ThoughtSpot 2020 Series: Episode 10: Supporting Marginalized Communities During Natural Disasters

Hello! Thanks for listening to Over the Counter the podcast from Drug Topics®. I'm Gabrielle Ientile, and welcome to our ThoughtSpot 2020 podcast series.

As part of our partnership with Good Neighbor Pharmacy (GNP) and AmerisourceBergen, we're welcoming guest host Susan Lorenz-Fisher, vice president of Corporate Citizenship at AmerisourceBergen, who will be interviewing Gina Clark, president of the AmerisourceBergen Foundation, and Nicolette Louissaint, executive director and president of Healthcare Ready, on the topic of supporting marginalized communities amid the coronavirus disease 2019 (COVID-19) and natural disasters.

We hope you enjoy this special edition of Over the Counter.

Hi, everyone, I'm Susan Lorenz-Fisher. I'm the vice president of Corporate Citizenship at AmerisourceBergen and the program officer for the AmerisourceBergen Foundation.

I'm very excited to be hosting our 2020 ThoughtSpot podcast today with a couple of my colleagues, both from AmerisourceBergen and the AmerisourceBergen Foundation, Gina Clark, who's our president, and Nicolette Louissaint, who is the president and executive director of Healthcare Ready, which is 1 of our main nonprofit partners.

We're going to talk a little bit today about what's happening with the pandemic, how we're responding to natural disasters, as well as healthcare disparities. I'm excited to dive right in and see what we can learn from each other.

Thanks for joining us today, Gina and Nicolette. Why don't you start by sharing a little bit about yourself? Gina, can you provide a little bit of your background?

Clark: Sure. Thanks so much, Susan, and very, very happy to be sharing this podcast time with Nicolette, a great partner and friend.

I have been in healthcare for my entire career, which is about 35 years now. I've been at AmerisourceBergen for almost 15 years, it will be 15 in January. I also am very proud to represent our foundation. AmerisourceBergen created its independent foundation about 5 years ago, and I took responsibility for about 4 years ago. And we are very committed, as is AmerisourceBergen Corporation, to creating healthier features, so I'm very proud to lead this foundation.

Susan is our program officer and does an amazing job with a small but mighty team. And we have a terrific board of directors, both external and internal, who helped us make good decisions. So it’s a pleasure to be here with you, Susan and Nicolette.

Louissaint: Thank you, and so great to be with you both. My name is Nicolette Louissaint. I guess I can both introduce myself and the organization. I've been in various parts of science and healthcare for my entire career. I'm really transitioning as a clinical scientist biomedical researcher into health policy, and then really the disaster preparedness and response world a number of years ago. My background is really as a clinical pharmacologist and I have long been interested in infectious diseases, so really starting my career around HIV prevention, moving into other infectious diseases, and lately responding to pandemics as a part of Healthcare Ready.

I’m very proud to serve as the executive director of Healthcare Ready, which next year will be 15 years old. It was created really as an informal coalition that became a nonprofit organization after Hurricane Katrina, recognizing that there needed to be better coordination across the supply chain and with the public sector during disasters. Specifically, recognizing that the issues of healthcare access, continued access to medicines, and continuity of care for individuals most impacted by disasters, needed a dedicated and focused approach.

And so that's what we do, that's where we serve, and very proud to continue to respond to disasters. I think we're now around 200 disaster responses over that 15-year time period.

Lorenz-Fisher. Thanks so much, Nicolette. Well, why don't we dive right in? So Nicolette, I'll pitch this first question over to you.

I will never forget last year's ThoughtSpot conference back in 2019. You were presenting to a team of AmerisourceBergen associates, and you mentioned that the world was due for a pandemic. I remember thinking, “wow, that's, that's interesting. I hadn't thought about that before.” And now here we are, living through month 6 or 7 now of COVID-19. What kind of brought you to saying that, and feeling like we were due, and if you could offer some perspectives there?

Louissaint: Sure. We tend to see small-scale disease outbreaks that have pandemic potential about every 5 to 10 years, and we've had some what we would consider near misses in the way of H1N1 really being widespread, but really a less virulent virus than it could have been. We had MERS-CoV, which was I think the last large-scale coronavirus, the Middle East Respiratory Syndrome, but again was contained. We had the Ebola outbreak, that had the potential to be a catastrophic outbreak, but was able to be contained largely in West Africa.

