The Start-Point for Community Pharmacy Clinical Services – The Walgreen Model

There is no doubt that when an individual undertakes fitness training they measurably do better if they have a fitness coach supervising the process.
And it works even better if there is some form of reward attached when goals are reached.
Jenny Craig weight loss programs would not have the success they have had without adopting their version of a health coach/reward program.

As a marketing model that could be useful for pharmacy adoption, there is not a lot of evidence around that many pharmacists have taken up the role of health coach to supervise any wellness initiative.

Today’s reality for pharmacy is that it has allowed a government health product (PBS) to dominate its landscape.
That product has now reached the end of its life cycle and as such, will be continually commoditised and it will not provide an income necessary to sustain a patient-centred business.
That a need to increase the paid service component of pharmacy core business is obvious, but for some indefinable reason, services have been suppressed in community pharmacy.
The 6CPA has recognised this fact, but pharmacists must patiently wait until a number of events take place – a parliamentary review into 5CPA management and that investigation causing delays in the uptake of the 6CPA; the lack of definition of specific services and the training systems to ensure appropriate skills; the fact that all professional services have to be approved by a doctor-dominated service review panel and on top of all that a further investigation into location rules and pharmacy ownership during the life of the 6CPA.

Pharmacy infrastructure and capital base will be badly affected by all these delays which are further fuelled by pharmacy critics and a manipulative government that has little integrity in regard to any organisation or individual.
On top of that we may see a return of Roger Corbett to Woolworths driving a Walmart initiative linking pharmacy to other departments for a “whole of health” integrated store.
This also means that if we wait for government funding we, might only start to see it after a period of 3-4 years and Roger Corbett will muddy the water with government at every stage.
Pharmacy must fight in unity to create the space in the mix of health professions that are starting to overlap each other,
Some pharmacists will find their “space” in medical centres, but the true “homeland” is community pharmacy, and a start is yet to be made there.

The message ought to be loud and clear that community pharmacy should start introducing services that are affordable by the general public, have their own pharmacy “stamp” upon them and be able to be used as a base to launch more complex services after acceptance by the community.
In fact, it should be an objective to not allow government funding to intrude on the price, quality and objectives for all of pharmacy services and never be involved with any future bulk-billing service offered by government.
The GP experience with bulk-billing is one worth studying.

Walgreens is one of the largest pharmacy organisations in the US, with a controlling interest in the Boots Alliance Lloydspharmacy group, the largest pharmacy group in the UK.
They have been trialling basic professional services on both sides of the Atlantic, since 2012.

Recently, their US division announced a range of successes through a program entitled Balance Rewards for Healthy Choices program (BRhc).
This program is integrated with a standard loyalty club program which becomes the reward component of the system.

Walgreens recently released a white paper showing the efficacy of its Balance Rewards for healthy choices (BRhc) program in terms of weight loss and adherence to diabetes and hypertension medication.
Launched in 2012, the program, which has over 800,000 users as of April 2015, gives users “Balance Rewards Points” for logging blood pressure or weight loss, tracking daily activity and setting achievable goals. 

According the white paper, a 2014 study of 100,000 users found that all of the 6,198 users who logged their weight lost an average of 3.3 pounds over six months, with 27% losing more than six pounds and 16.5% lost over 10 pounds. Those who logged at least a mile daily lost about 3.7 pounds on average. 

Beyond weight loss, the BRhc program also seems to help medication adherence, with those who tracked their blood glucose through BRhc adhering to their diabetes treatment at 82.9% about five points higher than the 77.% adherence for those who didn’t track their blood glucose through BRhc. Additionally, those who logged more than a mile of walking every day were 7.9 percentage points more adherent (86.4%) than those who didn’t.

Regular use had similar effects on participants taking hypertension medication, with those who tracked their blood pressure adhering slightly more than those who didn’t—81.7% versus 79.1%.
A similar adherence increase was found between those who logged more than a mile per day (81.5% adherence) and those who did not (79.1% adherence).

These results demonstrate how an easy to use wellness program that integrates incentives, like Balance Rewards for healthy choices, drives engagement and positive behavioral change — this creates a more enjoyable experience for participants that ultimately leads to better health outcomes.
It also integrates component systems that already exist within a community pharmacy, so the cost to start is minimal.
The future battle will be won on the number of real (registered) patients in a database a pharmacy has, so a patient profile design is the first priority.
Do it once and do it right!

Walgreens’ chief medical officer, Harry Leider, said:
“The results also underscore the program’s value for health plans, employers and other payers. It’s a big step toward reducing health care costs when you can effectively promote more active lifestyles among members in a cost-effective manner.”

This suggests that registered patients involved in a pharmacy program may be able to negotiate reduced premiums from health funds if the type of evidence Walgreens produce can be developed into a negotiating tool for use locally.
At the very least I sense opportunity here for medical funds to reimburse their own members for pharmacy wellness programs.

With some 250,000 devices and apps like FitBit and MapMyFitness connected to the BRhc program, the company is working to expand the ways in which users participate.
There is also a secondary market here through the sale of these wearable devices.
Using your loyalty club you can offer additional points for the purchase of services and for products and appliances ordered by pharmacist prescription.
Make it the premium segment of your loyalty club and award double or treble points.

Walgreens want customers to enjoy a seamless and convenient user experience.
By making available a selection of connected devices together in one easy to find portal furthers that goal.
As Walgreens’ customer base approaches 1 million users there is major encouragement to research new activities to a tied mailing list comprising these customers.
It is a potent marketing tool.

The mailing list can be leveraged to provide other information services and offerings, even a special promotions catalogue that is publicised “under the radar” that inhibits competitors from copying all your innovative ideas.
It also works well with established online booking systems to save on software costs.
Recommended is Simply Book Me which starts free and can then be rented at a moderate cost as business expands.

And nearly all this work can be done with minimal cost outside of market groups.
Their costs should be offset by your own efforts to produce a better bottom line and market expansion that you can personally control, unless they can prove they can do it better.

Patient databases of this type will generate many opportunities for pharmacy research that could benefit the academic community of pharmacy and provide published evidence for government funding.
There is a positive side to the current turbulence in pharmacy.

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