ONU Healthwise Mobile Health Clinic brings needed services to underserved county

BY Vivian Lee

ADA, Ohio — What happens when the community can’t simply walk a few steps or drive a short distance to a local pharmacy?

Hardin County, Ohio, is a rural expanse with barriers to healthcare access that have rendered it a medically underserved area with a shortage of primary medical care health professionals. The College of Pharmacy at Ohio Northern University understood that given the county’s extensive elderly population and high poverty rates, the people of Hardin couldn’t easily get to a pharmacy or clinic. The ONU College of Pharmacy team would have to take the clinic to them.

This desire to do good for the people of Hardin by addressing their substantial healthcare needs led the team to seek and obtain funding — secured in April 2015 — from the Health Resources and Service Administration for an innovative mobile clinic patient care program that provides much-needed pharmacy and healthcare services to the county’s underserved population.

Amy Fanous, the director of the HRSA-funded mobile clinic, discussed with DSN the extensive planning that went into bringing the project to fruition and what the immediate future has in store. “The desire to contribute to the local community continues to drive this project. As an institution of higher learning, it is essential that we lead the community beyond our campus borders,” she said. 

“Common statistics demonstrated great need we wanted to further explore. In Hardin County, 14.6% of the population is older than 65 years and 28% is 19 years or younger. Thirteen percent of the population does not have health insurance, while 31% are insured through the Center for Medicare and Medicaid Services. According to the Behavioral Risk Factor Surveillance System, 19.6% of Hardin County residents rate their health as fair or poor compared with a state average of 15.3%. A number of factors are relevant to the county ranking 53rd of 88 Ohio counties in overall health outcomes and 73rd for premature death.”

Planning the mobile clinic took two years. The team did not rely solely on their good intentions, and made sure to get concrete feedback from the very community they aimed to serve. Doing so has allowed them to develop a more robust program that is better prepared to fulfill its mission and that patients can actually use and depend on.

After conducting a community health assessment in 2013, the team talked with Hardin County citizens in the fall of 2014.

“These direct conversations were extremely useful because they allowed us to hear firsthand what the real health issues in our county are,” explained Fanous. “Community members told us that health issues in Hardin County included limited access for patients to physicians and other primary care providers, transportation problems accessing existing medical care providers and difficulty with understanding and managing chronic medical conditions.”

The clinic was operational by September 2015. Fanous said that the longer she spends time in the community holding consistent events at the same places, such as the food pantry or a community dinner, the more trust and rapport she builds with the people and the more patients the clinic sees.

“These community relationships are essential,” she added. Trust is indeed essential to the success of any community pharmacy, and the mobile health clinic has invested the time and effort needed to establish it.

Services offered include cholesterol, glucose, hemoglobin A1c, blood pressure, bone density and skin scope screenings; United States Preventative Services Task Force screenings; immunizations; tobacco cessation; medication reconciliation; and education on a variety of health topics. All these services offered at no cost to the patient. The clinic is staffed by pharmacy residents and pharmacy students. Additionally, there are opportunities for nursing, clinical laboratory sciences, exercise physiology and students from each discipline at Ohio Northern, which provides students with authentic training and patient care experiences.

To increase access to care, the mobile clinic heads out to various locations throughout the county three to four days a week during hours convenient to the people of Hardin. The clinic sets up at churches, community buildings, businesses and schools, including the Hardin county fair grounds, the Kenton-Hardin Health Department, the Forest EMS Building, the Plaza Inn in Mount Victory, the Dunkirk EMS Building, the Roundhead Post Office, Hardin Northern Local Schools, Ridgemont Local Schools, Upper Scioto Valley Local Schools, Ada Exempt Village Schools, Ada Presbyterian Church and Ohio Northern University.

“We choose locations based on community partners and those that are convenient for the patients. Keeping lack of transportation in mind, we try to cover as much of the county as possible. Our entire county is rural, but some locations are more remote than others. For instance, the Roundhead Post Office is in Roundhead Township — the entire township only had a population of 752 according to U.S. Census Data in 2000,” Fanous said.

