David Pope, PharmD, CDE

I’ve long been an advocate for pharmacists’ ability to evaluate and prescribe, so hearing President Biden announce a pharmacy test to treat initiative for COVID-19 during his State of the Union address was a thrill! The COVID-19 pandemic brought national attention to pharmacy and what we can do to serve our communities, and this felt like a great continuation of that narrative in the national spotlight.

Pharmacists are ready for test to treat, but there are a few steps that need to happen before this can become a reality:

The FDA must update emergency use authorizations (EUA’s) to allow pharmacists the authority to prescribe.

Payers must allow pharmacists to be reimbursed for the act of prescribing through the medical benefit. A positive test doesn’t necessarily mean Paxlovid should be administered. Therefore, pharmacists need to be reimbursed for their efforts as a provider to evaluate patients based on the outlined protocols and either prescribe directly or refer the patient if more complex medical decision making is necessary. Medicare will lead the way here with reimbursement guidelines, and other payers will generally follow what Medicare does. This is significant as it will reimburse pharmacists as medical providers on the medical benefit (aka provider status).

The Health Resources and Services Administration needs to allow pharmacists to submit office visit codes when there isn’t coverage elsewhere.

Right after the State of the Union, the steps above felt like a formality. But, now we’re seeing pushback from those outside of our community about whether or not pharmacists should have the ability to prescribe and it’s possible that one or all of the steps I’ve outlined above won’t happen. What a disappointment. Yet again, pharmacists are left to advocate for our seat at the health care table.

The biggest issue I have with the argument against allowing pharmacists to prescribe is that it’s already happening today. For example, in Idaho, pharmacists are prescribing a statin to patients with diabetes through a protocol. And in Florida, pharmacists are prescribing Tamiflu based on positive flu test results. Pharmacists are qualified to make basic medical necessity determinations based on the clearly defined protocols; it is well within our abilities and training as doctors of pharmacy. If the medical decision making becomes more complex, we can refer the patient to their PCP for follow up.

The cost of not allowing pharmacy to prescribe is too great and will prevent access to Test to Treat pathway for many Americans. Let's do this!

David Pope, PharmD, CDE, is the Chief Innovation Officer at OmniSYS and a member of the Drug Topics® Editorial Advisory Board.

Articles

President Biden’s recent State of the Union address included a pharmacy Test to Treat iniativie for COVID-19.

Let’s Do This! A Call to Action for Test to Treat in Pharmacy 

The sharing of clinical data between pharmacists and physicians has often been, quite frankly, relatively paltry.

) vendors have shown little interest in investing in new development to provide clinical data to the pharmacist, the community pharmacist has been equally culpable due to the lack of consistent documentation in a usable structure with bedrock pharmacist interventions, such as drug therapy problems.

Related article: Pharmacists Get Involved in Direct Patient Care

Highlighting this siloed approach to data isn’t breaking news to the industry, but an emphasis on improving quality over the past few years has fueled a renewed interest in breaking down the traditional barriers to exchanging data. The most exciting–and likely to succeed–answer to the interoperability conundrum in pharmacy has recently hit the market and is already receiving steady adoption: the Pharmacist eCare Plan.

The eCare Plan project, spearheaded by the 

, will result in an improved communication between pharmacists and physicians. Essentially, pharmacists will be able to update the eCare Plan with details regarding a patient’s current medication regimen and health concerns, including drug therapy problems, therapeutic goals, and medication support needs, in addition to the pharmacy’s interventions and the patient’s health outcomes.

That information, through the eCare Plan, will be able to be received and consumed by any EHR, allowing the data to be used by the healthcare team in significant ways. Pharmacists who want to provide clinical services will want to use a vendor that harnesses this new technology. 

Previous efforts to solve interoperability issues revolved primarily around the utilization of a single platform that both physicians and pharmacists could access. As you can imagine, the likelihood of engaging pharmacists and physicians on the same platform is minimal. The Pharmacist eCare Plan leverages the current clinical documentation system of the pharmacist to communicate clinical data. 

In order to transfer the data to an EHR, the document must be written in a common language and format. This language, known as HL7 has been used in the healthcare landscape for several years. Also, this language must also be adequately structured into a specific template. These predefined templates, called Clinical Document Architectures (CDAs), allow any EHR to read the document. The Pharmacist eCare Plan, while not yet approved by HL7 as an official CDA template, is already gaining steam throughout the country.

This new technology comes at an opportune time as healthcare is experiencing a rapid movement towards improving quality of care. Through the Pharmacist eCare Plan, pharmacists can provide interventions–such as diabetes education and chronic care management–and provide care coordination by sharing the information and formal plan with the rest of the healthcare team. As a result, the Pharmacist eCare Plan has already piqued the interest of payers looking to improve outcomes and reduce costs of high-risk chronic care patients. 

Related article: How Pharmacists Can Team Up with Physicians to Improve Care

Due to the new ability to share data with other healthcare providers, this technology has kickstarted a revolution in the community pharmacy industry, encouraging pharmacists across the country to engage their patients with clinical opportunities, then document clinical findings in a usable way. This not only marks a significant and blazingly fast shift in the marketplace, but also serves as a launching pad for preparing community pharmacists for the next generation of pharmacy practice.

David Pope, PharmD, CDE, is chief of innovation and cofounder of STRAND. 

Pharmacists are often siloed from vital patient information- and this pharmacist thinks something needs to change.