Parawell: Redefining Pharmacy Care
Healthcare terrain has been fundamentally altered through recent seismic shifts in consumer perspectives, provider roles, technology integration, and pressures along policy and payments fault lines. A recent commentary through the New England Journal of Medicine goes so far as to imagine an entirely new typology of primary care, segmenting based on care delivery modalities as opposed to more traditional differentiators like provider type. The authors explore evolving difficulties in primary care delivery because of system stressors like an aging and dwindling primary care workforce, and shifting patient utilization patterns.
Among the most evident ongoing evolutions is in the pharmacy profession. Traditional viewpoints are expanding to recognize the myriad skills pharmacists contribute to healthcare delivery and patient care. No longer are pharmacists solely defined as dispensers and managers of prescriptions. Rather, these highly trained and highly skilled health professionals are being elevated to fulfill a more engaged, patient-facing role in care delivery.
These trends support a model of pharmacy care that is far less transactional and much more longitudinally invested in the personalized wellbeing of the patient, benefitting from enhanced access to patient health information and medical records, care teams, and the same depth and quality of resources that are generally available in medical settings.
Consider, for example, the topic of continuity of care. For as long as we’ve been in this modern era of healthcare delivery, continuity of care has been a concern, with potential solutions offered including electronic health records, Accountable Care Organizations, promotion of the “medical home,” and more. However, none of these has really created trackable continuity that truly follows the patient regardless of setting or clinical need. The reality remains that existing electronic health record (EHR) systems historically have not been designed for interoperability, though currently there are external policy pressures to amend that. And multiple prescribing or episodic providers caring for the same patient may have limited awareness of a patient’s full health or medication history, and may inadvertently issue a prescription that is contraindicated to a product the patient already uses. Verbal or written health histories taken at intake are potentially incomplete. Our overarching system still prioritizes volume over baseline wellness. These factors and more mean that continuity of care has, thus far, remained mostly a nice idea.
There is ample discussion that pharmacists can contribute to this issue through services like medication therapy management, often referred to as MTM. While helpful, this only goes so far. To fully realize their roles as participatory, skilled, connected members of a patient’s dedicated care team, pharmacists can and should be granted more comprehensive access to patient health information that informs outcomes-oriented and consistent engagement. Driven in part by the circumstances created by the pandemic but originating in mounting concerns about the longstanding fragmentation, inaccessibility, and inequity within U.S. healthcare on a larger scale, more policymakers, providers, payers, and certainly patients are demanding a better way. That better way rests in understandings of value framing care, and in forward-looking emphasis on population health and prevention.
Health in Motion Network, through our Parawell pharmacy platform, is positioned, and already underway, to help evolve pharmacists’ day-to-day through consolidated, real-time, secure patient health information access, embedded tools to streamline patient and care team communications, and access to resources to add greater efficiencies into practice workflows while optimizing the logistics supporting a patient-provider relationship. Equipping pharmacists to function as continuing, committed health providers for patients in all settings, including home-based care, ambulatory, urgent/emergent, hospital, chronic and long-term care, contributes meaningfully to that elusive goal of continuity of care. Their talents, including MTM and services like disease state management and lifestyle coaching, are directly relevant to ongoing priorities to better integrate value-based care systems. These strategies amplify pharmacists’ reach, enable their clinician colleagues to similarly focus on their most pressing professional responsibilities in a collaborative way, and empower patients as active influencers of their own wellbeing.