The mobile clinic has been very well received by patients and community partners alike. In fact, the team is expecting the arrival of a new vehicle, which will allow them to cover more of the community and attract new community partners. Existing partnerships with Hardin Memorial Hospital, Kenton Community Center and the Kenton-Hardin Health Department have also expanded: Primary care and specialty providers from these places plan to head out in the mobile clinic with the pharmacy team.

Given the clinic’s success so far and the need that exists across the nation, Fanous agreed that other colleges of pharmacy could develop similar programs based on ONU’s model.

“Services that improve access to care are needed in many rural communities. A mobile clinic, using a multidisciplinary team of healthcare providers and students, is an option for improving access to care,” she said. “The concept of ‘bringing health care to the people’ is feasible in many settings. Any outreach that consistently provides care for patients outside of a medical facility would serve this purpose. Periodic, rotating mobile care sites in the community that use existing facilities can easily be implemented with proper supplies, personnel and time.”

And colleges of pharmacies are in a unique position to address any potential shortage of healthcare professionals by mobilizing health profession students that need hands-on experience.

“Although a workforce of professional students may not be available in all rural communities, many health professions training programs exist in states with vast rural areas,” Fanous added. “It is feasible to recruit groups of students from nearby universities, such as students on clinical rotations or outreach activities, or using a pool of healthcare volunteers to boost the workforce. Additionally, use of professional students allows the mobile clinic services to provide a dual role as a focused, high quality learning experience in addition to providing enhanced patient care.”

Fanous believes that that a better understanding of the community and its people helps create better pharmacists.

“To provide care to people, you must first understand the issues they face, and you can’t gain that comprehension until you get out in the community,” she stressed. It certainly provides pharmacy students with the experience they need so they can work in whatever setting they choose once they graduate. Students also see for themselves that behind the statistics in Hardin County are real-life people with real-life problems — tapping into the humanity teaches them compassion and patience that together with their skills and experience will allow them to build their own meaningful relationships with patients. “Students also learn that every person is unique, and the way they respond as pharmacists and healthcare providers must also be unique for every situation. … We fill needs — not prescriptions. The mobile clinic is a perfect opportunity for our students to live that mission.”

This article was originally published on Drug Store NewsContinuing Education site as part of the Drug Store News Community Pharmacy Quality and Performance Spotlight. If you know of a deserving pharmacy team that works hard to drive adherence and outcomes, click here to nominate them.


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CVS Health’s Moriarty: Pharmacy services, clinics can cut Medicaid costs, improve outcomes

BY David Salazar

WASHINGTON — At the POLITICO Pro Health Care Briefing on Medicaid as a Driver of Care Innovation in the States Tuesday, CVS Health chief policy and external affairs officer Tom Moriarty shared with attendees CVS Health’s efforts to bring better value for patients to the healthcare system.

From the outset, Moriarty highlighted the role that pharmacists can play in helping reach patients with chronic conditions and improve their adherence through personalized interactions. He pointed to a Health Affairs study that found one-on-one counseling from pharmacists can improve adherence and save $3 for every $1 invested in these efforts.

“Through personalized counseling and clinically-effective interventions, pharmacists are a trusted voice in helping patients with chronic conditions like diabetes and cardiovascular disease manage their medications,” he said.

Two key efforts that CVS Health uses to reach patients are its Transform Diabetes program — which provides personalized support and one-on-one counseling, as well as MinuteClinic comprehensive diabetes visits, a connected glucometer and access to digital tools — and its Pharmacy Advisor program. However, Moriarty noted that not all Medicaid Quality Programs include adherence and medication management measures in their pharmacy benefits.

