Can I eSign Colorado Patient Satisfaction Survey

Can i document type e sign patient satisfaction survey colorado

all right we're gonna go ahead and get started thank you all so much for tuning in today for our webinar entitled Colorado community pharmacy enhanced patient care services this is a part of our chronic disease management and Prevention project that we are also working with the Colorado Department of Public Health and Environment on so we're really excited to have you all here today and excited for for our speaker to be able to present to you on this topic my name is Katie Jeff Miller I am the program coordinator at health links and I'll just be doing a little quick intro a little bit about us hopefully most of you are familiar with health links already but in case you're not we are a mentoring program based at the Colorado School of Public Health the champions health and safety at work we offer evidence-based healthy workplace certification and advising to help organizations and their team members achieve total worker health I wanted to mention that we are also partnering with the skaggs school of pharmacy today which is just down the road so really excited to have them on board for this webinar quick agenda for today we're gonna start with a presentation from dr. Wesley doofer then we'll move to a question and answer so if you have any questions please feel free to save them for the end and we'll hopefully get to them and then quick closing wrap-up and what's coming up next just some general housekeeping before we get started all participants will be kept on mute throughout the duration of the presentation this webinar is being recorded and we will be sending a link to that in the follow-up email in case there's something you want to go back and revisit or share with other colleagues please use the chat function for any technical issues that you have and I'm here to help you with that if you have a question for our speaker please use the Q&A box in the control panel of your screen and as I mentioned we will get to those at the end there will be a survey at the end of this webinar so we would love for you to take a minute to complete this all right our speaker for today is dr. wesley new fer dr. new fer is an associate professor at the university of colorado Skaggs School of Pharmacy an assistant director of experiential programs where he works to play students in various pharmacy practice settings across their curriculum currently dr. nifa is working on a variety of funded initiatives involving transforming community pharmacy practice to patient centered care models dr. new furs experience is an experiential education diabetes obesity and immunity immunizations and his clinical practice is in the endocrinology department at the University of Colorado Hospital in his spare time dr. new fir enjoys the martial arts and the great outdoors of Colorado with his family so please join me in welcoming dr. Newport and you can go ahead and take it away Thank You Katie and I would like to thank healthlinks for giving me this opportunity as well it's always exciting to be able to talk about some of the things that we're doing so what I want to talk to you today about is some programs that we are really focused on in the community pharmacy setting and so my background when I graduated I am an alum of CU School of Pharmacy and I went into community practice and was really motivated to do a lot of the things that I'm talking about today but there was a whole lot of barriers and there there still are some but but things our landscape is much sunnier than it was in the past and and I'm going to kind of go through a little bit as to why that is but I did want to go ahead and just start out this talk with a poll so currently those of you on the call how many of you go to a local community pharmacy somewhere around your neighborhood to fill one or more of your prescriptions I'll just give people a minute to answer it still got some responses coming in you alright go ahead and share the results alright excellent I'm pleased to see that it's one of the challenges that that we face is is that we're not always in control of our own options I recently was what is mandated to wear on routine maintenance medications which my son gets that we have to use mail order and so it's frustrating because I really do believe in the in the community pharmacists relationship to to their patients and I and that's some of what I'm going to talk about today all right so the practice of pharmacy has really changed over the last couple decades we transition to a farm the only degree right around the year 2000 nationally and Canada followed in our footsteps and before this there was a there was a bachelor's degree available for pharmacy practice but now the only degree is a doctorate in pharmacy and what that extra schooling really involved was a lot more therapeutics and a lot more pharmacology so a lot more knowledge about diseases pharmacists have always not known about the medications but the depth of the disease knowledge really was one big focus when the farm be on degree became mandated community practice itself has really changed when I first was going into community practice it was still a pretty good margin to be made you would buy your medications at one point and sell them at another one but that margin has really gone down and a lot of people don't understand that because it is high dollar on some of these medications as you know are thousands of dollars sometimes per month but the problem is is that that's not a pharmacy profit we buy high and and and sell you know and insurance covers very close to our margin and so the traditional model of dispensing prescriptions and being able to cover your salary is really not something that is the case anymore and so particularly for the individual community pharmacy mom-and-pop shop which I always a hold near and dear to my heart it's if the model we still see it in rural rado but it's the old pharmacy model with the soda fountain in the store and and you would kind of get to know your your patients and their families and and know everybody by name and and that really a transition with some of the bigger chain pharmacies again except in specific locations and unfortunately community independent pharmacies are quickly going the way of the dinosaur if they if they're not able to evolve and change because of because of a lot of these market pressures that are that are occurring so what is our role and this is something I