One way CMHCs are able to develop more personal connections with their consumers is through on-site pharmacies. By partnering with a national pharmacy services vendor, many centers are realizing the benefits of having a qualified pharmacist on-site-a member of the staff with the time and capability to offer their undivided attention.
“Retail pharmacies are just not set up for that-everyone's always in such a rush,” notes Vic Topo, president and CEO at the Center for Life Management (CLM), a New Hampshire-based nonprofit community mental health organization. “Clients of mental health centers are patients, but they are also our customers. It's important to keep that in mind and continue to offer them new and unique benefits.”
Time is of the essence
Every CMHC's story is different. So when CLM first started working with on-site pharmacy services provider QoL Meds in 2007, the possibilities were immense. According to Topo, what's resulted in the three years since the pharmacy opened in early 2008 is exactly what he envisioned: a “one-stop-shop” experience for CLM's clients.
“Patients who go directly to the on-site pharmacy get more of an education from the pharmacist, a better knowledge of the medications, and a very personalized approach,” Topo says. “The pharmacist is always there to answer questions and can take the extra time with the client.”
The extra time can go a long way. Still challenged by getting patients to fill prescriptions and properly take their medications, centers with on-site pharmacies have the resources to explain the meds and even follow up to make sure consumers are taking them properly.
According to QoL Meds president and CEO Jim Smith, on-site pharmacies provide a solution to one of the primary tasks of a behavioral health center-getting (and keeping) patients titrated on their medications.
“Once a patient is compliant on a medication, the pharmacist needs to be working closely with them and maintain continual feedback,” Smith explains. “This level of interaction can make a world of difference to a patient's total outcome.”
Strategies vary depending on the patient, the physician and CMHC involved, but often include communicating potential compliance issues back to the psychiatrist and making sure prescriptions are being filled.
Pharmacists also can review a patient's refill history prior to each visit, set up refill schedules, provide “short” prescription fills, and other services to help customers stay compliant.
“Our customers are already going to be in the building getting counseling, so it makes sense to incorporate this one-stop shopping experience as an added benefit,” says Topo. “It provides a communication mechanism that does not exist with retail pharmacies.”
Have space, will travel
At the time Topo first considered the benefits of partnering with an on-site pharmacy services vendor, CLM was already in the process of constructing a new building that would serve all of its patients in one location. Including an on-site pharmacy seemed like a natural extension of the plan.
“We were building a new center, a brand new physical environment, so the timing was perfect,” he explains. “Having a pharmacy fit so beautifully with what we were trying to accomplish in terms of bringing something helpful to our community-and to the clients we would be serving.”
A number of investments are involved in developing an on-site pharmacy, including a series of licensing procedures and the pharmacy space itself. So before moving forward, vendors typically meet with a CMHC's administrative staff to make sure the arrangement is going to benefit both parties. They also have to determine if the center services enough patients to support the investments.
Finally, a vendor will determine whether a center is willing to sign up for a true partnership. “If a center doesn't want to form a partnership to really drive those outcomes, it's going to be a failure,” states Smith. “Those are the two key factors-are they big enough, and do they share our vision? If you get those two pieces, you're likely to be successful.”
What's surprising to many CMHCs is that having enough capital to fund these projects doesn't factor in at all. In fact, a center doesn't have to do anything except give up 300 to 500 square feet of space. Once an agreement is reached, the vendor takes care of everything else.
“We build the pharmacy, get all the licenses, and hire the pharmacists and any other staff members that we need to effectively run the facility,” Smith explains. “We also set up billing to all third parties-whether it's Medicaid, Medicare or any other commercial third-party vendor.”
Directing the flow of traffic
To make new pharmacies an attractive alternative for clients, accessibility-to the space itself and to the pharmacist-is key. As a result, most pharmacies are placed near outpatient waiting rooms to enable consumers to ask the pharmacist (or the staff) any questions they may have.
“Generally that is where we target and generally that's where we end up,” says Smith. “Of course, there are situations where the space isn't available, so we work with the center to pick out a site within the building that is acceptable to both parties. It's a very collaborative effort.”