Complex patients, sometimes referred to as high-need, high-cost patients, typically have multiple health and behavioral conditions, as well as significant social needs. Community health workers (CHWs) have long been used in different clinical settings to facilitate the care of persons with complex needs. CHWs are not routinely utilized in community pharmacy settings, but have the potential to contribute substantially to the care of patients through innovative roles. A CHW can build pharmacy capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy. A second role being proposed to help address social determinants (SDoH) of health in the community pharmacy setting is the SDoH Specialist. This model involves training a pharmacy staff member in SDoH identification and management, utilizing the steps of the CPESN Care Model. A SDoH Specialist’s role in a pharmacy is to assess patients for opportunities for intervention, implement a patient-specific plan, refer the patient to community-specific resources, and follow up in order to ensure that the patient attained and maintained access to these services, augmenting the patient plan as necessary. Many pharmacies already have staff members likely to succeed in this role, making the development of this new staff model more efficient for pharmacies whilst also generating new business and improving patient care. Proper implementation of a SDoH program in the community pharmacy setting is especially important because it can set the stage for continued success throughout the life of an intervention. Working alongside the enhanced service networks of CPESN, we propose to: 1- develop a SDoH program toolkit outlining processes to be implemented in community pharmacy settings using a stakeholder driven and consensus building approach, 2- analyze the feasibility, fidelity, and impact of a SDoH program embedded within community pharmacy practice, and 3- establish a prospective payment model for SDoH programs embedded in community pharmacies.
University at Buffalo
University at Buffalo School of Pharmacy
Four Corners Pharmacy
PharmD MBA PhD