point of care testing in pharmacies

Advancing Population Health Outcomes 1

Point of Care Testing in Pharmacies

1


THE EXPANDING SCOPE OF PHARMACY PRACTICE

Immunizations

Basic Screenings

Point of Care Testing

Initiating Drug Therapy

Modifying Drug Therapy

Acute Care

ChronicDisease

Mgmt

Preventative Services

http://www.iconarchive.com/show/medical-icons-by-icons-land/People-Pharmacist-Male-icon.html

http://www.iconarchive.com/show/medical-icons-by-icons-land/People-Pharmacist-Male-icon.html


• Increased Demands of an aging and unhealthy population

• Shortage of Primary Care Professionals

Access

WHAT’S DRIVING THE EXPANDING ROLE OF THE PHARMACIST?

25% with undiagnosed

Diabetes

35% of patients have no PCP

Increased Needs

http://www.iconarchive.com/show/people-disability-icons-by-anatom5/seniors-icon.html


BENEFITS OF ENGAGING THE PHARMACIST AS A PROVIDER

7 Day AccessNo Appointment

Needed No office visit fees Immediate access to Medications & Immunizations

93% of Americans live within 5 miles of a Pharmacy

300 MillionCustomer visits to a pharmacy

every week


PREVIOUS PHARMACIST SCOPE EXPANSIONS HAVE BEEN SUCCESSFUL

• Over 25% of people get their flu shot at a pharmacy

• Immunization rates for Shingles have increased from 12% in 2009 to 20% in 2014


BASIC SCREENINGS TO SUPPORT POPULATION HEALTH

• Glucose

• Blood Pressure

• BMI

• Cholesterol

• A1C

Most states will allow pharmacists to perform CLIA waived testing


POINT OF CARE TESTING (POCT)• Trained Pharmacists performing Rapid

Strep or Flu test and dispensing appropriate therapy if positive

• Structured similar to Immunizations– Special Training Course– Collaborative Practice agreements

with Physicians to dispense therapy

• Current NACDS Pilots underway in multiple states – started in MN, MI & NE

Strep test

Flu test

Most states will allow pharmacists to perform CLIA waived testing, but not all will permit them to “act” upon a result

even with a CPA


COLLABORATIVE PRACTICE AGREEMENTS• Collaborative Practice Agreements with

Physicians To Dispense Medications– Smoking Cessation Products

• CPA + CLIA testing capabilities: – Strep and Flu– Oral Diabetic & Statin medications to patients

after screeningsBenefit: The CPA should follow the CDC treatment protocols and ensure prescribing guidelines are followed, no overprescribing and only dispensing appropriate therapy


PROVIDE AFFORDABLE ACCESS TO TREATMENT• CPAs combined with the ability to conduct

basic screenings will allow pharmacies to get patients on therapy and into the healthcare system

Abnormal Screening result CPA “standing order” New or “modified” Rx based on CPA


MOST STATES ALREADY ALLOW

• Ability of Pharmacist to MODIFY drug therapy with a Collaborative Practice Agreement

• Ability to INITIATE new drug therapy with a Collaborative Practice Agreement

45

38


How Advancing Pharmacy Scope could help Public Health with Disease

Surveillance


HELP IN BATTLING INFLUENZA• Pharmacist flu testing in stores provides

quick access to patients• Treatment with anti-virals will decrease

the severity and minimize the contagious period

• Provide real-time reporting to the states• Immunizing negative test patients


SCREENINGS FOR HEP C AND HIV• Testing patients for Hep C and HIV,

reporting reactive and non-reactive cases to state and referring to public health for diagnosis and follow up

• Pharmacy barriers to performing today are: – Privacy concerns (space issue)– Pharmacist training on having these

difficult conversations with patients


ZIKA VIRUS OR ANY NEW “THREAT”• Providing education to patients • As soon as CLIA waived test available,

could test patients • As soon as vaccine is available could

immunize patients to prevent spread• Reporting desired information to the

states


HOW PUBLIC HEALTH COULD HELP PHARMACIES

• Collaborative Practice Agreements are a big barrier for Pharmacies in treating strep and flu– Would the public health protocol physician

consider partnering with pharmacies?

point of care testing in pharmacies

Health & Medicine