From blood to sweat and tears, smart technology is changing the way diabetes is monitored and treated. Last spring, a continuous glucose monitor (CGM) that attached to the abdomen was the first of its kind approved by the FDA. Last summer, the development of a non-invasive smartwatch—which is purported to continuously and non-invasively monitor and track major chronic health risks, such as diabetes, cardiac arrhythmia, congestive heart failure, COPD, sleep apnea, and hypertension—was announced. Testing on a disposable skin patch is underway in Europe and the United States. Next up, perhaps a device that pinches the ear will make it through testing. It’s not always sunshine and rainbows, however. The afore-alluded-to smart lens that was the brainchild of a Google/Novartis team hit hard times and was abandoned late last year (see “tears” above). No one will easily forget the debacle at Theranos.
With a reach of 32 million lives, Accountable Care Organizations are good testing grounds for new concepts and programs to improve the quality and delivery of healthcare. More and more, those organizations are relying on pharmacists to help them deliver results. Physicians are recognizing the expanded role—in wellness visits, transitions of care, servicing rural areas, ambulatory care, anticoagulant management, and diabetes care, to name a few. Collaborative care models get arguably more critica las patient disease states get more complex. Even the business press has identified the upside of team-based care.
However, change comes slowly to this profession—and it’s hard.
The lack of supply chain resilience in pharma is nothing new, and pharmacists and hospitals have been negotiating the problem for years. The task force set up in July that is focused on solving the problem has tossed out a range of solutions, including a national stockpile of critical medications. A retroactive study released last month of 1.3 billion prescription claims and a cohort of 1,114 generic drugs found that low-priced generic drugs were at a higher risk for drug shortages. Manufacturers have been quick to blame lack of regulatory clarity on the FDA. The FDA has said that it is playing with half a deck: It can’t force manufacturers to disclose the reasons for shortages. Chintan Dave, PharmD, PhD, Brigham and Women’s Hospital, Boston, MA, the study’s author, said: “In the short term, the FDA should recognize that very low generic drug prices might be a factor in subsequent shortages and continue to consider the risk of shortages when taking steps to promote the safety and quality of the generic drug marketplace.” Check out this discussion of the problem and some of its causes.
“Rural folks are older, poorer, and sicker,” Brock Slabach, MPH, FACHE, senior vice-president for the National Rural Health Association (NRHA) told attendees last weekend at the 2018 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting. With widespread hospital closures and the rate of rural poverty higher than that of metropolitan areas, healthcare delivery faces a broad range of challenges. Family practice residency programs like this one in Pennsylvania are taking a shot at the problem. For pharmacies, opportunities presented by the shortage include medication therapy management (MTM) and counseling for chronic diseases. Here are some ideas being implemented across the pond. Check out these best practices for engaging with physicians through transitions of care states. In some states, remote dispensing is also legal. Thinking about leveraging telehealth in your pharmacy? Here are some “golden rules” for starting a program in your pharmacy and some considerations for policy development along the way.
In the only literacy study of its kind, published just over a decade ago, health practitioners learned that more than a third of U.S. adults would have difficulty understanding basic health instructions. Since then, there has developed a plethora of literature around improving patient comprehension. One of the key ways to improve that communication is by simplifying your word choice. Using analogies to explain complex phenomena helps bridge the gap, too. This study identified some tools to consider when screening for health literacy among your patients. (Boston University has a simple four-question downloadable form to use to assess patient comprehension.) That communications gap is obviously even more challenging when patients have limited proficiency in the provider’s native language. The implications are immense both at the pharmacy counter and in other healthcare settings, like transitions in care, where patients with limited English proficiency experience longer hospital stays and more readmissions. Check out these approaches to better counsel such patients in the pharmacy.
Here are a few other stories that might be of interest:
Continuing education is critical to maintaining your edge in the pharmacy business. This list of pharmacy podcasts from Pharmacy Times inspired us to dig a little deeper for some wider-ranging, business-related podcasts you might enjoy—especially during the holiday next week. (By the way, the Weekly Roundup will not be published the day after Thanksgiving. We hope you enjoy a happy, grateful holiday with your loved ones!) ZigZag is a hodgepodge of stories around entrepreneurship from a new, woman-owned media company called Stable Genius Productions. It’s a little artsy and very genuine. Also, we regularly share stories from Harvard Business Review on these pages; their podcast, Ideacast, provides commentary from an impressive group of leaders in business, politics, science, and journalism. Finally, no list like this would be complete without mentioning The Tim Ferriss Show, covering tactics used by groundbreakers in a range of fields, from finance to sports to business and the arts.
In a study published in October in Infection Control & Hospital Epidemiology, Judith A. Anesi, MD, from the University of Pennsylvania in Philadelphiareiterates what many health professionals have been observing: “Drug-resistant infections are difficult to treat, and our study shows that relapses are common. This is an alarming finding, and interventions to curb antibiotic resistance are urgently needed.” The story is similar in Europe. A recent report by the European Centre for Disease Prevention and Control attributed 33,000 deaths annually to antibiotic resistance—but the field of study remains wide open. German researchers are exploring the incidence of resistant E. coli bacteria on produce. In the U.S., scientists from Boston University posited
Are competitive pressures keeping you up at night? Having trouble shutting down at the end of the day? You’re not alone. When we think of sleep-deprived safety issues in the workplace, many of us think of shift workers or risks like industrial accidents or impaired driving. In fact, the cognitive repercussions of fatigue should make it an important conversation to have in the pharmacy as well—folks like these are making a living off of it. The most forward-thinking in business are focusing on providing intermittent opportunities for employees to “renew and refuel.” Admittedly, the smaller the company, the more challenging that can be (here are some ideas), but it may be even more important. Here are some approaches to keep in mind. The benefits of a good night’s sleep should also make it on your radar at staff meetings—or you run a demonstrable business risk. So make a plan to figure out how to get enough sleep. Set an alarm for when you will stop working for the day. Start the morning with a list of three (ONLY THREE) essential tasks to keep you on track. And don’t forget: This weekend you have an extra hour to think about how to make your workload more sustainable for you and your employees.