Eighty percent. It's a daunting percentage that shows how many counties across the U.S. are considered healthcare, or medical, deserts.
This was an unacceptable problem even before the COVID-19 pandemic. And now it's revealed a glaring truth as the world manages a global public health crisis—a time when people need more access to and a greater understanding of healthcare.
Medical deserts exist in both rural and urban areas. It's not uncommon for communities of color to also face a scarcity of medical resources. And those same underserved neighborhoods also have disproportionately faced disruption and loss because of the pandemic.
It's past time to retell that story.
Within the medical desert crisis, there may be an opportunity—certainly, there's an obligation—to redefine what a healthcare desert is. Pharmacists can harness the expansion of telemedicine, their patient-based skills and strong community ties to fill some of the gaps in access.
Where so-called "traditional" brick-and-mortar medical facilities do not exist, pharmacists have been using telemedicine to help patients connect with their physicians to answer questions, address concerns and set health goals. With digital tools such as tablets and smartphones, they sometimes "accompany" patients during telehealth appointments, which can be done remotely or in person if a telemedicine hub is present at a pharmacy.
Some rural areas have implemented telemedicine models to provide remote pharmacy services where there were no pharmacies.
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In North Dakota, pharmacy technicians prepare prescriptions and obtain approvals from pharmacists via videoconference to dispense medications (patients first receive counseling from the pharmacist, also through videoconferencing.) Some of Nebraska's rural hospitals are using remote pharmacists to review electronic health records to verify prescriptions and review patients' medical history before hospital staff dispense prescriptions.
The TelePrEP program provides yet another model, expanding access to pre-exposure prophylaxis (PrEP) medication to people at risk of contracting HIV who live in rural Iowa. Patients use a smartphone app or video technology to meet with pharmacists who counsel patients and prescribe PrEP regimens. Pharmacists also conduct follow-up telehealth calls with patients to oversee their adherence.
Pharmacists also can use their experience and training to provide basic primary-care functions, especially for patients with chronic conditions, to monitor things like blood sugar and blood pressure. Some pharmacy chains have already embraced this model with walk-in clinics. If the pharmacist is concerned with a reading, they connect patients with physicians to review results, adjust medications and discuss follow-up care.
Pharmacists aren't simply pill dispensers and patient navigators. They're often a community's most familiar, accessible medical professional. Throughout the COVID-19 pandemic, for example, they've offered guidance, COVID tests, vaccine advice and the vaccines themselves.
That's been effective because pharmacists often are already connected personally with the communities where they work because their daily, face-to-face interactions give them credibility and trust throughout the neighborhood, offering patients (sometimes neighbors) common ground and effective, tailored messages about medications, health and wellness.
A scarcity of medical resources doesn't have to doom the health of entire communities. A few key well-placed resources can go a long way to boosting both access and understanding. Pharmacists certainly have a role to play and can do so effectively (and cost-effectively) by providing important, basic medical services in conjunction with telehealth technology. Filling some of the holes in resources puts pharmacists in a position to elevate and empower communities and begin to transform medical deserts into more healthy places to live.