think we've really struggled with as a profession because if data out there really shows that that you all that people trust their pharmacists were among the most trusted professions but they really don't understand exactly what a pharmacist does outside of you know everyone sort of envisions the community pharmacists in the grocery store or the Walgreens there's a lot other options available for today's pharmacists there's a lot of practices in hospitals and physician offices but my focus today is really on this community practice because of the accessibility the numbers are you know somewhere between 12 and 30 times a year that our pharmacist is going to make a touch to a patient because we're seeing you not just when you're sick but we're seeing you routinely as you come through and fill your prescriptions and so that accessibility as far as promoting immunizations as far as talking about any changes that have happened and an overall caring for your health is something that pharmacists are by far the most accessible health care profession out there drug-related problems are huge that's another entire talk in itself I could go on and on about you know herbal products and over-the-counter products and things that people get online or just several different medications from different providers transitions of care when you when someone enters a hospital and they get on different medications while they're in the hospital and then they transition back home all of these are times when there can be therapeutic duplications where someone's taking two drugs for the same problem or maybe got put on a drug for a problem that was was acute and was not something that was long-term come home and they're still on this medication and they really never should be in so there are a huge area of opportunities for pharmacists to really just sit down and go over the complete medication profile and and really help patients sort through a lot of bad information all right adherence is is one area that any healthcare professional and really the data suggests any even health coach can help with but the challenging thing with adherence is is that any intervention that we do is short term if if if I help you and I sit down today and I really emphasize why it's important for you to take the medications that you're prescribed the data shows that for a few months that intervention works really well and then by six months you're almost back to baseline on your behavior and there's a lot of things that effect adherence the more times a day that you have to take something I mentioned my son he has a congenital muscle disorder and he's supposed to take one pill four times a day and and both of his parents are pharmacists and boy we still struggle to get them every one of those doses because we're busy lives and taking something four times a day is challenging and so so there's a real role here I've done I've been entire presentations on adherence and and this is always staggering to me for if you're a physician and you write a hundred prescriptions you're down to about 50 20 percent 15 to 20 percent are refilled as prescribed so right out the door there's about half to a third of patients they're just even not ready for the medication or it's not covered or they can't afford it and so it just never even gets to the pharmacy and then out of the ones that do get there then now you know the price and maybe you go home and you look it up on the internet and and the numbers go down to where you're really not leaving with that drug and then even when you're leaving with the truck now we're down to a third that are actually being used the way they're supposed to and then as I mentioned down to about a fifth that are being taken long-term and so this is a huge problem as mentioned I work in endocrinology we assume with diabetes that you're taking everything and so when I'm measuring your lab values to see how your diabetes is controlled when it's not controlled we're assuming that all the Mets are doing job and we're looking to increase medications and so when it hearings is a problem you can really see this be something that is an issue because it starts to be something where suddenly you decide okay I need to be in here and I need to control this disease and unfortunately if we have you on a whole bunch of medications at that time that can really cause some bad outcomes so the answer to this is having conversations it's getting to know your patients it's taking the time to sit down and have a conversation with your patients around their medications and their health or I just flipped the pharmacy initiative is something that I'm pretty excited about this is a national movement that's really come out of a group called CPS n which is a they call themselves accountable pharmacy organization and a POS so some of you may be familiar with an ACO accountable care organization where it's a group of practices that really are working together to manage a population of patients and they provide all the care and try and cost save and so basically what CPS n is trying to do is set up a network of pharmacies that are really doing the services that I'm going to talk about here enhance services patient-centered care the tagline you can see at the bottom is moving from a moment in time of filling prescriptions to taking care of patients over time as we transition to where our focus should be on the patients and that is really what this initiative is doing and so what it is is a two-year program that really breaks all of these things down into manageable monthly bites and really helps all the pharmacies convert what they're doing one month at a time while still practicing and still doing all the things you have to do in a day when you talk to people that really want to change their pharmacies everyone wants to do it but nobody has time yeah I've got all these scripts to fill a day I've got all these things that are demanding my time and now this is one more thing and so this initiative has really helped to transform the practice and and manageable bites you have a champion in the store that really sits down and goes through what needs to happen that month and bit by bit you begin to implement these changes that I'm going to describe next to where the pharmacies look very very different after two years alright so in Colorado we've been very fortunate to have a couple health departments Edie Phe Colorado Department of Public Health and Environment has been absolutely paramount and their support to help