Walgreens’ continued transformation into comprehensive health solutions provider is an opportunity for all

BY Michael Johnsen

Beginning July 1, Walgreens will be able to provide tube feeding services to Medicare patients in 97 of 100 competitive-bidding areas nationwide, the healthcare solutions provider announced last week. The contracts are up for renewal every three years. 

This is just another example of how Walgreens is transforming its pharmacy business into a center for healthcare solutions — this goes far beyond dispensing and ultimately aims squarely at reducing hospitalization costs, another way that Walgreens is helping payers bend the cost curve. It begs the question: Should traditional suppliers be thinking about the role their products can play as Walgreens develops new business segments like infusion services?

The underlying question is whether those patients — who may need nutrition information and possibly education on how to better manage a chronic condition — can make a difference to your business. 

Approximately 40,000 PN patients and 344,000 EN patients each year receive their nutrition therapy at home.

Walgreens has certainly proven its services help generate positive outcomes. According to a joint release from Walgreens and the American Society for Parenteral and Enteral Nutrition issued earlier this year, Walgreens’ home nutrition support team interventions improved patient care and potentially prevented an estimated 429 hospital days over a three-month period. The cost savings of those interventions were estimated at more than $850,000. 

The study included data from 16 Walgreens Infusion Services offices, with 2,500 enteral nutrition patients and 270 parenteral nutrition patients on service during the study period. Interventions were performed by the Walgreens Infusion Services home nutrition support team, which includes nurses, pharmacists and dietitians who work closely with physicians to provide care to both EN and PN patients. 

The patient-centric multidisciplinary approach to care enabled the teams to identify therapy complications and intervene. There were 373 total interventions completed during the three-month study, including correcting over/underfeeding, preventing dehydration, reducing/eliminating diarrhea, managing hyperglycemia, managing electrolyte imbalances, transitioning patients from PN to oral eating, and starting patients on PN therapy in the home instead of in the hospital.





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With its pharmacists moving out front, Walgreens boosts role of technicians

BY Jim Frederick

With a striking new pharmacy design and workflow system that pulls the pharmacist out from behind the counter and right into the patient waiting area, the nation’s top pharmacy retailer is helping to drive healthcare reform and the accelerating revolution in pharmacy-based patient care. And in the process, Walgreens also is dramatically elevating the role of its more than 37,000 pharmacy technicians.

Those changes are driven by the company’s still-unfolding transformation from traditional drug store retailer to full-service “destination for health and daily living” focused on delivering “a complete ‘well experience,’” according to Walgreens president and CEO Greg Wasson. To that end, Walgreens has developed a dramatic new store and pharmacy design from the ground up. Called “Well Experience,” this design marks a radical departure from the past and a bold commitment to the company’s ramped-up health-and-wellness mission.

“These stores bring together new urban retail design concepts, enhanced product assortments, innovations in our pharmacies and health clinics, improved customer engagement and new e-commerce technologies from our multichannel strategy,” the company reported. “All position Walgreens to step out of the traditional drug store format.”

Among the innovations embodied in the new store concept is a major shift in the way pharmacists and pharmacy technicians perform their tasks. Pharmacists now are engaging more directly with patients in front of the pharmacy counter, connected via laptop or tablet technology to the main prescription-processing and patient-record system inside the pharmacy. Technicians are taking on a significantly enhanced role in the prescription-dispensing process behind the counter. Many of the Well Experience stores also feature Take Care walk-in health clinics adjoining the pharmacy, staffed by nurse practitioners who can prescribe some medications and work collaboratively with the pharmacist in a more holistic approach to a patient’s health regimen.

“We’re moving our pharmacists from behind the counter out to where … they’re able to talk with our patients,” explained Kermit Crawford, president of pharmacy, health and wellness services and solutions. “We are deliberately transforming the way we practice pharmacy from a transaction-based environment to one that is more about patient relationships.”

The goal, said Nimesh Jhaveri, the company’s executive director of pharmacy and healthcare experience, is “to move out of the traditional drug store business, … play a larger role in people’s healthcare journeys, and create a differentiated experience in terms of retail footprint.”

“In order for us to truly do that effectively, we had to change our core business and the profession along with it,” Jhaveri said.
“The goal was to get the pharmacist to play [a] larger role in health care [in such areas as] adherence, medication therapy management and immunizations,” he explained. “But in order for us to do that, we have to take the pharmacist out from what they do today, which is preparation and filling of prescriptions, including all the administrative tasks like insurance billing and phone calls. So, in essence, we took the clinical aspects of pharmacy and the production aspects of pharmacy and completely separated them. We put the pharmacists on the clinical side and the technicians, who are all certified and trained, on the production side.”

“In addition,” Jhaveri added, “we had to take some of the tasks that pharmacists do and either virtualize them — meaning putting them onto a technology platform to help them — or take those tasks out of the store. So, in some locations, we have centralized phone calls and third-party billing and data entry of prescriptions at a central facility … to give the time back to our pharmacists and our technicians to spend time with patients.”