When you look at all of those things from my lens, and also think about the fact that the climate is changing. When we're thinking about climate change, and what it means for the environment, we often forget that it also changes biodiversity, or just the bacteria that may be accessible, bacteria that we might not have previously been exposed to and may not have immunity towards.

From my lens, just thinking about the convergence of all of those factors. I just thought it was time that we that we would see a pandemic.

Lorenz-Fisher: So we'll pivot over to Gina. As president of the foundation, how has the foundation strengthened its giving and partnership practices to support the needs of communities during this terrible pandemic?

Clark: Well, first very important lesson we've learned is always listen to Nicolette, because she tried to get us all ready ahead of time, so I will always always listen to Nicolette.

The other things that we have learned really is that we do have to pivot quickly. We were very, very deep in terms of our foundation support, really in supporting communities around the opioid crisis, both with deterrent and with treatment, and with a number of other initiatives around that, and we are still doing that.

But we did pivot a lot of our services and funding over to meet the pressing needs of these communities during COVID. We do believe that philanthropic organizations have a responsibility and have a unique opportunity to address these global health emergencies. And I think that by their very nature, by their definition, they do that very collaboratively.

And we choose our partners, such as Healthcare Ready, and others because of their desire and willingness and expertise that collaborating for solutions. So with Healthcare, Ready, Direct Relief has been a major partner for us. And they've allocated emergency support to us and community centers: these serve those most vulnerable populations. They've also shipped that all important protective gear to health care organizations all over the world.

Americares is an important partner of ours and Americares is really focusing right now on a lot of the mental health needs. But just broadly mental health needs, which have, I think, always been underserved. Part of my career was in serving in that community, and I believe it continues to be underserved. And then they are specifically providing webinars for trained professionals who were treating COVID patients. They have their own specific and very challenging mental health issues, the families caring for them do. I'm very proud of the work that America is doing really in addressing those mental health needs. And then they too, are also providing PPE and protective equipment for frontline workers really all over the world everywhere from right up the coast in Connecticut to all the way over to Colombia, El Salvador and other places, so there’s a broad amount of support coming from them.

Lorenz-Fisher: Thanks, Gina.

And I would just add that from the AmerisourceBergen perspective, really making sure that our associates understand the work that our nonprofit partners are doing is something that's just really, really important to us as a foundation and broader corporation. So we’re excited to have opportunities like this and some that Gina mentioned, to make sure that our associate population really understands the on-the-ground work that our partners are out there doing.

So with that, we'll turn over to Nicolette and start talking a little bit more about health care disparities. Over the past 6 months, as we highlighted during this year’s ThoughtSpot, pharmacies play a critical role in providing access to care to underserved communities.

Nicolette, would you mind talking us through how you think we can go about supporting the role of pharmacists and addressing healthcare disparities?

Louissaint: Absolutely. Pharmacies have been, for many years, a very important part of our disaster response coordination.

When we look at most disasters, oftentimes, there tends to be a focus on hospitals. But really, if we're thinking about, especially for patients that have chronic care needs, continuity of care, that question of how people who have medical needs without getting to medical crisis are getting care, pharmacies are a critical part of that solution. And with that in mind, we've long been supportive of pharmacies as well as pharmacists having the ability to have what we call expanded scope of practice: the ability for them to be able to vaccinate during a pandemic.

When we really think about the range of things that pharmacists are trained to do, and the fact that 93% of Americans are within 5 miles of a pharmacy, they're the closest type of health care in the United States to most people, especially those who are in rural or traditionally underserved communities.

For us, they're a critical part of all disaster responses. And as such, we have to make sure that first and foremost, they have the resources that they need to be able to continue to operate. That can be in the form of a business continuity plan or in an enterprise resilience plan, but what that really means is that not only do they have the training, but they have the resources and the coordination that they'll need to continue to operate.

And then, again, recognizing that they are a very critical linchpin, and being able to make sure that those communities that need that continuity of care have access, getting them the resources to be able to disseminate broader information.