us with these independent pharmacies and implementing services as I mentioned when I first wanted to do this there were a ton of barriers and still on the billing side of things there is not the reimbursement for pharmacists time Labor's is the most expensive piece and so we need what we call a proof of concept we need to show payers and employers groups like yourselves that we can really make a difference in patient's health and really generate the data that's going to be able to go then to a third party insurance plan and say you know we will manage your most difficult patients here highest utilizers there's a very small percentage of the population somewhere around 10 to 20% that's using 80 to 90% of the healthcare dollars in our country because they're very complex patients and those are the patients that we are really looking at when we start managing patients that where we're wanting to care for everybody but we really want to focus on that small percentage that's consuming so much of the healthcare system and really optimize their health so that they're not going to the hospital so they're not going to be and they're not and they're not as sick and that's really what we've wanted to do and so the model is is that the School of Pharmacy I am partnering with a whole bunch of independent pharmacies and really helping them implement these services and CD Phe it's around cardiovascular disease and diabetes and we'll look at that in more detail and then I'm also working with Tri County Health Department which is the Adams Arapahoe in Douglas County you're closer to the Denver closer to home specifically on some smoking cessation work where we're one of the exciting things in pharmacy that we'll talk about as pharmacists can now take a specialized training and become specialists and helping people quit smoking and and so that's a big goal with that initiative is to really get that up and going and helping patients quit quit smoking all right so these are different locations where we actually have pharmacies that are doing these specialized services most of these are independent pharmacies there are a couple within like a health system like Valley wide health centers in Alamosa Atlanta and then there's a couple like that but most of these are mom-and-pop pharmacies many in rural areas some of which there may not even be a medical practice in that town and so you do see a much bigger scope of practice for the pharmacists in these areas where they don't have all the resources that were used to here in Denver and and so there is a real role for helping patients understand their diseases and and really working with them to optimize their health and again you can do an entire talk on the disparities of rural areas across the country where there's just not as many healthcare professionals there's not as much access to specialty care and there's a real need for these education services to really help people understand what their disease is and what they can do to really minimize the complications and and again that literature is very clear that this is an ongoing conversation and it's not something that should happen one time it should be happening over a lifetime and it's something that you really do want to establish trust and a relationship with your patients and it's very difficult to do tha if your patients are going to a different pharmacy every single time or mandated mail order so this model is really bringing things back to where you know your pharmacists where your pharmacist isn't hidden way out in the back of the pharmacy where you can't see them but they're coming out front they're sitting down in a private consultation area and they're spending somewhere between 5 and 15 minutes one-on-one with you talking about your health and and/or your disease states and and really spending that time outside of the pharmacy spending it with patients so here are some examples of services that have been going MTM or medication therapy management is really the most well known because this is something that medicare put in place several years ago where as any Medicare Part D plan that pharmacists would offer this service and it's very targeted it's management to those patients that have been identified as having the most risk so patients that are on many different medications patients that are on certain disease states and they're basically there's these third-party software programs that flag these patients and if they go to your pharmacy you can pull up this database and you can identify that this is a service that needs that needs to be offered and so this is something that's been going on across community pharmacy for several years now but it's very suboptimal there's a number of reasons why and the biggest reason why is because it really is intended to have that community pharmacist patient relationship but in the vast majority of cases you might be hearing from a pharmacist that you don't even know so some plants have pharmacists in other states that are calling you patients don't fully understand the role of this why would I need to talk to you my doctor talked to me about these things why do I need to talk to my pharmacist we like it to be face-to-face and we ask patients to come in whenever possible and again there's a misunderstanding as to why they need to come into the pharmacy because typically in the past the pharmacist has really been tied more to the dispensing role and not to the education law and so you know why why is this it's just a growing a growing pains type of thing but and it's in its true form and there's now what's called an enhanced MTM that's being piloted where it really engages the pharmacists that patients know and recognize and and that person is providing the care and then communicating all of the information that they talked about back to the primary care provider and that's another area that we're working very highly on because that communication piece needs to be there if I'm providing all this great education and information to patients about their medications and about their diseases but the doctor and the PA and the rest of the healthcare team has no idea what I've done there could be redundancies where we're giving the same information it's it's inefficient and it really is just not the way to integrate pharmacy services into the rest of the interprofessional team and so it's very important that number one I can access information from the medical record I know what your allergies are I know any house elevations