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Join us at 11 a.m. CT (12 p.m. ET/9 a.m. PT) on Thursday, March 17, for a live hour-long chat on the changing role of your neighborhood pharmacist. The chat will be moderated by Chicago Tribune health care reporter Bruce Japsen and feature panelist Richard Ashworth, vice president of pharmacy services for Walgreens, the nation's largest drugstore chain.

Topics addressed will include retail medicine and clinics launched by drugstores, retail and grocery outlets. Other topics include the pharmacist's expanding role in consumer medical care. There will be an increasing number of medical care services available from pharmacists--thanks to state regulations becoming more open to others being involved in primary care--and health reform encouraging an expansion of what pharmacists can do as well as what consumers would like to see, including immunizations done in a drugstore to wellness exams.

The health care overhaul law will also figure in the future of medical care and the role played by pharmacists, who are expected to pick up the slack given a nationwide shortage of primary care physicians who will be inundated with patients, particularly when medical care coverage is expanded to more than 30 million uninsured Americans by 2014 under the health law.

Richard Ashworth, who joined Walgreens in 1992 as a service clerk, rose through the ranks of store management before becoming a pharmacy manager in 1999. By 2003, he was a store manager and promoted to district manager in 2005. In 2007, he became vice president of benefit management services for Walgreens Health Services. He earned his pharmacy degree from Nova Southeastern University in 1999 and his M.B.A. from the University of Phoenix in 2004.

If you are unable to make the chat and would like to send your question in advance, e-mail Bruce Japsen at bjapsen@tribune.com.

Health Chat: Pharmacists' role after health care law

(03/17/2011)

  

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10:53

Bruce Japsen:  Welcome today's health chat on the changing role of pharmacists. Joining us today is Richard Ashworth, vice president of pharmacy services at drugstore giant Walgreen Co. So Richard, there are a lot of new laws and regulations coming with health reform, but there are also state rules that are allowing pharmacists to do more. Can you tell me how this impacts customers at the nation's pharmacies? Thursday March 17, 2011 10:53 Bruce Japsen

10:58

Richard Ashworth:  Customers will have a broader access for the expanded services such as health screenings and immunizations. The benefit to customers will be a positive one since community pharmacy is located in the local communities and are a natural extension of the healthcare system. Thursday March 17, 2011 10:58 Richard Ashworth

11:02

Bruce Japsen:  Richard, Wayne Bennett, the Publisher of Drug Store News e-mailed me earlier and asked how pharmacists and Nurses Practitioners work together to deliver collaborative care to optimize patient outcomes? Thursday March 17, 2011 11:02 Bruce Japsen

11:03

Richard Ashworth:  Coordinating care is an important aspect of the future of the healthcare system. In the 33 states where Walgreens has Take Care clinics, inluding Illinois. We are able to connect with physicians and pharmacies in a manner that ensures patient care and positive outcomes. Thursday March 17, 2011 11:03 Richard Ashworth

11:03

[Comment From Dennis Bryan RPh,MBA,FAPhDennis Bryan RPh,MBA,FAPh: ]  I also have a collegue, named Warren Winston, who has spoken highly of you. Thursday March 17, 2011 11:03 Dennis Bryan RPh,MBA,FAPh

11:05

Bruce Japsen:  Thank you Dennis. Warren is a well-known advocate for pharmacy downstate. Do you have a question? If so, please let us know. Richard and I are here until noon Central, 1 pm Eastern talking about health, wellness and pharmacy trends Thursday March 17, 2011 11:05 Bruce Japsen

11:08

Bruce Japsen:  Richard. Another reader also e-mailed me earlier, apparently because he could not participate live. This gentlemen, from Rush University Pharmacy said: "In order for there to be comprehensive community based medication therapy management ( MTM) certain pieces of the puzzle need to be provided. Specifically, lab values, medical history, medication history and time for the pharmacist to interpret and act on these variables is essential. Is there a viable model in place at Walgreens that incorporates these essentials and can evaluate outcomes?" Thanks for your question Thursday March 17, 2011 11:08 Bruce Japsen