And so that's been a big part of what we've done. For many years, I think it's about 12 years now, we've operated the Rx Open Map, which is a free service that allows for individuals to go online and see the status of pharmacies in their area. Thanks to the support from the AmerisourceBergen Foundation, we've actually expanded that to be able to include dialysis centers, which are another critical part of care for underserved populations. And we've been able to turn it on for the entire nation, for the entire pandemic.

When we're thinking about healthcare disparities, we want to make sure that first and foremost, we're understanding the needs of those populations and not treating it as a broad stroke, kind of everyone needs everything. But then also understanding that if we are actually focusing on avoiding medical crisis, the ability to continue the care that they're receiving, and possibly even improve the quality of the care that they're receiving, and the frequency of those touch points is critical.

Pharmacies are a big part of that. And 1 thing that I've actually seen pharmacies do, is actually engage in telehealth-based solutions and text messaging solutions that have also been able to increase the frequencies of those touch points. And so for those individuals who have access to technology, have access to broadband, that is an important part of how pharmacies have been a part of the answer for the last 10 months.

Lorenz-Fisher: Thanks, Nicolette. And it also seems like to a certain extent, we're seeing the pandemic actually escalate some of the technology utilization that maybe would have taken quite a bit longer had it not been for the terrible pandemic we're facing right now, so bit of a silver lining, but any thoughts on that?

Louissaint: Absolutely. I think one of the interesting piece of the stay at home orders for an organization like ours, our first thought was, “how are we going to get information out about emergency refills? How are we going to support pharmacies, in making sure that people understand, yes, you do not need 6 or 9 months of your medicines?” But let's get you that emergency refill, you can come in now and you can get that refill, and you can have an additional 30 or 45 days, and that that will be sufficient.

And that's actually I think where the role of technology started: really thinking about just how we're pushing out messages. And then in the interim, as you pointed out, the pandemic allowed for individuals to say, “okay, telehealth in the large scale, we're going to have this very dynamic web-based solution, that may not be what we need, right now.” We may just need a hotline. Or we may need a text based messaging system, where we're able to say, “we're going to be able to just text in a few questions and have kind of standard answers, or we're going to have something that's in between that, where you put in a request and someone calls you and then they determine if they need to get on Zoom or Skype to be able to examine you via video.”

And so I think what that did was it actually allowed for the concept of telehealth and the broad scale implementation to become practical in a way that actually increased the uptake. So now, my 82 year old grand aunt is telling me, “Oh, don't worry about me getting to urgent care, I'm just going to call my doctor, and I'm just going to get a telemedicine appointment.” And you know, she's 82, she barely texts me, but that is for her a very realistic way of being able to get care, and I think for most people, that's what we're seeing. It's no longer viewed as this access that's only afforded to some. It really has become a more accessible and more readily used solution because also people are already using these portals.

So they're already on Zoom. They're already on Skype. I think that's been a big part of it. And I know that a lot of pharmacists are working really hard to make sure that they are doing those routine touch points with so many of their patients, especially those that are older or have multiple comorbidities.

Lorenz-Fisher: Gina, would you mind sharing a little bit about how the foundation has worked to enhance access to care in underserved communities?

Clark: Absolutely. We have a series of safety net grant giving opportunities that we have activated to help provide patients with access to free charitable clinics. So these are for both the uninsured, but also the underinsured. That underinsured group, I think we sometimes jump over them, and they're very challenged in terms of they may not be completely uninsured and don't have access to some of those other federal products, but they don't have the money to pay for the care they need, particularly during a time like this.

We're really happy to have that opportunity to help fund those clinics. And even like an example that close to home, right in Chester County, Pennsylvania, we have a large migrant worker population, and we've been able to find access to care for that population specifically. I think it's so important to pay attention to those and look for those specific opportunities to give as well as more broad base giving, so the foundation will always be about access to care, and we will look for every opportunity to enhance and provide access to the best care possible.

Lorenz-Fisher: So we're gonna keep the conversation moving here and start talking a little bit about healthcare access amid natural disasters. So Nicolette, I'll go over to you.