you have recently I know things beyond what the dispensing software shows me and that I'm able to communicate information back to the providers on what we've really talked about and so medication therapy management can be there's a CMRR comprehensive medication review where it's really going over all the medication or it can be very targeted where we're looking at one specific thing like you need to be on a statin because you're at high risk of a heart attack and stroke and so we would really like to do that to have that or you have diabetes we want to maximize the use of metformin because of it how important that is and some of those things alright so at then I'm going to have another poll here and this is another thing that that we generally do quite a bit and that is vaccinations and so I'd be interested in how many of you have gotten a vaccination from the community well just give it a minute for people to respond in the null share the results all right there are the results okay and that's and that's actually a little bit surprising to me because this is again one area that pharmacy has been really well known for and that is is that that we're providing vaccinations and happened for some time and in in many cases the physician is actually kind of handed that off to the pharmacist as a role I know in in rural areas sometimes with flu shots that the pharmacies will actually get the vaccine in before the physician's office and and that's simply because it's sometimes a big buying group and those types of things but these are all of the different vaccinations that we can provide everybody thinks of the flu shot and and and schedules it around that October date and indeed the pharmacies are very busy with that but there's a lot of other ones right jinguk's is the new shingles vaccine it is tremendously better than the previous shingles vaccine any of you that got the old shingles vaccine that sauce the back should go and get the sheen brick series because it's much more effective any of you that have gotten it you're probably rubbing your arm and memory because the secrets does have an adjuvant that causes a little bit of injection pain at the site will notice that you that you receive that when you get it but there's other opportunities right HPV and meningococcal for teens teens any of you that I have teenagers at home I have a 13 year old now and just keeping up with their daily life is exhausting so keeping them going to physicians and getting their their routine examinations can be very challenging in that age group and so this is a great opportunity or they require them very highly recommended vaccines for for them to receive and then there's some some other ones as well so there's a whole bunch of different vaccines that pharmacists can give I trained the students on immunization so I hear every horror story of when a vaccine goes wrong so if some of you had a bad experience in the pharmacy I'm sorry we are working very hard to give the injection technique exactly the way it's supposed to but again I hear every time someone in my office or someone in there and the in the pharmacy school knows and has a has a vaccine that they that neither hurt more or whatever but this is a huge ball for today's pharmacists to be doing and then travel vaccines is another whole whole field and it's not just vaccinations right it's it's you actually go through CDC maps and and make recommendations as far as as if malaria is a risk and and what you might need to take with you and some very specific recommendations for traveling around the world and hopefully we'll be able to get back to traveling around the world at some point this is something that I think pharmacy does very well and so I would highly recommend if you're going anywhere that is that it's a developing country that you you access a travel health clinic and get all of the recommendations so that you stay safe and enjoy your trip to that the most all right so moving beyond that medication synchronization this is something that that is also pretty well established across all a community pharmacy where anybody who is taking three or more medications they really try and get them to where people are picking all of the scripts up on the same day and the point of this is is really to optimize the time so that you're not having somebody come in every week to get something one of the things that really changed in pharmacy practice across the time I was there is is the inventory and so there was a real push to carry a low inventory a low cost of drugs and the frustration to patients and I'm sure many of you have experienced this is the fact that anytime you go in they don't have your full amount so you're getting partials and you got to go back and get the rest of them and and that's because when they really don't know if the medication is going to be dispensed or not there's been a real pressure to not have a whole bunch of the money tied up and an inventory on your shelves and to order it as it's needed and that's very hard to predict and so if someone else comes in and gets the medication you're on the same day then lo and behold we don't have extra and we don't have it for you by arranging medication synchronization this is one way that we can make sure that on the day that you're coming and and and way to flip the pharmacy we take it a step further and we really say hey what day is good for you when you can bed and extra 10 and show minutes where you can spend with me the pharmacist and we can really go through some of these things and so it's it's not only optimizing when you pick this up but it's also asking a commitment from you as the patient to sit down and be able to go through a consultation and go through all of these things though that we are talking about here because we're really focused on patient health and sitting down and having one-on-one interactions opioid education and drug abuse is is a huge problem right now and Pharmacy is very much in the middle of this that a lot of times patients get inadvertently they have a condition that requires them to get on on painkillers and lo and behold they they they end up getting dependent on those and there can be a real challenge around this and so there's a lot of very valuable education that can go around this a part of it is explaining the difference between dependence and addiction just because you're dependent on something because you used it for a while does not mean that you're addicted to that drug and unfortunately there's a real