and administer vaccines throughout the community. CT