By donalee Moulton
Illustration by Martin Bregman
Over the last several issues Pharmacy Business has explored the appointment-based model (ABM) and the benefits for Canadian pharmacists and their patients.
Together we have taken a step back in time to the formation of this innovative approach. We’ve also examined the mindset changes that need to occur as a first step to success, and in our last issue, we took a practical look at implementing medication synchronization.
Now we’d like to take you inside the appointment process, a cornerstone of the model. Central to this process is the pre-appointment call. The American Pharmacists Association Foundation says this call “fuels the engine that drives the ABM.”
Before the patient’s appointment day, a member of the pharmacy staff, often a technician, phones the patient to determine the refill order for that month. This call benefits both the patient and the pharmacist, says John Sykora, the California-based pharmacist who created ABM. “We realized the monthly call could be used to manage other health-related issues. We were also managing adherence.”
Sykora and his team would take this time to enquire about compliance, side-effects and other medication issues – and offer solutions. They also asked about physician and hospital visits and any recent health changes. The call is about being fully informed to more fully help patients. It is also about standing apart from the competition.
In the APhA Foundation’s guide, “Pharmacy’s Appointment Based Model: Implementation Guide for Pharmacy Practices” [http://www.aphafoundation.org/sites/default/files/ckeditor/files/ABMImplementationGuide-FINAL-20130923.pdf], authors Dr. Lindsay L. Watson and Benjamin M. Bluml point out that the pre-appointment call signals the uniqueness of the appointment-based model. “This call differentiates the ABM from an automatic refill program because it provides meaningful information about relevant changes in the medication profile since the last visit to the pharmacy.”
The pre-appointment call also reaffirms the important role the pharmacy plays and further cements the relationship with patients, driving greater customer loyalty. It is services like this, says Gerry Delli Quadri, client relationship director at Willis Towers Watson, “that demonstrate real value to the patient and, ultimately, to the business.”
Patients will have a scheduled appointment day, which is distinct from a scheduled appointment. It is not necessarily a specific time or place, and the pharmacist does not have to carve out a set amount of time for a one-on-one discussion with every patient every month. The scheduled appointment day, however, does offer an important opportunity to check in with patients as they pick up prescriptions. The check-in can include questions about medication issues as well as provide information about the treatments to help educate patients. The check-in could also be a scheduled appointment to provide a service that is appropriate for that particular customer, at that particular time. Whatever the content, the result is increased customer loyalty and stronger patient relationships.
“A pharmacy is a business, and at a minimum, it needs to respond to its patients and customers. Today, you need to go beyond the minimum to thrive,” says Delli Quadri.
Some pharmacists have questioned the wisdom of having customers come into the store monthly as opposed to dropping in more often. They are surprised at the answer. While patients may pick up a pack of gum on their way out of the store, this is not the same as having a sustained and significant relationship. With ABM, patients move from having a pharmacist in their neighbourhood to a trusted advisor, says Delli Quadri. “This increases levels of engagement and increases discretionary purchases.”
As the relationship becomes stronger, he notes, so does loyalty. “It opens the door to other opportunities that can have a dollar sign attached to them.”