stigma to that just knowing alternative options that are available for patients that are very concerned about opioids them what are some options and how well will they work and is this going to be enough helping to identify providers that have a lot of experience with managing patients properly because you know in the past there's been a huge miss use of these medications and there's a way of using them very properly where you get the best pain control and you minimize some of the aspects that can lead to dependence and addiction and then entering into somebody contracts and having them only come to your pharmacy because when you start having patients go to multiple pharmacies and multiple providers that's a real red flag around the entire opioid problem so so just again there's consultations and working with your with your patients around this field is really important all right I mentioned smoking cessation already a little bit we have statewide legislature that passed now where if pharmacists take a specially-trained program that's offered they can actually prescribe any medications for cessation efforts and I do a lot of work in this area and the numbers are dismal across the board it's hard to quit smoking very hard to quit smoking however when you're using somebody that's specially trained and when you're using pharmacologic help ie nicotine replacement therapy you're more than twice as likely to be successful and so the the version that we have that sort of core version has asked advise refer where we partner with quit line and the pharmacist is able to do a consultation and really work with the patient and select an appropriate product and send the patient out the door with medication that they need to help them quit and then refer them to quit line which will do all the behavioral pieces which are also very vital to success in smoking cessation and there's a lot around this as far as like when you fall off the wagon you haven't failed its you just just slipped and so letting the patient know that that it's okay to have that moment where all I found a pack of cigarettes in my garage and and relapsed don't just give up you've made so much progress and again having that person to talk to and to really help you through that one of the most difficult things you'll do in your life is absolutely essential and is a really important service that that pharmacists can provide in some cases of pharmacists have actually stepped up to a higher tier where they're actually going to do the behavioral counseling they'll actually help monitor the CL levels that first week after quitting the show that the levels of poison and bloodstream are actually coming down it's a very nice objective measure at a time when you're angry at everybody and everything and it's the hardest time that first week of quitting it's nice to see oh wow you know compared to yesterday my blood is so much cleaner and people can really relate to that setting quit dates I'm talking about all these little behavioral things changing the way you drive to work because you light up when you get in the car so you need to change that behavior cleaning even things like your curtains and washing every sheet in the house because you'll smell the tobacco and it'll really cue you to want that these are in huge pieces that are important for being successful in quitting smoking alright diabetes self-management education DSM II diabetes is a self managed as it's something that 90% of all of the management falls directly on the person who has it and it's very difficult this is one of my main this is what I do in clinic and so being able to sit down and explain the disease and explain why things are happening and clear up all of them is some information that the Internet is a vast wealth of knowledge but it's also a vast hole of misinformation and having a healthcare professional guide patients on what's real and what's true and what's the best information out there and helping as a partner to set goals and to individualize how to manage them somebody's disease is huge and this is an area that is really growing for pharmacists the first education piece is one-on-one while you sit down the pharmacist sits down and goes through the complete past of the person's knowledge and and where they're at and then we transition into these group classes where there's a lot of good group interaction and what you really try and pair up people that are new to the disease but people who have had the disease for a long time and really help to educate patients on what that's looking like and how they can get better and so there's four group sessions that first year and then a yearly follow-up I'm just check-in and see how people are doing within this you're actually doing point of care lakum so we're measuring an a1c we're measuring cholesterol we're measuring blood pressures and these are also new things that are more and more available to the pharmacies and we'll look at that a little bit and that's something with this flip the pharmacy that we're really trying to do every time you come in if you have cardiovascular disease or high blood pressure we sit you down and we measure your blood pressure and we talk to you about what that is and how you've been doing just like you would do at any time you go to the position office and again people are sort of like you know why why are you doing this I'm not familiar with this but this is really the direction we feel that pharmacy is going and that we need to be spending time with our patients and optimizing their disease and keeping them out of the hospital and non routine visits to the doctor all right for our group format we use these conversation maps this is a very highly published successful strategy where patience stand around a huge map on a table and interact together and really talk about the disease and and it's challenging because the pharmacist really becomes a facilitator I am NOT all answering person that's going to answer all the questions I want you to talk through them and again we have dynamic where some people have had diabetes for twenty years and some people are just newly diagnosed and there's nothing more powerful to that patient than being able to have somebody that's been like man I've been there I totally remember that and you're going to get through this and let me tell you what I did and again just that that street cred that brings forward when when you have patients interacting together and you just keep the conversation moving along and don't get