Transforming Community Pharmacy: The New Walgreens at UCSF

Thursday, March 13, 2014

There’s something different about the new Walgreens in Millberry Union. From its clean minimalism and wide-open spaces to its frosted whites and pastel blues, the pharmacy exudes what is dubbed “the Apple Store experience.”

Employees carrying iPads even greet you on your way in. But the design aesthetic hints at differences that are more than just skin deep. With merchandise pushed to the side and pharmacists and technicians placed front and center, the pharmacy physically de-emphasizes products, refocusing of the community pharmacy as a viable center of healthcare.

A feat more than a year in the making, Walgreens at UCSF is the result of a triple collaboration: Walgreens, the Department of Pharmaceutical Services in the UCSF Medical Center and the Department of Clinical Pharmacy in the UCSF School of Pharmacy.

“The idea was how can an academic medical center, a school of pharmacy and one of the largest chains really work together to create a new vision for community pharmacy and look to study it,” said Dr. Marilyn Stebbins, Clinical Pharmacy Faculty.

With the expected increase in the insured population from the Affordable Care Act, baby boomers hitting the age for multi-drug therapies, and the primary care shortage, there is the drive to create a new type of pharmacy—one that tackles the increase demand for health care while delivering care in places most accessible—people’s communities. Walgreens at UCSF is a laboratory to explore how such issues might be addressed and a model for other community pharmacies.

Several resources are at the disposal of the new Walgreens. The involvement of the Medical Center gives this Walgreens a terminal into their electronic Medical Record System (EMR) known as APeX.

The information stored in the Walgreens’ system is woefully lacking—there are no lab results, diagnoses or anything outside a basic (and often incomplete) list of medications. APeX helps fill these data holes. With APeX, pharmacists can see a UCSF patient’s health information (height and weight, lab results, kidney function, etc.) to ensure that each person receives the correct medication at the correct dose.

Cameras capture key points in the prescription filling process so that pharmacists can verify prescriptions remotely, preferably in a space visible and accessible to pharmacy patrons.

The School of Pharmacy is present to develop and test clinical programs. Serendipitously, the opening of Walgreens at UCSF coincided with the enactment of SB493 that gives expanded roles to pharmacists now recognized as providers. As soon as the details and protocols for this expansion are hammered out, this pharmacy will be one of the first to implement those programs.

Currently, the first clinical program is the Med List Clinic. By appointment only, a pharmacist and patient will review a patient’s medication list in one of the cozy consultation rooms in the back of the pharmacy. The goal is to create a “personalized, actionable, portable, patient centered medication list…to empower the patient to own their med list,” said Dr. Stebbins. The Med List Clinic, officially launched last week, has already seen some positive preliminary feedback.

While a collaborative effort, the School of Pharmacy looks for the day when it can walk away from Walgreens at UCSF and have the Walgreens pharmacists sustain all of the clinical efforts. Ultimately, the goal is not to create one unique Walgreens, but to transform all community pharmacies into centers and providers of care—a place that truly fulfills Walgreens’ mission “to help people get well, stay well and live well.”