He also pointed to the opportunity for affordable care that CVS Health’s MinuteClinic locations offer Medicaid beneficiaries. In fact, Moriarty noted that MinuteClinic is an enrolled Medicaid provider in 31 states and the District of Columbia, and that its availability at more than 1,100 locations can have an impact on patient health and costs.

“Through affiliations with 70 major medical systems, we can facilitate joint clinical programs and real-time integration of electronic health records, enabling coordination across providers,” Moriarty said. “Research shows that patients who use MinuteClinic make fewer ER visits, and overall their health care costs are about 8 percent lower.”

Moriarty also highlighted efforts that CVS Health’s Caremark pharmacy benefits manager makes to deliver lower cost prescription drugs, particularly in Ohio, where CVS Caremark worked with Ohio Medicaid’s managed care plans to control costs.

“As a result, Ohio spent 13.3 percent less — on average — than states without prescription drugs in their managed care system and earned higher average quality scores than the national and state averages,” he said. “These strategies can play a significant role in delivering value, but Medicaid programs need to be structured in a way that reward and incentivize better outcomes.”

He called for a consistent set of quality measures alongside meaningful incentives as a methof to improve health outcomes and drive Medicaid savings — both on the federal and state levels

“We must also recognize the important role that pharmacy management and medication utilization play in health outcomes and the total cost of care, particularly for those with chronic disease,” Moriarty said. “Including pharmacy programs and incentivizing medication adherence ultimately delivers better value to patients and taxpayers through better health outcomes and lower costs.”


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Upsher-Smith’s McBride given HDA Research Foundation’s Nexus award

BY David Salazar

PHOENIX — The Healthcare Distribution Alliance’s nonprofit HAD Research Foundation has awarded Upsher-Smith Laboratories’ VP partner relations Mike McBride its 2017 Nexus Award for Lifetime Achievement.

The award — which was given by the foundation, alongside Genentech and Mylan at the HDA’s annual Business and Leadership Conference — recognizes character and professional accomplishments, as well as leadership in HDA, the industry and the community.

“For more than 60 years, the Nexus has recognized extraordinary supply chain leaders,” HDA president and CEO and HDA Research Foundation president John Gray said. “HDA and the HDA Research Foundation are pleased to continue the proud legacy of the Nexus Award by recognizing Mike McBride — a consummate team player and champion for trade relations — with the distribution industry’s highest honor.”

Mike McBride

McBride began his career at Upsher Smith in 1988 as a consumer sales associate and rose through the company to lead its national account team. He helped grow the company’s product lines as it added branded pharmaceuticals to its generics portfolio, and he played a key role in establishing its consumer products, managed markets and institutional sales teams.

In 2005 he began his work in an industry relations role, helping build Upsher-Smith’s trading partner relationships. In his current role, McBride works to establish and grow relationships with chain, wholesale and other partners to support product developments. He also helped facilitate Upsher-Smith’s divestiture of its AmLactin brand to Sandoz in late 2016.

“For almost 30 years, Mike’s leadership — driven by his ability to connect with colleagues and collaborators, and tireless dedication to advancing industry excellence — has not only benefited Upsher-Smith, but the entire supply chain,” Upsher-Smith president Rusty Field said. “All of us at Upsher-Smith are lucky to work with Mike every day, and thrilled that HDA has recognized his unique vision and talents by presenting him with the 2017 Nexus Award.”

McBride has been involved with HDA and other pharmaceutical supply chain organizations for more than 10 years and has been a member of its industry relations council, as well as its manufacturers’ government affairs advisory committee, among other working groups. Because of his work, Upsher-Smith has been recognized multiple times with HDA's DIANA awards, and it was named HDA’s Manufacturer Partner of the Year in 2014.

“Over the past decade that I have had the pleasure of working with him, Mike has shown great passion for his industry, at many times serving as a sounding board for his fellow trading partners,” HDA EVP industry relations, membership and education Perry Fri said. “Quite simply, he is an exceptional person and the embodiment of what the Nexus represents for the pharmaceutical supply chain.


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