too hung up an in one area is a very different way of facilitating and it's very powerful and the feedback is routinely very very strongly positive that patients get a heck of a lot more out of this then let's say a full-day class right when you're diagnosed three years ago that you barely remember anything and so the retention is strong the overall openness and ability to ask questions is strong and and there's it really has facilitated people getting better control of their diabetes and avoiding some of the long-term complications that go along with it and so this is very much the model that we are implementing all right the diabetes prevention program if you're not familiar with this program this is a preventive program it's we screen people that are at risk for diabetes and really work with them to try and reduce their risks this is a very aggressive program where patients are putting in some money they're paying about $200 and they're getting weekly group classes with a health coach it's almost like a personal trainer but it's also focusing on all the behavioral changes that are important to healthy eating regular activity even if it's just walking specific to each individual okay if you have bad knees let's help you do this weight loss promotions decreasing risk factors and the DPP has very good statistical data that shows that when you work with these health coaches and this is a formal program these health coaches are formally trained through the Centers of Disease Control and we have to submit data to the CDC on how these programs are doing in order for them to maintain their accreditation so it's very standardized but the data is very clear that when you work with these people that your progression to getting diabetes is absolutely cut in half if not more the initial program actually compared it to putting people on medication diabetes medication and this program out outperform the medication the metformin group that they that they were put on as far as being able to prevent people to progress from pre-diabetes to diabetes so there's the screening that we give folks and if you screen positive then yeah if you have diabetes in your family if you have certain risk factors if you have central obesity and some of these things then yeah you're at high risk and the chances are if we do nothing you will develop type 2 diabetes this program is only for patients that have not yet been diagnosed and it really helps to identify these patients and help them change their behavior now while the disease has not yet done enough damage to your body that you have to be on medication to really change your lifestyle and hopefully prevent it indefinitely and so the smaller financial investment is well worth the huge goals that you can get out of the program by working with these health coaches for six months it's a weekly program and then after that then it's once a month where we just keep checking in and helping you and slowing that progression or stopping the progression from type 2 diabetes cardiovascular disease management we were focused around all of the things cardiovascular disease so we're doing blood pressure measurements were promoting you to check your blood pressures at home there's actually ways that patients can take their blood pressures from home and upload them and put them into a database that I can see as a pharmacist the physician can see at the office education around diet again behavioral changes and and again performing these different laboratory tests in the end the pharmacy so it's another focus around with cardiovascular disease remains one of the highest on killers in our country and managing that and helping patients understand that is a very important service okay so I do want to do one another poll here specific to point of care so how many of you have ever received any sort of testing so not a vaccine but cholesterol test or an INR and a1c or blood pressure or rapid swim test any of those types of testings at a community pharmacy I'll give it just another moment all right here are the results all right so it's about 10% of you have and not surprisingly most people have not this is a very new area and it's not something that people generally associate with pharmacy practice but the exciting thing for us is is that there are a whole bunch of the services that are now available for patients and so these continue to grow there is going that there's a co bid one that's now available in the pharmacy for testing on cholesterol rapid Lu kidney functions electrolytes strep throat HIV TSH which is the library test a genetic testing is available at the pharmacy so all of these are lab tests that are given at the pharmacy that can give you results without having to send them off to a lab and and wait for the results I can do them right now I can in some cases recommend medications for you recommend that hey you do have strep so we need to get you an antibiotic for that and a lot of these services that previously you had to go in and see a physician about and this has really helped our pharmacists on have these conversations with patients and really help them be clinicians in this setting all right and then I would be remiss if I didn't bring up a student pharmacists piece it's important that we're exposing our student pharmacists to this type of care and that they're able to see this innovative type of practice that is likely going to be the future of pharmacy one thing I tell every come incoming first-year student is if you think you're going to make $100,000 a year by counting by 5's in the corner of a grocery store years sadly mistaken there's machines and highly trained technicians that are taking over that role and so there is a much different sort of focus on what pharmacy is going to be as the movement of the future all right I'm providing several lists of the stores just to give you idea of where these are located the good news is you don't have to frantically write these down on the the abbreviations of what the services are and where they're located will be sent out to you after this and so you can see if there's a pharmacist in the area that you can engage with and prefer many of these services are free of charge to the patient and and again can really prevent bad outcomes I'm not going to here these are the more rural sites several good day pharmacies up north down in Pueblo out southeast Colorado and then and then Colorado City and Colorado Springs so don't worry about that list because you will receive it but I encourage