Traci Poole, PharmD, BCACP, BCGP: The medical billing was quite cumbersome. If you are a smaller operation and you have no one set up to handle whether you are being paid for those claims or whether you are billing those claims properly, and you have a good relationship with the medical debtors then it has it made a little more difficult for those with a smaller staff. For those with a larger staff and who are already used to medical billing for DME [durable medical equipment] and other things like that, it’s probably just another day for them. You just add things. But the volume was a bit problematic. On the plus side, the reimbursement is a bit better with medical billing. Sometimes it pays off in that case.
In my practice, we use a system that is popular with independent pharmacies. We have the option to do a 2-way pull. Our system speaks to the national register and vice versa. It’s an extra fee on top of everything, but it helped us a lot to be able to watch very quickly. However, there is a little delay. It’s not always filled in the system for that second dose in the series and things like that. It’s been extremely helpful when patients lose their cards and things like that, where you try to confirm things. That has helped tremendously.
Overall, COVID-19 has completely expanded the use of registries. Ed and I talked earlier about the H1N1 pandemic and having to record those doses. At the time, those state records were pretty new, and now it’s in much of the verbiage that we use constantly. It is a requirement of most state health departments. That’s another positive of the addition of an added workflow. The automation makes it so much easier to do that.
Ed Cohen, PharmD, FAPhA: Are there other ways pharmacists can track patients’ immunization status for COVID-19 and other routine vaccines?
Lynette Chastain, PharmD, BCACP, TTS: One thing we’ve forgotten since the beginning of this immunization push is that we said a lot “be safe”. We encouraged it with everyone. We have forgotten that over time, and our patients have forgotten that they ever registered too. Especially as we start to immunize more of the population, it might be a good idea to amplify that and make sure they get that handout because that keeps track of all their COVID-19 doses and gives them the ability to present. that if they go on a plane trip or something like that, because that can be a motivating factor. They don’t want to give the government their information, but they do want to fly, so that could encourage their use.
We also use the programs that Dr. Poole was talking about, regarding the instant retrieval of information in our outpatient setting. That was helpful, along with the use of state registers. That’s about it. You can encourage them to use that card, but people lose things. That’s what we used. Our state registry has the ability to print what they are intended for. It will print what they have had and at the top what they still have to pay for. When I worked in retail, we often printed that and gave it to the patient and showed them other offers so they were aware of it. Even if they decide not to make it at that point, it’s good for them if they can come back.
Ed Cohen, PharmD, FApha: Which brings me to 1 additional question. When I go to the counter and approach my patient, I have a piece of paper in my hand that says which inoculations the patient has had and which inoculations are recommended. What do patients think if we can get that information proactively? Instead of asking, we tell. What kind of reactions do you get? Sure, you get a few people saying, “Thank you,” but do they all say that?
Wesley Nuffer, PharmD, BCPS, CDCES: That’s an important transition in what I see community pharmacy practices on the way. We have to be very proactive in this space. I see the community pharmacist of tomorrow as concerned with the health of the entire patient around their medicines, of which vaccines are 1 part. There is some skepticism. Sometimes we hear, “My doctor usually treats this. Is this your job?” It’s no different than taking a blood pressure in a community pharmacy or doing a lipid panel, these are areas that some community pharmacists have picked up and done a great job.
I do believe that we are educators. We are now producing pharmacists who are highly trained in doctoral programs, and they should be able to use their skills and abilities to have these conversations and show the patients that these are the things we should be doing. You see your pharmacist more often in a year than any other health care professional. These are the conversations we need to have. I feel very passionate about that, and that’s why I like your example, because I don’t think we should wait for them to talk to us. We need to proactively engage with them.
Traci Poole, PharmD, BCACP, BCGP: Wes hit the nail on the head with the educational piece of why we have that information, why it was given to us, and what role we play outside of your doctor’s offices. I’ve often said that we almost have a little PR problem that the public doesn’t know what we’re doing. COVID-19 brought pharmacists, especially community pharmacists, to the forefront of the knowledge that they don’t just count pills. There are other things they do. The educational part of what we’re asking for is a huge part of buy-in and trust.
Lynette Chastain, PharmD, BCACP, TTS: If you talk to a patient while they are getting their COPD medicine [chronic obstructive pulmonary disease] or asthma, which can be a good chance to say things like, “This puts you at greater risk for pneumonia. This vaccine would help you stay out of the hospital.” Explain why it is necessary.
Transcription edited for clarity.