11:09

Richard Ashworth:  Great question, we have worked dilligently to be able to deliver face to face interventions in a community setting. One important aspect is enabling the Rph to have the time to spend with patients. We fully believe in the value of MTM programs, adherence is a $290B problem in this country and nobody is better positioned to help than retail pharmacy. With that being said, we (as a industry) have a lot of work to do to create the policies and protocols and standards to ensure appropriate communication. Thursday March 17, 2011 11:09 Richard Ashworth

11:09

[Comment From Scott MathewsScott Mathews: ]  In some states, will pharmacists become involved directly in such primary care functions as examinations, diagnosis, and prescribing? If so, are there any potential conflicts of interest in having the same person prescribe a medication and fill it? Thursday March 17, 2011 11:09 Scott Mathews

11:13

Richard Ashworth:  Scott - I believe the primary positioning of the pharmacy profession is around medications and their appropriate use. There is a strong need in this Country for Pharmacists to provide additional services. We do alot in the area of consultations in disease states such as diabetes and blood pressure. We help patients after they have a defined diagnosis and would defer patients to their primary care physician related to diagnosis etc. Health test results are good indicators for patients to have to act as a catalyst for them to see their primary care physician. Thursday March 17, 2011 11:13 Richard Ashworth

11:13

[Comment From FaytheFaythe: ]  I have been fortunate to have been a pharmacist for about 30 years and the changes in the past few years have been amazing! I think immunizations are a huge part of preventitive care, with medication therapy reviews rating tops also. I think for the future we must forge ahead with these in mind but never loose sight of our patients. I am very big on patient counseling and treat every patient as if they are entering my home when they come to my pharmacy. We must keep conversing with our patients...they have to know they can come to us for problems. Multi drug therapies make this crucial. Thursday March 17, 2011 11:13 Faythe

11:15

Bruce Japsen:  Faythe. Thanks for your question. If you e-mail me at bjapsen@tribune.com, I can e-mail you a story I did a year ago on the changes in pharmacy and how states are changing regulations to allow pharmacists to do more than just flu immunizations, etc. States allowed more vaccinations to prepare for swine flu. It worked well enough that states see pharmacists filling a role as primary care practitioners Thursday March 17, 2011 11:15 Bruce Japsen

11:16

[Comment From MichelleMichelle: ]  Hello, I'm interested to know what types of questions patients ask the pharmacists using the online chat function. Also, are there physicians staffing the Walgreens online chat in addition to pharmacists? Thursday March 17, 2011 11:16 Michelle

11:19

Richard Ashworth:  Michelle - we get a broad spectrum of questions from the patient population, ranging from medication related side effects, OTC's, general health questions about a recent diagnosis etc. Pharmacists will many times be able to answer the questions and if not, we will point patients to another more appropriate healthcare provider. With respect to the chat, Walgreen Pharmacists are on the chat today! Thursday March 17, 2011 11:19 Richard Ashworth

11:19

[Comment From GuestGuest: ]  My son is thinking of Pharmacy school after he graduates from U of I. What is and what will the job climate be like for future years to come considering the health care law if applicable. Thank you. Thursday March 17, 2011 11:19 Guest

11:22

Richard Ashworth:  The pharmacy profession is a wonderful profession and I recommend it to many of my friends and family members. As we continue down the road of expanding services that Pharmacists provide - the profession will continue to need highly trained clinicians to interact with patients and providers. As a side note, Walgreens currently ermploys 27,000 pharmacists. Thursday March 17, 2011 11:22 Richard Ashworth

11:22

[Comment From AnnAnn: ]  When you say filling a role as primary care practitioners, what do you see as the expanding scope of the pharmacist, other than immunizations? Thursday March 17, 2011 11:22 Ann

11:25

Richard Ashworth:  Ann - very good question. i think about areas that are natural extensions of what a Pharmacist does today. Immunizations, health screenings, disease state management and monitoring, medication therapy management, health education, wellness activities - coaching, as well as other ancillary services like bone density scans and light laboratory services. Thursday March 17, 2011 11:25 Richard Ashworth

11:26

Chicago Tribune:  Here is the link to the article Bruce referred to (at 11:15) about the change in pharmacies. Please feel free to read: "Drugstores want shot at more vaccines: Walgreens, CVS seek to lift restrictions" http://articles.chicagotribune.com/2010-03-01/business/ct-biz-0301-shots--20100301_1_seasonal-flu-vaccine-production-flu-vaccines Thursday March 17, 2011 11:26 Chicago Tribune