you to go through and look where they are we cover most of the states and we're really able to provide a lot of services to patients that need all right so moving forward what does that look like well these are the things I'm working on explain the payment models we're really trying to establish pharmacies role in this and we want to pay the pharmacist for their time this is what I believe the future will be which is increasing what a pharmacist does it wasn't that long ago where our state Colorado State had pharmacists as not in the healthcare field but we were like with plumbers and other technical type of skilled labor folks and and we really push to say hey and we should be on the same side of the state board as the physicians and nurses and and Dennis and everyone else and so it's just again everyone is trusted their pharmacists for years but no one's really recognized what role we play and what role we can play and that's really the first step of what I'm trying to do here is just increase awareness of these are the things we're doing and these are the things we can offer patients followed by looking directly to folks like yourselves and making contracts that will take care of all your employees and keep them healthy so you're minimizing this time at work we can approach payers we're going to do with this enhanced MTM goals and then again being able to access the medical record and document in the medical record really is going to help us with being able to be part of the interprofessional team all right so one last survey for you all and we're gonna take some questions so what is the likelihood after learning about this that that you would refer somebody that need that to one of these sites if you happen to have one in your community to receive these services from one of the pharmacists all right looks like it's starting to slow down all right excellent I was always a little reluctant except not very likely I haven't done my job today so I'm pleased that that's not the case I appreciate that that you recognize that these are a resource and and I do believe that this will continue to grow and and prosper so with that this is my email feel free to email me directly if you need to I believe that we will also send this slide set out so you will get all that information as well and I am going to go ahead and turn it back to Katy so we can field any questions you might have awesome thank you so much was that was really informative and admittedly I didn't know that some of these services were offered at the pharmacy so that was so kind of bookending off of that last poll that we had we have a lot of employers and HR professionals and health and safety professionals in our network how should employers be presenting this information to their employees and then kind of a part two to that is there any concern about privacy or confidentiality issues well that's a great question and I think that there's always that concern right because a lot of times the employees don't necessarily want to disclose that they have a certain condition because they don't want that to look upon them badly so first and foremost Pharmacy as with every other health care professional is HIPAA trained and formation is very private to us I would I would recommend globally if you have a pharmacy in the area to admit just to let employees know by any means or by several means because we know that communication different people receive different ways that these resources are available again the biggest thing is people just don't realize that these are things that pharmacists do and if they're going to one of the chain locations the chains are a slower uptake on some of this again because of the labor piece and because of corporate pressures so this is we're letting them know that this independent pharmacy is a very different type of practice and hey give it a shot go in and and talk to them and and once they walk in the door and the pharmacists in the pharmacies will take over and and what you'll find is it generally is a very friendly environment and and people do know who we are and it just seems to be a nice interaction and so I think that's where you start you let people know the resources there if you have people like the tobacco cessation I think it's great we've had employer groups in the past really get behind a movement whatever you're passionate about hey I'd like everyone to be healthier you know I want to prevent diabetes so everybody that is that risk let's take the scale and here you can go down the street and join this DPP program and we can make sure you never get diabetes and those are those are great avenues to just start the conversation great thank you so much so sounds like just making the announcement to all employees at the same time and that can kind of help with some of the privacy or confidentiality issues too because then you're not maybe calling out one specific employee right yeah I wouldn't I would definitely not single them out but again our our whole intention is to promote healthy behaviors and and preventative medications or preventative medicine right and so it's just making it clear that we care about your health we want you to be healthier as an employee and here's a resource that we have that can help you with that and really we're partnering with them you know we will be looking with my partnership with the Tri County and with with CD Phe to establish actual contacts with with employers where we can provide all these services and we can help to advertise what we can do and where they can go just so they realize that as an employer you care about their health and you and you want them to access services that will keep them healthier and keep them out of the hospital great and there will be more information about this at the end in ways that you can kind of follow up with us about this but I wanted to point out that we're working with employers on helping to implement diabetes prevention programs or get their employees connected with them as well so just wanted to put a plug in for that that you can reach out to us if you're wondering about how you can go about that we have another question how does a pharmacy become a community pharmacy with expanded services is it just a matter of opting into all of these different trainings and certifications that's an excellent question and that really depends on what services that you would want to offer if you're an independent pharmacy then then there are groups that you can join CPS ni mentioned