How to foster continuity of care

With community pharmacies feeling the squeeze, there has never been a more important time to provide continuity of care by building patient loyalty.

Self-serve checkouts, online stores and banking through phone apps: these days there’s often little need to talk to a person when making day-to-day purchases or transactions.

Pharmacy, however, remains one of the last bastions of good ol’ fashioned human connection. ‘Patients are looking for connection,’ said Capital Chemist’s Elise Apolloni MPS. ‘So often when people engage with services or businesses there’s nothing magical about the interaction.’

Fortunately, pharmacists can use these increasingly rare personal interactions to provide patient-centred service and foster continuity of care, bringing positive patient outcomes.

What customers want

The strength of a patient’s loyalty is primarily driven by the behaviour of the pharmacist treating them – not the price of the medication or the location of the pharmacy. And there’s no shortage of studies that reach this conclusion.

A 2013 Gri­ffith University study found that patient-centred care, such as providing individualised medication counselling, continuity of care, development of relationships and respectful advice, emerged as the most important attribute when it came to retention of regular community pharmacy users.

Additionally, a US study published in the Journal of the American Pharmacists Association found that a pharmacist’s patient-centred communication style had a major influence on whether a patient would return to the pharmacy.

Associate Professor in Marketing at the QUT Business School Dr Gary Mortimer said while many customers seek pharmacies with lower prices, consumers are turning to pharmacy for healthcare solutions and triage prior to consulting their GP.

‘We see this mostly in consumers seeking access to flu jabs and health check-ups, possibly as a result of patients looking to avoid the high costs of seeing a GP for minor healthcare matters,’ said Dr Mortimer, who is currently working on the research topic ‘Clinical trials or pharmacist advice: The influence on health consumers’ perceptions of trust and decision making’.

PSA NSW Branch Vice President Krysti-Lee Rigby MPS said that consumers also wanted value. But that does not necessarily mean being the cheapest.

‘Value can come from having engaged and competent staff, service that meets or exceeds expectations, the pharmacist being accessible, being able to trust their pharmacist, and of course convenience,’ Ms Rigby said.

Holistic care bene­fits for patients

The relationship between pharmacist and patient should not be the transactional kind of relationship you have at your local convenience store, Dr Mortimer said.

‘Better patient healthcare outcomes result from ongoing, regular contact based on continuity of service and advice,’ he said.

Ms Apolloni said this was particularly apparent in the chronic disease space, where often a one visit solution wasn’t possible.

‘If a patient is not dazzled by your pharmacy and team, they may not return and you’ve missed an opportunity to build a therapeutic relationship with that person and contribute positively to their healthcare,’ Ms Apolloni said.

‘We’ve laughed with patients – and cried with them. I can’t see how that kind of connection and holistic care can be anything but great for the patient, the job satisfaction of the pharmacist, and the wider healthcare system.’

Ms Rigby added: ‘By building trust with patients, we can increase compliance of medications, create better health outcomes by educating patients on how to better manage their medications, and empower patients to take a proactive approach to their health.’

Ensuring continuity of care

Dr Mortimer suggests pharmacies take a five-stage approach to maximising holistic care opportunities, starting with establishing integrity.

‘Pharmacy must consistently deliver open and honest information across all touch points with consumers. Integrity cultivates trust between the patient and the pharmacy retailer,’ he said.

Pharmacists and assistants then need to provide expert advice around purchasing decisions.

‘Consumers have access to significant amounts of information today,’ Dr Mortimer said. ‘If a pharmacy assistant delivers inaccurate advice, or ill-informed advice that is not consistent, the patient-pharmacist trust relationship is damaged.’

The third ingredient for maximising holistic care opportunities is ensuring the security of personal data, said Dr Mortimer.

And fourth, pharmacies need to demonstrate competence.

‘Trust and continuity of care decrease when the consumer perceives that the pharmacy is incompetent in its dealings with them,’ he said.

‘For example, if the pharmacy is unable to perform transactions e­fficiently, loses prescriptions, has poor service, fails to offer a lower-priced generic alternatives, or fails to keep promises.’

Finally, and most importantly, said Dr Mortimer, the pharmacy must exhibit benevolence.

‘When a pharmacy demonstrates or promotes actions that indicate the support of the welfare of others over financial outcomes, consumers develop stronger levels of trust,’ Dr Mortimer said. ‘Benevolence is di­ cult to cultivate, as benevolent acts must be purely altruistic.’

Ms Apolloni added that being genuinely present and interested in a patient was another important precondition for holistic care.

‘We have many competing priorities, but it takes very little extra time to really listen and repeat back key pieces of information,’ she said.

Digital solutions

One way pharmacists can deliver more holistic care and maximise time with patients is by harnessing the power of technology.

Robert Read is CEO of MedAdvisor, a mobile and web app that manages all aspects of prescription medication use.

One of the advantages of this type of digital solution, said Mr Read, was that it prompted patients when it was time to re-order their medication. ‘And 50% of orders from the app go into the pharmacy outside of business hours,’ he said.

‘A pharmacy can then process those scripts before the doors even open so that when the patient comes in they can spend quality time counselling them.’

‘It’s really busy at the dispensary and pharmacists are doing all this processing work and not spending time talking to the patient about all the various things they might be eligible for,’ Mr Read said.

‘What MedAdvisor does is identify all the eligible consumers, and then helps you invite them to services they’re eligible for.’

Mr Read said their research showed more than 90% of patients stayed loyal to the pharmacy that signed them up to the app.

‘Not only does it play a big role in driving loyalty, but it improves a patient’s adherence to their medication,‘ he said.

Another way pharmacists are spending more time in front of patients is by purchasing an automated dispensing cabinet.

Pharmacy owner and technology consultant Robert Sztar MPS said the cabinets could free up your staff to deliver high-quality services, while the dispenser tackles the more routine tasks.

Avoiding poor patient service

Making patients aware of additional services they’re eligible for is an important part of providing holistic care, but Dr Mortimer said pharmacists need to be aware that not all up-sells are appreciated – especially product-based ones.

‘It frustrates consumers. They’ll pop in to collect a prescription and be up-sold OTC products, cosmetics or skincare products,’ he said.

‘While revenue and the bottom line is important, pushing sales is a short-term solution. If a consumer genuinely feels a pharmacy is taking the time to get to know them, really understanding their needs to develop healthcare solutions, they will keep coming back.’

Take a stand

While consumers do not necessarily become loyal to a particular brand or pharmacy, they do become loyal to what the business stands for, Ms Rigby suggested.

‘For community pharmacies to continue to be viable, they need to have clear missions and values, and ensure their staff align with them,’ she said. ‘Pharmacies need to show consumers what they stand for, besides making money.’

References

1. McMillan S, Sav A, Kelly F, et al. How to attract them and keep them: the pharmacy attributes that matter to Australian residents with chronic conditions. At: research-repository.gri­ffith.edu.au/bitstream/handle/10072/56443/90113_1.pdf;sequence=1
2. Journal of the American Pharmacists Association. The effect of pharmacy setting and pharmacist communication style on patient perceptions and selection of pharmacists (2018). At: sciencedirect.com/science/article/pii/S1544319118301845

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