11:26

Traditionally, most vaccinations have been given in a doctor’s office but states are changing regulations to allow pharmacists to administer vaccinations for a variety of diseases and viruses. Who do you prefer to get your vaccination from? Doctor  ( 15% ) Pharmacist  ( 38% ) Another health care professional  ( 46% ) None of the above  ( 0% ) Thursday March 17, 2011 11:26

11:27

[Comment From tom Gochenourtom Gochenour: ]  There is pending legislation in Ilinois that will define "a clinical Pharmacist" in the pharmacy practice act. This gives the " clinical pharmacist" prescribing privileges under standing orders from a physician. Do you see walgreens supporting this legislation and expanding into more indepth clinical programs, if for no other reason than to forge another revenue stream Thursday March 17, 2011 11:27 tom Gochenour

11:29

Bruce Japsen:  Tom. Do you have a specific bill number for this "clinical pharmacist" idea you are talking about? Based on the above story I referenced, pharmacy roles are expanding relative to vaccinations but we would need to see the bill number and read it to comment. Thursday March 17, 2011 11:29 Bruce Japsen

11:31

[Comment From MiriamMiriam: ]  What do you see as the role for pharmacy techs in the future? Thursday March 17, 2011 11:31 Miriam

11:32

Richard Ashworth:  Miriam - Pharmacy technicians are one of the most important folks in our community pharmacies today. Their abilities and empathy toward our patients not to mention the complexities around billing and payments are vital for the patient experience. I see the future of pharmacy technicians in advancing their role in supporting the pharmacist as retail based services expand. Thursday March 17, 2011 11:32 Richard Ashworth

11:32

[Comment From FaytheFaythe: ]  In this economic environment, money is on everyone's mind. Health often takes a backseat. Many of my patients can not afford expensive therapies and look to us to suggest ways to reduce expenses. It is important to get a positive balance of proper care and affordability. Pharmacists are trained to be proficient in many areas of medication and patient care. They are a positive link between patients and nurses and doctors. Thursday March 17, 2011 11:32 Faythe

11:34

Richard Ashworth:  Faythe - Great comment. I agree, it is very important to have appropriate balance between patient care and affordability. This is what retail pharmacists deal with every day - trying to find appropriate solutions for patients so they will be compliant with their medication regimen. Thanks for the comment. Thursday March 17, 2011 11:34 Richard Ashworth

11:34

[Comment From StanStan: ]  Many patients do not really understand their medications well, how to know if they are working or not, and when to seek advice about adverse effects before things go too wrong. But it seems pharmacists really don't have, or make, the time to spend with patients fully explaining things. Similarly, it seems many patients don't want to take responsibility for learning about proper use of their meds. This all results in many ER visits, hospitalizations, and generally avoidable large costs. How do you see this changing in community pharmacy in the future? Thanks. Thursday March 17, 2011 11:34 Stan

11:39

Richard Ashworth:  Stan - Health literacy in this Country most certainly is a major issue. Pharmacists are the medication experts and are perfectly positioned to help customers make wise choices. There is not a option to do nothing - $290B problem. We are taking actions to streamline workflow in our pharmacies so we can position our pharmacists to have more interactions with their Patients. Industry data shows MTM programs provide a $12 return on investment for every $1 spent - the value is there. The downstream costs and consequences of poor adherence or not understanding why you are taking your medication is the problem we are all working to resolve. Thursday March 17, 2011 11:39 Richard Ashworth

11:39

[Comment From John KellerJohn Keller: ]  Too many pharmacy schools opening currently, I would be leary about recommending pharmacy school at this time. Thursday March 17, 2011 11:39 John Keller

11:40

Bruce Japsen:  John. Thanks for your question. Across the country, state governments are considering opening more programs, rather than schools given state budget issues. More broadly, medical care providers I talk to eventually see more job prospects in certain areas of health care because the medical care system is going to get more than 30 million paying customers under health care reform when these people get coverage and the ability to pay for services Thursday March 17, 2011 11:40 Bruce Japsen