Technicians in the new format pharmacies have received additional training and are all fully certified by the Pharmacy Technician Certification Board, Jhaveri said. What’s more, they’re working with enhanced technology and advanced techniques for assuring the accuracy of each prescription at every step in the dispensing process, including working on just one prescription at a time and using digital photography to capture, record and transmit on-screen images of “the tablets, the tablets inside the bottle, the bottle itself, the label, the receipt — everything they take pictures of,” Jhaveri said. “And everything is bagged in one prescription at a time to improve quality. [The completed script] is then transmitted to the pharmacist via their computer system or tablet for final verification.”

The new workflow system marks a clearly defined set of roles for pharmacists and techs, Jhaveri said. “The area where the pharmacist now works is all about care and outcomes,” he noted. “Where the technicians work is about quality and efficiency. And when you combine those two areas together, you get highly efficient, high-quality service and care. But everybody has to do [his or her] part.

“When you look at baseball, everybody has [a] position,” he pointed out. “If everyone plays their position extremely well, that’s how we get a team to perform at the highest level. We have our nurse practitioners, our pharmacists, our pharmacy technicians and our pharmacy cashiers. All of them have positions that are vital to patient care.”

Internally, Walgreens dubs its new pharmacy workflow and layout designs as “Project Bridge,” and calls the effort “a bridge to the future,” Jhaveri said. “Project Bridge is really the healthcare component of the Well Experience stores.”

Since creation of the Well Experience format in 2010, Walgreens has opened more than 400 of the new concept stores around the United States, said company spokesman Jim Cohn. In those pilot stores, he said, “we have seen … a significant increase in the number of pharmacist consultations just by virtue of the pharmacist being out front and more accessible.”

Jhaveri said, “We’re seeing a higher level of engagement, with almost 49% of the patients [in the Well Experience stores] talking to the pharmacist and approaching them to ask about everything under the sun — including their medications, health conditions and prescription regimens.”
Even more striking, he added, is the fact that a significant number of Walgreens’ customers in those new concept stores are looking for even more. “From what we can see, 11% to 15% of patients in those stores are looking for a private consultation,” Jhaveri enthused. “That’s one of the reasons we put a private consultation room in those stores. It respects the privacy of our patients.”

In line with Wellness Experience, Walgreens also is working to overturn outdated and unnecessary state regulations governing pharmacy practice that hamper the kinds of practice advances and patient-care efforts encompassed by the new pharmacy format and workflow. “Believe it or not, there are states that actually have indicated in their regulations how far a pharmacist can be from a technician,” Jhaveri noted. “So part of this effort also is helping boards of pharmacy and legislators understand that if you want to advance health care and pharmacy, you have to be willing to move forward and train technicians to do more. And there’s technology today that will allow a pharmacist to supervise a technician and what they do with very little effort.”

The changes being pushed by Walgreens dovetail neatly with efforts by the pharmacy technician community itself to raise the bar on techs’ training, skill level and qualifications. To that end, the PTCB unveiled changes in its certification program earlier this year aimed at boosting techs’ qualifications and capabilities.

The new, higher certification standards will be phased in over the next seven years. “PTCB is elevating our certification requirements in order to meet the demands of the evolving healthcare system,” said PTCB executive director and CEO Everett McAllister. “We have made bold decisions on what will be required for candidates to become certified pharmacy technicians.”

The organization, McAllister added, “is sharply focused on ensuring that the PTCB program prepares CPhTs for the integral roles they play in supporting pharmacists in all practice settings.”

The new requirements, PTCB announced, will include additional education courses in such topics as medication safety and pharmacy law, as well as a mandatory criminal background check.


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Giant-Carlisle sponsors diabetes fair

BY Alaric DeArment

CARLISLE, Pa. — Free health screenings, a weight-bearing exercise and other activities will be featured at an upcoming diabetes fair sponsored by Giant Food Stores, the supermarket chain said.

Giant, the Ahold USA banner based in Carlisle, Pa., and also known as Giant-Carlisle to distinguish it from fellow Ahold chain Giant Food of Landover, Md., said it would partner with Pinnacle Health, Capital BlueCross and the American Diabetes Association to offer the "Living with Diabetes" event at a Harrisburg, Pa., store.

"More than 25 million people in the United States today have diabetes, and 79 million have prediabetes," Giant nutritionist Sarah Glunz said. "We encourage both those who have already been diagnosed with diabetes and those trying to prevent it to attend our health fair and learn how they can take control of the disease by eating properly, exercising and living an overall healthy lifestyle."

Pinnacle Health will sponsor the health screenings, while Capital BlueCross will sponsor the weight-bearing exercise. Other activities include soul line dancing and a healthy cooking demonstration and nutritional shopping tips.

In other news, Giant-Carlisle said it had collected more than two tons of unwanted and expired medication as part of the nationwide medication take-back day on April 27, under partnership with the Drug Enforcement Administration and local law enforcement.

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