Pharmacists are on the front lines of dealing with the historic healthcare challenge that is COVID-19. Now, with a COVID-19 vaccine on the market, the battle moves to planning for and executing the massive effort to administer the vaccine to more 330 million people in the USA. We sat down recently with David Kirkus, PharmD, pharmacy consultant for EnlivenHealth™, to discuss his thoughts on how the COVID-19 vaccine will impact retail pharmacies and the role they will play in administering the forthcoming vaccine. Prior to joining EnlivenHealth earlier this year, David spent 18 years in pharmacy leadership positions, most recently at Publix.
How does COVID-19 impact pharmacies immunization administration?
I think it’s going to accelerate the demand for vaccines at pharmacies in general, which is already growing very rapidly. But, the COVID vaccine is going to be much more challenging from a management perspective. There will be a need to increase staff in order to support the current business of vaccinations, immunizations and prescription fulfillment, while also handling the administering of the COVID vaccine. Absent an increase in staff, the current staff will need to handle an increased number of tasks. This expanded workload underscores the huge need for improved efficiencies in the entire pharmacy process of vaccine administration. Pharmacies need solutions to streamline administration and make it more of an automated, electronic process so that pharmacists can do more with the same amount of staff they already have in place.
What is the biggest concern that retail pharmacies have regarding the COVID-19 vaccine?
I think safety is a concern across the board for retail pharmacies as far as being able to handle masses of people. We’re anticipating that a large percentage of the population is going to want the vaccine as soon as it’s broadly available, which is expected to be in the mid-2021 timeframe. As such, managing the increased patient demand and workflow, being able to process everything efficiently, and handling the additional reporting registry requirements required for COVID, all highlight the need for technology solutions to streamline these processes. In particular, there will be a challenge to pull in all the data elements from the patient, pharmacy and vaccine administration record that then must be combined and reported to the state registry.
What are the implications of pharmacies moving towards a year-round immunization strategy?
The concept of a year-round immunization strategy has been evolving and growing rapidly during the past few years. A great example of this is the Shingrix launch a few years ago. As a very effective vaccine for preventing shingles, a viral infection that you can get year-round and is also covered by Medicare, Shingrix really accelerated the public perception for pharmacies as a destination for all vaccines.
Another factor driving this year-round vaccine strategy is HHS’s recent national expansion of pharmacy’s ability to administer vaccines down to the age of three. This regulatory change enables pharmacies to reach a population that has a specific vaccine schedule that needs to be followed year-round. Now, I don’t think this will cause parents to completely replace pediatricians with pharmacists, but the convenience and trust of the neighborhood pharmacy definitely means that more people will go there for vaccinations of all types. The bottom-line is that pharmacies are becoming more of a vaccination destination, which means there will be an increased need for technology to streamline the workflow for this critical healthcare service. Without such technology, pharmacies just will not be able to efficiently and effectively handle the increased patient demand.
Do you think most pharmacies will require appointments to get the COVID vaccine, or can they just be walk ins like with flu?
I think for the COVID vaccine, appointments are going to be much more critical. Not having to make an appointment is hugely convenient for patients but given the logistical and safety concerns associated with COVID-19, that’s going to be a challenge. Pharmacies will have to know who is coming in and how many patients they’ll be seeing in a day to ensure that they have the correct number of doses and that they can maintain a safe, socially distant environment within the pharmacy. There will also have to be some risk stratification initially to make sure that vaccines are given out to the appropriate patients first based on health factors. All of that said, I think there will probably be some balance between requiring an appointment and allowing walk-ins.
I do think that the concept of making an appointment to see your pharmacist is something that can only benefit the profession and the patient – and I’m really excited about that. The appointment will help to shift the vaccine administration from a transaction-based encounter to a true value-based opportunity where the pharmacist can consider the patient’s entire medication profile and review their medication adherence and other health factors. It really empowers pharmacists to practice at the top of their license, which is a major goal for our profession, one that leads to significantly improved health outcomes.
What is EnlivenHealth™ doing to help pharmacies prepare for the eventual COVID-19 vaccine right now?
EnlivenHealth’s CareScheduler is the best, most comprehensive vaccine solution that exists in the marketplace. I say that because the solution approaches the issue of pharmacy appointment scheduling very holistically. It enables the pharmacy to proactively reach out to patients while also allowing the patient to reach out to the pharmacy organically through their website. In this way, patients can use convenient digital channels to both schedule an appointment and provide all the health questionnaire information and consent electronically prior to setting foot in the pharmacy. It allows the pharmacist to transform the inefficient paper process of documenting the administration record into a fast, convenient electronic process. The CareScheduler tool will then take all the data elements that must be reported to the immunization registry, pulls all the necessary information from each source, and automates the reporting. In effect, CareScheduler automates the entire process and makes it dramatically more efficient and convenient for the patient and pharmacy.
Additionally, the more appointments pharmacists have scheduled in advance the more they can effectively manage and forecast required staffing assets. The CareScheduler solution also allows for proactive inventory management, making sure there is enough vaccine on hand to administer to all the patients scheduled for that day. These are all real issues that pharmacists are going to face in the early days of COVID vaccine administration.