11:41

[Comment From AmyAmy: ]  How will Walgreen's work with physicians to get them comfortable with referring patients to pharmacist's services to truly integrate care for the patient in the community? Without this coordination -- the risk is more fragmented silo care. Thursday March 17, 2011 11:41 Amy

11:42

Richard Ashworth:  Amy - There is strong risk without having coordination. With the creation of ACO's the need for coordination will be even more evidenced. At Walgreens, we will be able to connect with other providers with the actions we have taken, electronic medical records will be the conduit for this to occur. Thursday March 17, 2011 11:42 Richard Ashworth

11:43

Chicago Tribune:  The following comment is in response to Bruce's query at 11:29. Thursday March 17, 2011 11:43 Chicago Tribune

11:43

[Comment From tom Gochenourtom Gochenour: ]  HB 2028 Thursday March 17, 2011 11:43 tom Gochenour

11:45

Bruce Japsen:  Thanks for looking up the bill number. We'll keep an eye on its progress. Thursday March 17, 2011 11:45 Bruce Japsen

11:46

[Comment From MargaretMargaret: ]  Hi Richard! It's wonderful to hear about the advances Walgreens has made in pharmacy and patient care. One of the leading areas of change is the widespread interest in the patient-centered medical home (PCMH). Can you please share your thoughts on the PCMH and the current/potential opportunities for Walgreens pharmacists? And the link between MTM and PCMH for Walgreens? Thanks! Thursday March 17, 2011 11:46 Margaret

11:48

Richard Ashworth:  Margaret - I believe there is a strong relationship between the medical home and MTM and retail pharmacy. Patient centered, quality, access, coordination and comprehensive care are at the cornerstone of a medical home. Pharmacy must be and should be strongly considered for inclusion considering the wide benefits of pharmacists interventions. Thursday March 17, 2011 11:48 Richard Ashworth

11:49

[Comment From tom Gochenourtom Gochenour: ]  Richard,in your opinion,is the general public ready to have the pharmacist manage their meds? If not what is the best way to educate them. Thursday March 17, 2011 11:49 tom Gochenour

11:51

Richard Ashworth:  Tom - I do. 85% of Medicare Part D recipients have a positive experience with their MTM intervention. There is a evolution to take place. The heart of your question is around the best way to educate them. I don't want to be overly simplistic - but relationships. Having a relationship between the patient and their trusted advisor (pharmacist) is the best way to educate them. Thursday March 17, 2011 11:51 Richard Ashworth

11:53

[Comment From ShirleyShirley: ]  How will this expanded role of pharmacist overlap (or be different) from that of a physician's assistant or nurse practitioner? Walgreens has these people in some stores currently. Thursday March 17, 2011 11:53 Shirley

11:55

Richard Ashworth:  Shirley - the pharmacist will be doing what we have spoken of earlier in the chat. With the 350 Take care clinics we have, they treat a variety of illnesses from sore throats to blood pressure. The NP and PA's provide diagnosis and treatment regimens where the pharmacists provide medications and counseling. The potential area for overlap would be around wellness and prevention activities - I view these as complimentary and ensuring appropriate access to the patient population. Thursday March 17, 2011 11:55 Richard Ashworth

11:56

[Comment From KathrineKathrine: ]  Hello. Are all of your pharmacies providing MTM services now? If not, when are you planning on rolling our this service nationally? Thursday March 17, 2011 11:56 Kathrine

11:58

Richard Ashworth:  Katharine - Yes, all of our pharmacies are providing MTM services today. If you are interested please go into your neighborhood Walgreens and ask about the service. Thank you for all of the great questions, I appreciated the opportunity! Thursday March 17, 2011 11:58 Richard Ashworth

12:00

Bruce Japsen:  We'd like to thank Richard Ashworth, Vice President of Pharmacy Services at Walgreens for joining us today in talking about the changing role of the neighborhood pharmacist. Please join us Tuesday, March 22 at Noon Chicago time (1 p.m. ET) for a chat about vaccines, vaccine safety and the anti-vaccine movement with Trine Tsouderos. Also check out www.chicagotribune.com/healthchats for other local health chat topics and www.chicagotribune.com/health for chats with our sister papers. Thursday March 17, 2011 12:00 Bruce Japsen

12:02