50 Stories from 50 States - Southwest

Arizona - University of Arizona

Description of Pharmacy

The location of Hickman’s Egg Farm is in Arlington, AZ, which is a town estimated to have a population of only 160. Its employees travel from outside of this small town from the surrounding towns and cities. While the population is 55% white, the remaining 45% of the population is Hispanic. The per capita income is estimated to be $30,834 on average. About 59% of the household income in this area is under $50k.  

Pharmacy Story

Vaccine hesitancy continues to be a barrier to Covid-19 vaccination during this COVID-19 pandemic. Dr. Henry, a pharmacist at CVS, as well as a preceptor for students on IPPE and APPE rotations, provided opportunities to her students to address vaccine hesitancy. Her students were able to travel to various Covid-19 vaccine clinics, many of which were in rural, low-income communities with patients experiencing language barriers. This not only allowed for the students to practice vaccinating, but it also provided an opportunity for the students to counsel the patients on what to expect from the vaccine as far as side effects and address any issues surrounding vaccine hesitancy.

During many of these clinics, the University of Arizona College of Pharmacy partnered with the College of Public Health and through a collaborative mobile health unit, faculty, students, and volunteers were able to provide efficient and effective vaccination services, all while creating a healthier community and protecting as many people as possible from coronavirus. There were plenty of Spanish interpreters at each clinic, and, considering that 31% of Arizona’s population is Hispanic, this allowed for a more comfortable and relaxed experience for the patients receiving vaccinations. Through this interprofessional teamwork, the environment created for the patients was one that was warm, welcoming, and safe.

While some of these clinics may not have vaccinated large numbers of community members,  Dr. Henry, her students, and volunteers from both colleges were able to travel to the patient rather than expecting the patient to travel to the provider. One specific example of this was a vaccination clinic that took place at Hickman’s Egg Farm. Bringing the Covid-19 vaccination clinic to the patient allowed for the patient to worry less about taking time out of his or her day, or worse, taking a whole day off work, to go get the vaccine. Instead, the patient was able to just take 20-30 minutes out of his or her workday to go get the vaccine and then promptly return to work.

Although this story does pertain to vaccinating the public against Covid-19, the teamwork used, and the effort put in to creating a friendly environment can be something to strive for at any communal location when healthcare providers are interacting with the public. Effective counseling, whether it be for a patient picking up a new prescription, or, in this case, answering questions about a vaccine, is an essential skill to have and be able to practice whenever possible. This will allow for a healthier and safer community overall and create trusted patient-provider relationships. 

State/Federal Connections/Advocacy/Impact:

The Arizona Medical Association has a website with links for information about the Covid-19 vaccine, how telemedicine could be a new and viable option for patients who are still hesitant to go into public, advocacy efforts Arizona physicians have done during Covid-19, and  the latest news and guidelines about the virus. Publicly available information such as this provides crucial information to communities not only about the virus and the vaccine itself, but also how and what healthcare professionals are doing on their end to ensure the public is as safe and protected as possible. 

Texas - University of Texas and 38th Street Pharmacy

Description of Pharmacy

38th Street Pharmacy is a family-owned and operated pharmacy located in a medical complex in Austin, Texas. The pharmacy serves a variety of patient populations with different demographics varying in age, ethnicity, culture, income, and health literacy. Individualized care is prioritized with each patient as the pharmacy provides MTMs, autofill, and med sync to optimize patients’ medication regimens. 38th Street Pharmacy also works with the organization Integral Care and its case workers in Austin to give patients living with mental health or substance use disorders access to medications. In addition to providing these services, the pharmacy provides medications to medical offices in the area. 38th Street Pharmacy has relationships with multiple providers in the area, such as family practice physicians, therapists, and caseworkers that will be a resource for patients. These providers can refer patients to the pharmacy and help increase eCare plan output. Lastly, the pharmacy offers free prescription delivery for eligible patients in the Austin area.

Pharmacy Story

38th Street Pharmacy in the process of becoming DSME certified to implement diabetes education to patients and utilize eCare plans, a documentation system for pharmacists, into their workflow. Patient DF has been with 38th Street Pharmacy for over 3 years and currently lives with type-2 diabetes (T2DM). The goal for 38th Street Pharmacy is to help DF with adherence and education about her diabetes. DF happens to be the patient that the pharmacy is utilizing during their Diabetes Self-Management Education (DSME) accreditation process.

The first step was to gather a comprehensive medication review and talk with DF about her medication regimen. After discussing her medications and T2DM, we followed up with DF and educated about continued adherence, discrepancies found, and answered any questions she had. Since the pharmacy is not yet accredited, we were not able to submit an eCare plan to CPESN. However, the pharmacy staff documented DF’s CMR encounter within an eCare plan template that was created in the pharmacy’s software system (PioneerRx). This encounter was a learning experience for the pharmacy by allowing them to practice the process of developing an eCare plan. University of Texas (UT)-National Community Pharmacy Association (NCPA)’s Ryan Hoffart and Prof. Terry Weaver met with Dr. Warnken on November 10th, 2021 to discuss eCare plans within PioneerRx and workflow challenges. Dr. Warnken had completed a rotation at PioneerRx and was familiar with their templates for eCare plans.

Since the pharmacy is in the early stages of implementing these services, they plan to start with this patient and monitor her outcomes. They will adjust to become more efficient and find the best way to continue normal pharmacy services and add diabetes education into their services in hopes of improving medication adherence and glucose monitoring as well as lowering A1c.

Currently, 38th Street Pharmacy is starting with a single patient and will optimize the process of conducting eCare plans within their pharmacy as they work on their DSME accreditation process. This time will be used to build efficiency within the pharmacy workflow and be able to provide personalized care to individual patients. Once the pharmacy has established a workflow, they hope to offer diabetes management services to more patients including group classes on diabetes education and helping individuals reach their goals. DF benefitted through this early encounter by gaining a better knowledge of her medications, disease state, and management of T2DM.

State/Federal Connections/Advocacy/Impact:

CPESN Texas supports quality-based services and helps pharmacies contract through insurance to bill for DSME services. With help of UT-NCPA, 38th Street Pharmacy will soon offer DSME enhanced services to better patient outcomes with T2DM. However, without support from local contracts with insurances and 3rd party payers, these services would not be available for reimbursement. As CPESN USA has evolved to help pharmacists through the pandemic and offer services beyond dispensing prescriptions, pharmacists are gaining more credibility in the healthcare field. This newfound recognition should provide valuation at the state and federal level to continue the advocacy for reimbursement at the pharmacy level for enhanced services. 38th Street Pharmacy looks forward to continuing to grow their enhanced services and expand their patient outcomes in DSME. 38th Street Pharmacy has also received Federal allocations for the COVID vaccines through CPESN USA. A pharmacist at 38th Street Pharmacy, Dr. Matt Warnken said, “CPESN is a wonderful organization for independent pharmacies to join as it supports and helps pharmacies offer enhanced value-based services to their patients.”