Community Pharmacists Expand Access Through Point-of-Care Services

Community pharmacies across the country are redefining their role in patient care thanks to point-of-care testing (POCT) for common infections. What began as a way to address access gaps has evolved into a clinical service line that is helping patients receive faster diagnoses, quicker treatment, and, in many cases, the chance to avoid costly urgent care or emergency department visits.

In fact, POCT is no longer an experimental offering; it is a practical, growing component of community-based care.

Meeting Immediate Needs in the Community

Jenny Wells, PharmD, pharmacist-in-charge at The Pharmacy at Wellington in Little Rock, Arkansas, noted her pharmacy offers COVID-19, influenza, and strep testing.

“Demand tends to ebb and flow with seasonal patterns,” she said. “We’re seeing a lot of flu activity right now. But strep is always prevalent in a pediatric community. Honestly, I would say it’s pretty even across the board as far as what type of test we administer.”

Beth Bryan, PharmD, owner of Surgoinsville Pharmacy in Surgoinsville, Tennessee, offers strep, flu, COVID-19, and urinary tract infection testing. She noted the service emerged from necessity.

“We actually started testing before [COVID-19] because we were seeing patients have access issues,” she said. “They were coming in sick, and their physicians couldn’t get them in for 2 or 3 weeks, and they needed help that day. We were just trying to bridge that gap.”

Gold Eneyo, PharmD, director of clinical pharmacy services at Cencora, within the Good Neighbor Pharmacy network, noted independent pharmacies across the country are seeing similar trends.

“Respiratory conditions such as influenza, COVID-19, and RSV [respiratory syncytial virus] remain the primary focus,” Eneyo said. “Demand depends on location, patient demographics, and community outbreaks, but pharmacies have proven they can respond quickly when their communities need them.”

For instance, in Williamsburg, Virginia, T.W. Taylor, RPh, owner of Williamsburg Drug, offers traditional Clinical Laboratory Improvement Amendments (CLIA)–waived infectious disease testing but said his patient base is increasingly interested in deeper diagnostic insights.

“While patients utilize rapid infectious disease tests, we’re also seeing strong interest in more comprehensive laboratory evaluations,” he said. “Patients want answers. They want to understand what’s driving their health concerns, not just treat symptoms.”

Redefining the Pharmacist’s Role

In recent years, POCT has changed the way patients perceive their local pharmacy, which is a good thing.

“We didn’t hesitate [when] this became available under Arkansas protocol,” Wells said. “We immediately jumped in. We saw it as an opportunity to lead.”

Her pharmacy employs a registered nurse who conducts testing, collects vitals, and completes intake assessments. The pharmacist evaluates results and, when appropriate, prescribes antibiotics for positive strep tests or recommends next steps for negative results.

“That model allows us to treat patients within an hour and keep them from having to sit in urgent care or the emergency [department],” Wells said.

Bryan noted POCT has strengthened trust in her rural Tennessee community.

“It’s made us a more trusted source of health care,” she said. “Patients didn’t know at first that we did that, and they were just suffering and trying to avoid urgent care. Being able to take care of that need built trust.”

Eneyo noted that pharmacies conducted more than 40 million COVID-19 tests nationwide during the pandemic, underscoring their public health impact.

“Pharmacies have transitioned from medication dispensers to accessible clinical care sites,” Eneyo said. “In many communities, particularly rural or underserved areas, pharmacies reduce travel and scheduling barriers and help patients get answers quickly.”

For patients without a primary care provider, that accessibility can prevent unnecessary urgent care visits and improve timely treatment.

In Williamsburg, Taylor noted POCT has complemented his pharmacy’s broader wellness mission.

“Williamsburg Drug is known as the place you go to become your healthiest,” he said. “POCT expands our role from medication access to trusted health partners and educators.”

Operational Realities and Regulatory Requirements

Implementing POCT has required workflow adjustments, regulatory compliance, and team coordination.

“There are definitely challenges because the pharmacist is still in the dispensing role and we also give immunizations,” Wells said.

Her pharmacy adopted an appointment-based model with online scheduling and digital intake forms to reduce disruptions at the bench. Utilizing a nurse and support staff helps minimize the pharmacist’s time away from dispensing duties. Bryan noted she similarly refined her workflow.

“We adopted an appointment-based model early on,” she said. “It wasn’t a huge interruption in daily workflow because we had already worked on med sync and other efficiencies.”

Both pharmacists emphasized the importance of CLIA waivers and proper training.

“CLIA waiver is something you have to have for [POCT],” Bryan said. “Anytime you add a new test, you need to make sure that’s added to your waiver. We have clear protocols, documentation systems, and collaborative practice agreements in place.”

Wells added that although newer pharmacy graduates receive POCT training in school, established pharmacists often need continuing education.

“It wasn’t more than several hours of continuing education,” she said. “But it was important to make sure we were fully trained.”

It’s important for pharmacies to integrate quality control into daily workflow and stay current on regulatory changes, including upcoming federal requirements for fully electronic CLIA documentation and payment processes.

“Quality control drives daily workflow,” Eneyo said. “When integrated into routine practice, it minimizes errors and supports uninterrupted patient care.”

Collaborative practice agreements (CPAs) can also pose barriers. Bryan noted that securing a CPA was initially difficult in her area, where independent practices were limited.

“In the beginning, it was really hard to get a [CPA] that would allow me to treat based [on] a positive result,” she said. “After [COVID-19], that became much easier.”

Payment Models and Sustainability

Reimbursement remains uneven nationwide, pushing many pharmacies to rely on cash-pay models.

“In Arkansas, there’s one payer that reimburses pharmacists for [POCT], and that’s Arkansas Blue Cross Blue Shield,” Wells said. “We’re reimbursed for the medical benefit as a midlevel provider.”

She said her pharmacy initially relied on cash pay while demonstrating value to payers.

“We had to start doing this as a cash-pay option so payers could see the value,” Wells said.

Bryan has begun some medical billing to serve patients who may not afford cash-based services.

“We just charge a fair cash price, and it’s usually cheaper than urgent care,” she said. “The patient gets tested, treated, and can be on their way.”

Eneyo said some plans are starting to reimburse for certain chronic disease tests, such as hemoglobin A_1c, but broader payer support is still needed.

“Medical billing for POCT is increasing, but coverage is not consistent across all payers,” Eneyo said. “There is a need for more plans to support pharmacy-provided testing.”

Taylor, whose pharmacy operates largely on a cash-based consultation model, said transparent pricing allows for longer visits and flexible care delivery.

“The cash model allows us to focus on better care,” he said.

Looking Ahead

Pharmacists see room for expansion in POCT based on community demand and the evolving scope of practice.

Wells is exploring RSV testing and additional services such as diabetes and dementia education, and Bryan is evaluating whether to add mononucleosis testing after noticing an increase in local cases.

Eneyo believes expansion should target care gaps, including chronic disease management and pharmacist-furnished therapies such as HIV preexposure prophylaxis and postexposure prophylaxis.

Pharmacists agree on one point: POCT has proven its value.

“It’s a cost-effective option vs urgent care or the emergency [department],” Wells said.

For community pharmacies navigating reimbursement pressures and evolving patient expectations, POCT is not just an added service. It is a tangible example of pharmacists practicing at the top of their license and meeting patients exactly where they are.