Community pharmacies make care possible in medical deserts

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We care for our clients who do not have easy access to high quality basic health services.

Cambridge, Nebraska, is the largest city in Furnas County, with just over 900 residents, according to the 2020 census.1 In fact, the 7 counties surrounding Furnas – 5 in southern Nebraska and 2 in northern Kansas – average less than 5,000 residents countywide. Cambridge is nearly 80 miles from the nearest Level 2 trauma hospital in Kearney, making the area a medical wasteland.2.3

The difficulty for patients who live in a medical desert is the decrease in access and quality of care associated with the increase in health care costs. As one of our county’s most accessible healthcare resources, the staff at Mark’s Pharmacy are committed to caring for both people living in Cambridge and those living miles and miles beyond. beyond the city limits.

Many south-central Nebraska communities with small medical clinics or nursing homes do not have a local pharmacy. We are committed to meeting the needs of people living in these communities by offering hand delivery to patients’ doorsteps and locally administered health care services, including vaccinations and health screenings. We take care of our customers.

Like many other medical deserts, this rural area faces multiple barriers to consistent, quality care. Lack of public transit, non-traditional workdays, much longer than normal mail delivery, and isolation (for example, living on a farm or in a small community with no medical services) are pervasive barriers that our pharmacy staff sees every day. In addition to these challenges, a high percentage of our population is comprised of older adults who are less tech-savvy, making mobile-friendly websites and intuitive healthcare apps mostly ineffective with many our patients.

These barriers challenge us to think differently and provide a “top of the line” level of care. We feel compelled to improve access to medicines and the quality of care, even as we face reimbursement controls from pharmaceutical benefit managers. During distribution, we focus on medication synchronization and adherence packaging to facilitate patient medication management and limit our need for additional deliveries. Before it was fashionable, we took a community wellness approach and focused on wellness services to help our patients stay healthy, rather than just providing medicine to treat diseases. We are a community care access point with services that complement and complement the entire health care delivery system.

Prior to COVID-19, we provided blood pressure monitors to patients who were called monthly and instructed to return the devices to the pharmacy or return them with shipments. The results were uploaded and sent to their GPs and specialists. We also carried out health examinations and administered vaccinations locally and in nearby locations. During COVID-19, we worked closely with the Department of Health to offer regional testing and vaccinations. We also served as a minor medical triage provider. Area medical clinics were often inundated with sick patients and referred minor medical cases to our pharmacy. We have extended our COVID-19 testing and vaccine delivery to local communities by hosting events at area schools and recreation centers. During these events, we often visited patients who were confined to their homes.

We have also seen a significant reduction in the number of beds in nursing homes and assisted living facilities in many local communities, including recent closure.4 We offer many services to help patients stay in their living environment for as long as possible. Our mantra of caring for our clients has expanded to include additional pharmaceutical care services “at home” instead of “in a home”. Hand delivery to patient doors, adherence packaging, vaccinations and ongoing medication management are examples of the pharmaceutical care services we provide.

Being the primary healthcare destination in a rural area comes with challenges, including weekend and after-hours antibiotic requests and prescription changes. These challenges are just a small hurdle in our overall effort to improve the health of every patient in the communities we serve while increasing patient satisfaction and building customer loyalty in the process.

We believe that reimbursement for the enhanced patient care and medication use services we provide is the future of community pharmacy practice. We have a small payer contract with one of the medical providers to reimburse us for some of the enhanced services we provide. Through our work with the Community Pharmacy Enhanced Services Network (CPESN) Nebraska, known in the state as Nebraska Enhanced Services Pharmacies, we hope to continue to show the value of our pharmacy to insurance companies and contract services directly. which reduce their overall costs.

Mark McCurdy is the owner of Mark’s Pharmacy in Cambridge, Nebraska, and a CPESN Nebraska fixture.

References

  1. Population of Cambridge, Nebraska 2022. World population reviews. Accessed April 13, 2022. https://worldpopulationreview.com/us-cities/cambridge-ne-population
  2. Carr BG, Bowman AJ, Wolff CS, et al. Disparities in access to trauma care in the United States: a population-based analysis. Wound. 2017;48(2):332-338. doi:10.1016/j.injunry.2017.01.008
  3. Nebraska Designated Trauma Hospitals. Nebraska Emergency Health Systems. Updated September 28, 2021. Accessed April 13, 2022. https://dhhs.ne.gov/OEHS%20Program%20Documents/Trauma%20Designated%20Hospitals.pdf
  4. Nitcher E. Nursing home closures have Nebraska seniors asking, “Where are we going? Omaha World-Herald. February 20, 2022. Updated March 29, 2022. Accessed April 13, 2022. https://omaha.com/news/local/govt-and-politics/nursing-home-closures-force-elderly-nebraskans-to-ask-where-do-we-go/article_75453b98-903e-11ec-95fe- 67f7ac3ca80f.html

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