Towncrest Pharmacy in Iowa has an innovative clinical community pharmacy business model. The team of pharmacists uses a customized documentation system that is integrated with the pharmacy’s dispensing software.
 
Using this system, the pharmacists are trained to make clinical interventions a part of each patient interaction. Every time a pharmacist speaks with a patient, the pharmacist asks focused questions and documents patient feedback to guide therapy recommendations.
 
The pharmacists also provide prospective drug utilization review (DUR) services to identify and resolve any drug therapy problems. They are trained to apply continuous medication monitoring to each and every patient encounter, including new prescriptions, refills, and drug information requests.
 
Recently, Towncrest Pharmacy was awarded a grant to conduct a review of its community practice model. The data revealed that the pharmacist team is currently recording 2000 to 3000 clinical interventions per month, which amounted to around 17,000 clinical interventions in the year studied.
 
More than half of the interventions were related to a drug therapy problem that was identified and resolved. Of those interventions, 60% had nothing to do with the drug being dispensed, but were rather the result of a prospective DUR.
 
Pharmacy staff members also make a point to promote the pharmacy’s other services to patients during encounters.
 
For example, the pharmacist will inform a patient about his or her eligibility to receive a vaccine during a counseling session. For patients flagged as nonadherent, the pharmacist makes them aware of the pharmacy’s medication adherence program and medication synchronization programs.
 
Encounters Provide Opportunities for Clinical Intervention
Each patient interaction is focused on 3 points:
1. Identifying whether the patient has achieved intended therapeutic outcomes.
2. Determining whether the therapy is effective.
3. Considering whether the medication regimen is safe.
 
Last year, Towncrest Pharmacy was involved in a pilot program with a payer that examined the effect of these interventions on 600 of the insurer’s commercial plan patients and compared it with health care costs among those receiving pharmacy services elsewhere.
 
The results were staggering.
 
After 12 months, Towncrest was statistically significant in improving clinical measures such as adherence, persistence, and the number of patients taking high-risk medications. The study results also revealed that the pharmacy saved the payer around $2.4 million for the year across those 600 patients.
 
Because Towncrest Pharmacy is committed to providing high-quality clinical interventions, it is implementing technologies such as dispensing robots in order to improve efficiency in the workflow process. The pharmacy is also experimenting with a new tech-check-tech program that has gotten very good results.  
 
Putting such systems in place frees up pharmacists to provide more clinical services for their patients.
 
Towncrest Pharmacy Co-Owner and Director of Clinical Services Randy McDonough, PharmD, MS, CGP, BCPS, also dedicates time to educating other pharmacists on the importance of clinical interventions in the retail setting. His business partner, Mike Deninger, also blogs regularly about community pharmacy at TheThrivingPharmacist.com.
 
Community pharmacy needs to innovate in order to get back on the right track and offer measurable clinical interventions. This will lead us one step closer to provider status
 
Towncrest’s commitment to patients gives me hope for the future of clinical community pharmacy.