A couple of minutes ago, you brought up the topic of climate change and how that is impacting the current pandemic. Well, we're also seeing impacts of climate change in natural disasters know intensity frequency have changed quite a bit over the past several years. And so as a healthcare company, we recognize that we have to be ready to respond no matter what, in any type of disaster. We're carefully addressing planning and taking bold steps to address climate issues. How is Healthcare Ready coping with this and helping communities to think about coping with this?

Louissaint: Sure. It's important that we're talking about this, we also think about what it means for the convergence of these events. We often remember 2017, we often think about Hurricane Maria. But often, we forget that 2 weeks before Maria, was Harvey, and Irma, and really some of the worst, at that time, California wildfires we had ever seen.

And so part of the challenge that we face is not just the intensity and the frequency of the events, but the fact that we are seeing more events happening at the same time, which is stressing our system and making it difficult for communities to prepare, because they're not clear on how much additional support they'd be able to get. That's been a big part of how we've been testing planning assumptions with communities, is to really look at what types of supports they will be able to pull together across their specific community, but then what they know they will need from the state or the federal government or external, national, or international partners, so that that can be very clear at the outset.

Also recognizing that when we are thinking about how we plan for events, we really have to take a step back and view it as a planning issue. And so a lot of our work has been around what we like to call resilience or community resilience based approach, which means that we have to work with local jurisdictions to actually incorporate their resilience plan into their cities plan. Urban planning, or community planning is really where it has to start.

We have to think about how we're building these communities and how we're building these systems, and then be able to prepare for the gaps that we know will inevitably fall from that because there will be gaps. And so that's been a big part of what Healthcare Ready has been doing over the last few years.

We've done quite a bit of work with cities like Baltimore, DC, Mobile, Alabama, some parts of Louisiana, really helping to think through how you incorporate planning into this perspective, recognizing that you're planning for the needs of your community, you're planning for the infrastructure that will be required to sustain their care, and then we'll be able to build a preparedness plan around it, and then we have to test it. But we have to test it in a way that really pulls in all of those vantage points. It's not about just how public health responds. It's about how the community is going to be engaged, how the faith-based organizations are going to be mobilized. Who's going to be able to go door-to-door and check on those who may have mobility challenges or access needs.

And so that is really how we've been going about it. And what we've seen even this year in California and Oregon and Washington is that it's really been the community that's been able to really stand in that gap. And so for our vantage point, everything we can do to bolster that is the appropriate response, we don't want to supplant it in any way. We want to make sure that they have what they need and that we're able to adjust and coordinate to bring in additional resources based on what insights they're sharing with us.

Lorenz-Fisher: Thanks, Nicolette, really great perspective there. And Gina, could you talk us through a little bit about how the foundation approaches natural disasters?

Clark: As a foundation, we again quickly pivot when these come up and the team is on it, the team does the research to understand where the need is the greatest. We are very conscious of where our associates are and where they're affected, and we have 2 to 3 vehicles via the foundation and our associate assistant fund to help them. But also in the vein of partnership and collaboration that I mentioned earlier, we partner with a number of organizations to respond. An interesting partnership is with the National Community Pharmacists Association (NCPA). We've partnered with them since 2019, with their disaster relief fund to ensure that community pharmacies that are affected by these are able to continue to give care and support community.

So just combine all of what we just talked about with Nicolette about the importance of pharmacies, and then understand that they're there under these dramatic disasters as well, and what kind of support can we give specifically to them, so they can continue to support the communities.

As tragic as the impact of COVID is, these natural disasters are tragic in and of themselves. I'm very proud that we, as a foundation, pay attention to all of those places where we can impact lives in a positive way.

Lorenz-Fisher: Thanks Gina. I would just close this out by saying thank you so much Nicolette for your time today and Gina for your time as well.

I think as a foundation we're so fortunate to have partners that are willing to talk about these really challenging issues with us, so we appreciate your perspectives and your time and ultimately all of the amazing work that Healthcare Ready does every day, Nicolette, so thank you for making the time.

And Gina thank you for your always fearless leadership of our company foundation. We've got a lot to be proud of and looking forward to bringing us all together again to see how things look in 2021. Hopefully it'll be a little bit different.