is one group that really will help you with a lot of that but if you're not ready or willing or wanting to do that and you have a passion for one of the services you know you can certainly reach out to the school to me and and explore what that looks like I'm partnering with folks in public health and medicine with the behavioral health on the smoking cessation and we're not going to turn anybody away what it really takes is getting a feel for the time investment and how that can balance with your business model and we want to optimize it so that we don't cost you time and money and so that's really my job is to be able to do these services but do them in a way that you're still going to make money and eventually make more money by offering them and that's really what I'm working hard with the health department's to do is to show this concept and expand it to more and more pharmacies that want to do it great another question that came in somewhat related is how do you imagine primary care or family medicine working together with community pharmacists to manage care collaboratively well I think that's a great question and and you know I don't really have to imagine it because we're doing it but we're doing it in rural areas because those are the areas that need the resource and so for example in Cedar Edge Colorado which is a really small area out by Montrose we have pharmacies to that go into the medical office two to four days a week and work in that medical office and we've done this for a number of years and at first it was one day a week and that office relax absolutely tell you that they would not be able to function without pharmacy student support now in it it grew it's been eight or nine years now but it really grew out of a we want pharmacy students to understand the pressures on the medical side and we want to build that collaboration and out of that those students now have access to medical records they can in the pharmacy pull up the medical chart from that office and work with that chart and document in that chart and then they go over and they see patients with the provider side by side in those areas so with today's telehealth capabilities you know the biggest challenge we have is we're in a different brick-and-mortar building but what cool bit has shown us is that's not necessarily a big deal and so I see more and more of this happening if you look at the most one of the most growing areas for pharmacy employment it is hiring pharmacists directly into medical practices where you know today's physicians and nurses and pas are training side by side with clinical pharmacists in school we have a very robust IPE program in a professional program at CU and because of that they train with them they know the value of the pharmacist and when they get out there advocating and saying we need a pharmacist on our team and that's really exciting and so what I want to do is take that a step further and engage that community pharmacists who can be a resource and not just have them have hired directly into that practice so I think that's going to continue to grow but certainly there's barriers and and turf things and all sorts of things we need to work through and that's getting that informa ion out if there's enough sick people for all of us right thanks so much last question that we have is do all these services that you mentioned applied to Kaiser Permanente members so that's a good question so they would when it comes down to what you would want the patient's to have some Kaiser plans restrict where you can get your medications so one the plan that I used to have you have to fill at a kaiser pharmacy and these are not Kaiser pharmacies or Kaiser is great a preventive but they're not grated engaging pharmacy in some areas that pharmacist assigned even the commune izing in that system yet and so things along the lines of smoking cessation and some of those you could still go to as a resource and and but but there again then it depends on whether your plan would cover the medications or whether your your wanting to pay a higher copay to take advantage of the services so for example the DPP program has a cost to it but the benefits of getting a weekly coach to help you with all of it well exceeds the value of what you're paying and so in that case you would pay that one cost and you get those services and and and get them all anyway so sort of short answer is yes but and the long answer is is that we're we're really working to try and see all patients all the time great all right thank you so much so that was all of our questions for participants if you have any questions that come to mind please feel free to reach out to me my email will be in the slides that I'll show in just a minute or as dr. new firm mentioned you can reach out to him directly - to find out more about these programs so I'm just really quickly going to share my screen again and let you know what we have coming up all right so if you're interested in continuing this conversation we are putting together a chronic disease prevention and management employers group so we would love if you would be interested in joining us for a quarterly breakfast meeting - again just kind of continue this conversation and provide any updated information that we have on how you can help your employees in this effort there are also the other employers there so it's a great opportunity to network with other employers who are focused on this as well and if you are interested in this there will be a survey that will pop up when you close out of the webinar and there's a space where you can mention that you're interested and I'm happy to reach out to you for more information and last just thank you so much again for taking the time to be with us today again there is that survey and if you saw in the promotions we are giving away 10 $25 gift cards so there is a spot where you can put your email in that survey which will enter you into that drawing and then I'll be following up with you later this month to let you know if you want again you can reach us at contact at healthlinks certified organic uestions in a follow up email going out tomorrow we'll have the recording of this presentation as well as the PowerPoint slides and the list of pharmacies that dr. defer mentioned earlier and if you have any questions for him his email is on those slides as well so and I'm happy to connect you so thanks so much for tuning in I hope you have a great rest of your Wednesday and thank you again West thank you you