Patient Advocacy: The Cycle of Paying It Forward

It was the spring of 2020. Independent community-based pharmacies were climbing an uphill battle against crushing DIR fees and tanking reimbursement rates; a raging pandemic only made it steeper. Will call bins overflowed, phones rang incessantly, and staff members did the work of three people, yet the bottom line declined month after month.

There had to be a better way.

How were other pharmacies optimizing their schedules and taking control of their workflows? Was there a place for community pharmacists to share our ideas and work together? How could my pharmacy better serve the community?

These questions led Ed Hudon to a late-night Google search, hunting for a way to accomplish more while doing less. It wasn’t long until he stumbled upon his local CPESN network, the Pennsylvania Pharmacists Care Network, and swiftly enrolled his pharmacy in cohort 2 of Flip the Pharmacy.

Ed Hudon is the pharmacist and owner at The Medicine Shoppe in Boyertown, Pennsylvania, although he prefers the title ‘Patient Advocate.’ “From pharmacists, to pharmacy technicians, to clerks working the registers, patient advocacy is at the core of our work,” Ed shares, “Flip the Pharmacy has given us the resources we need to better serve our community.”

Ed Hudon, pharmacist and owner at The Medicine Shoppe in Boyertown, Pennsylvania

As a part of Flip the Pharmacy, pharmacies like the Medicine Shoppe work on teams to transform their community-based pharmacy practice away from prescription-driven transactions toward a patient-centered longitudinal care model.

“I felt very isolated and alone before joining Flip the Pharmacy, struggling to make payroll and crying the blues about low reimbursement rates,” Ed admits, “Then, I found this community of people that genuinely wanted me to succeed. I no longer worried about my competitor, because I saw how we could change health care when we all worked together.”

Using monthly change packages, Flip the Pharmacy coaches work with local pharmacy teams to implement the six key transformation domains with an emphasis on continuing patient care planning with documentation in various eCare Plan platforms.

The Flip the Pharmacy difference became apparent to Ed’s staff during the COVID-19 pandemic, as they implemented the appointment-based model by leveraging medication synchronization. Medication synchronization involves proactively aligning medication fills on a single pharmacy appointment day to allow more time for the delivery of enhanced clinical services. Ed proudly remembers the first day the state of Pennsylvania shut down due to COVID-19, when he closed the store at 6:00 PM with an empty will call–an unheard-of occurrence before Flip the Pharmacy. Thanks to medication synchronization, his team was able to notify each and every patient and distribute their medications in the wake of a closed state. With 85% of his patients now enrolled, Ed has regained control of his workflow and freed up countless hours to serve his patients in unique new ways.

The Medicine Shoppe has recently been granted a CLIA-waiver, which enables the pharmacy team to perform point-of-care testing for HIV, dyslipidemia, strep throat, influenza, as well as COVID-19. Additionally, they direct a Diabetes Self-Management Education and Support program and offer Medicare Part D counseling during the annual open enrollment period.

With a newfound focus on various aspects of his patients’ health, Ed sought to approach patient care more holistically. Spearheaded by his NCPA Innovation Center/CPESN Community Pharmacy Fellow Alex Tirado, PharmD, a collaborative practice agreement with a local federally qualified health center was launched in 2021. He believes that pharmacists’ frequent touchpoints with patients position them to meaningfully impact their health outcomes.

“When you only see a patient once a year, how do you assure that quality measures are met? Pharmacists can actually create a plan,” Ed explains. “A 50-pound weight loss goal is an insurmountable task. We can break that down to five pounds a month and check in along the way.”

The Medicine Shoppe emerged as a leader in Boyertown during the COVID-19 vaccine rollout. When Ed recognized that Berks County was falling behind in vaccine allocations, he knew that the county government underestimated how many vaccines his team could safely and effectively administer. Without delay, he created a presentation for the county commissioner, highlighting his pharmacy’s local roots and relationships. “Soon after, 1,000 doses arrived at the pharmacy. Then 2,000. Then 3,500. We were unstoppable,” Ed reflects proudly.

Ed followed through on his promises. He championed apartnership with local churches to create a call center to field questions about COVID-19. He also leveraged his relationship with a local school district to vaccinate teachers and hold mass vaccine clinics at the schools. “Our community thought we were different before the pandemic,” Ed shares. “Now, they know.”

With pharmacists in the spotlight, Ed took advantage of the opportunity to talk with members of the community about the issues facing pharmacy practice at each clinic. His pharmacy’s efforts caught the attention of the Pennsylvania Department of Health, who now sponsors Team Pennsylvania of Flip the Pharmacy. This team sponsorship donation, along with funding from the Community Pharmacy Foundation and national and local team sponsors, will support practice transformation coaches.

The pharmacy’s coaches, Nicole Pezzino, PharmD, BCACP, CDCES, and Kristen Hartzell, PharmD, have played an instrumental role in The Medicine Shoppe’s practice transformation. Ed is grateful not only for the support of his coaches, but the Flip the Pharmacy community as a whole.

“I now have access to this passionate, collaborative network of pharmacists who are always willing to lend a hand,” Ed expresses. “They have all touched my community in some way without ever stepping foot in Boyertown.”

In the future, Ed plans to continue advocating for his patients in innovative new ways. He has now hired several nurses and acquired the office space next door to make room for his booming clinical service programs. To address different social determinants of health, the pharmacy plans to forge a partnership with National Association for the Advancement of Colored People (NAACP), register as community health workers, and even begin learning sign language.

“Pharmacy is on the precipice of something fantastic!” Ed exclaims, “It’s all about the cycle of paying it forward. When we advocate for our patients, they advocate for us.”