Like many community pharmacists, Lucas Smith found a small community, Buena Vista, Colo., where he wanted to work as a pharmacist, and has set down roots. He has moved from pharmacist to owner at Buena Vista Drug, and is now expanding the business, opening another location 30 minutes away. Smith is also an example of the pharmacist of the future, as he looks to clinical services and products to augment his prescription business. He has forged collaborative relationships with area providers in this town of 3,000, two and a half hours southwest of Denver. Since Smith arrived at Buena Vista five and a half years ago, and he and his wife took on ownership two and a half ago, his goal has been to expand access to services.
The pharmacy’s med sync program now has 400 patients enrolled. Smith has taken advantage of Colorado protocols that allow for counseling in contraception and smoking cession; point-of-care testing for A1C, cholesterol, and high blood pressure; rapid flu and strep testing; diabetes education and prevention; and nutrient depletion counseling. The pharmacy’s flu vaccine program, which administered 1,000 vaccines between August and December 2018, hit that mark in October this year.
Buena Vista Drug was the first pharmacy in Colorado to be accredited by the American Association of Diabetes Educators to offer diabetic self-management education, and can bill Medicare for 10 hours of diabetic education. Those patients whose insurance doesn’t cover the education sessions pay out of pocket. Currently, Smith is trying to build a diabetic prevention program to show effective outcomes and receive accreditation for that as well. Customers can take advantage of Medicare Part D consultation and compounding services.
“We’re trying to offer a lot more unique clinical services to help us grow,” says Smith. “The challenge is we can’t bill insurance. But people do pay cash for the services.”
“We Can Do That”
Buena Vista Drug is 4,000 square feet, and includes a large gift department and over-the-counter selection. Where Smith has found opportunity is around renting oxygen concentrators, wheelchairs, and knee scooters. Another unique item the pharmacy rents is the biliblanket, used to treat neonatal jaundice. This rental is billable to Medicaid, but the rest are invoiced to the patient.
Since it’s a small community, Smith knows the providers well — running and rock climbing with some — giving him the opportunity to explain what the pharmacy can offer. He joins a quarterly provider meeting that includes four doctors and five mid-level practitioners, and gives an update on what the pharmacy is offering. To promote these services, Smith uses traditional radio advertising during sporting events, as well as Facebook posts.
“I love the services we offer, because they fill the needs of our community,” says Smith. “Both the biliblanket and the oxygen concentrators came about because a provider asked if we could do it. I did the research and said that, yes, we could.“
Value of Flexibility
Smith, along with the other full-time pharmacist and two technicians at Buena Vista Drug, uses the PioneerRx system to document clinical encounters. Smith has found he can document his clinical programs using features available in his system. When he installed the system about a year ago, he felt overwhelmed by all he could do with it. But, he says, by working through the screens, using the on-demand training modules, and calling the support desk, he has come to value the system’s flexibility.
“When we first got it,” he says, “I thought ‘Oh, this is cool, but how do you build it out to what you want it to do?’ Once you learn about what’s available, you can customize the system to what works best for you to document almost any clinical thing you’d want to do.”
The on-demand training was particularly helpful, since it explains how to develop clinical programs. This helped Smith to understand the best workflow for his pharmacy. For example, with his med sync program, he plans to use PioneerRx’s new care plan module to document phone calls. “I’m excited to use the prebuilt documentation program for our med sync,” he says.
Smith has customized the system through prompts based on clinical offerings that are triggered during the dispensing process or at the point of sale. One prompt indicates to the staff that a patient is on a medication that causes nutrient depletion. This gives the pharmacy staff an opportunity to counsel the patient and explain the benefits of a nutritional supplement.
Another trigger Smith plans to use is counseling around blood pressure medications. Smith has built a care plan in the system that prompts the staff to ask patients if they would like to have their blood pressure taken at the store, or if they take it at home, have the store record the data in the care plan. By tracking a health measure like blood pressure, Buena Vista Drug staff are able to alert patients of any trends, such as several months of an elevated blood pressure. Smith says that the staff will ask patients if they want to share the information with their doctor, or if patients would like Buena Vista Drug to contact the doctor. “It’s another touch point where we’re talking to our patients and offering more than just a prescription,” says Smith.
The pharmacy was nominated for Health Mart’s Clinical Innovation Award by its McKesson sales rep. Smith says it was an honor to receive the award. “I was surprised,” he says. “I’m enjoying expanding our business and offering these services. I’m a young pharmacist, and I’m glad that I can expand the business to use the skills I learned in school, more than just dispensing medication.” CT
Maggie Lockwood is VP, director of production at ComputerTalk. She likes sharing the stories of pharmacist entrepreneurs who use technology to find success. You can reach her at firstname.lastname@example.org.