Pharmacist checking blood pressure of patient

Test-to-Treat Protocols in Pharmacies

June 21, 2022

by Hannah VandeRoovaart

Basic Diagnosis and Treatment in Pharmacies

The pharmacist’s role is continuously evolving, with more and more clinical capabilities being executed. While the education and training are there, the proper implementation of these services in a community setting is lacking. One of these clinical services is known as the test-to-treat protocol, which gives pharmacists the ability to practice at the top of their license providing point-of-care-testing (POCT) followed with proper medication management. This has proven to be both beneficial for our patients in local communities and the entire health system. The test-to-treat protocol, as Dr. Justin Cole, Director of Cedarville University’s Center for Pharmacy Innovation, puts it, “is a no brainer.” Pharmacists can confirm the diagnosis of many conditions and have the resources to then give the patient what they need in that moment. However, many questions remain: How do test-to-treat protocols fit into the daily pharmacy workflow? What are the barriers to implementation? How do we move forward and make progress today? 

In episode 18 of the DISRxUPT Podcast, Dr. Justin Coby, Director of Cedar Care Village Pharmacy, shares his insight regarding test-to-treat protocols in the pharmacy setting.

Defining Test-to-Treat Protocols

In short, test-to-treat protocols allow pharmacists to provide POCT and diagnostic services for minor health conditions that can be treated more efficiently through the utilization of our most accessible healthcare providers, pharmacists. A pharmacist uses POCT to determine the diagnosis, then recommends and provides the resources (i.e., medication, OTC self-care items, or a combination of the two) needed to provide care. Staggering statistics point to the gap in care that occurs due to patients not getting their prescriptions filled after seeing their healthcare provider. The ease of accessibility that these test-to-treat protocols bring can improve healthcare in the community setting in ways not seen before.

We need to reimagine the role of pharmacists and help others to see the value of the services pharmacists can provide.
Some healthcare providers may be apprehensive to the idea of delegating “diagnostic duties” to pharmacists. Through advocating for these protocols, pharmacists must engage other healthcare professionals to ensure proper continuity of care and communication. This is where a mindset shift could do wonders; we need to reimagine the role of pharmacists and help others to see the value of the services pharmacists can provide. With proper collaboration, other healthcare providers will ask the pharmacist to have a place in the care of their patients. 

Role of Health Information Technology in Fostering Collaborative Care 

Widespread change can be achieved through incorporating what is known as data liquidity, the ability of data to flow throughout the healthcare system easily and securely. This would have an undeniable effect on the impact pharmacists could have in the community setting. Imagine a centralized data platform consisting of all the patient’s medication, vaccination, and diagnostic history available for pharmacists to access and make appropriate treatment recommendations based upon. While currently a rate-limiting step, novel technology solutions could be the secret to catalyzing widespread implementation of test-to-treat protocols in pharmacies. 

Fostering the Spread of Test-to-treat Services

Just like with any other significant change, test-to-treat protocols need to start somewhere. Dr. Coby recommends starting slow and starting now. Finding ways to implement, document, and then bill for these services is the first step. Working with state boards of pharmacies is another great starting place. Efficient billing for these services is a major barrier when executing this test-to-treat protocol. It is in the best interest of insurers to compensate those who provide preventative care to their patients, as it often serves as a way to mitigate future medical expenses. It is no secret that community pharmacies can be quite busy, so the documentation and billing of these services must fit in seamlessly with the workflow. 

The traction that has been made through advocacy, training, and interprofessional collaboration cannot be denied; however, raising awareness of test-to-treat protocols is not enough. We need to initiate change. The Ohio Pharmacists Association and the American Pharmacists Association both have numerous resources available for pharmacists to begin with these initiatives, and yet more collaboration is needed.

Will test-to-treat services be coming to your pharmacy soon? We think so.

Hannah VandeRoovaart is a student pharmacist at Cedarville University School of Pharmacy. She is on track to graduate in 2024 with her Pharm.D. and M.B.A. Her current interests include medical affairs and market intelligence within the pharmaceutical industry. 

The Cedarville University School of Pharmacy is equipping its Doctor of Pharmacy students to be on the leading edge of healthcare innovation. Cedarville’s Pharm.D. students are fully prepared to begin a rewarding career as a pharmacist and to use their calling to make a difference for Christ as they serve with excellence and compassion.

Resources: 

  1. Successful Healthcare Analytics: Data Liquidity. (n.d.). Retrieved June 20, 2022, from Point B website: https://www.pointb.com/insights/successful-healthcare-analytics-data-liquidity/#:~:text=Data%20liquidity%20is%20the%20ability

 

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