Kerr pushes the boundaries of pharmacy care

Drug Store News, Dec 17, 2001 by James Frederick

DURHAM, N.C. -- Say you're diabetic and want your glucose levels monitored by a professional. Or you're concerned about heart disease and wondering about your cholesterol level or blood pressure. Maybe you're trying to quit smoking--or you're worried about osteoporosis and want a bone density screening. Where do you find help quickly, affordably and with a minimum of effort?

In more and more markets served by Kerr Drug, the answer may be the pharmacy. Kerr's pharmacy leaders believe increasingly that if they had the choice, many Americans would turn to their local pharmacy for first-line treatment, health education or routine screenings before calling their doctors for an appointment.

But it's a big "if." Giving consumers that choice requires a drug store operator to make a big investment in time, money and professional staff to establish the concept and practice of pharmacy care and disease management. It requires an investment in space for private offices, a reception area and perhaps a patient waiting lounge within the drug store--preferably adjacent to the pharmacy. And it usually requires a close working relationship between the pharmacy and a local university.

Kerr executives are betting big that the company's own investments in patient care will pay off. In line with a retooling of its basic retail mission to emphasize pharmaceuticals, clinical care and prevention, the chain is revamping more of its pharmacies to accommodate patient education, screening and disease management programs. It also is enlisting a broad range of partners--physicians, educators, health plans, pharmacy students, drug manufacturers and community groups--to expand its growing clinical-care services to the communities that surround its stores in North Carolina and South Carolina.

"There's an expanded role pharmacy can play," said Ralph Petri, Kerr's senior vice president of pharmacy and logistics. "We really believe the pharmacist will play a key role in monitoring and managing disease in the future."

The 154-store drug chain helped define and shape the pharmacy-care concept with the opening in Chapel Hill, N.C., of its first practice site--dubbed the Kerr Drug Enhanced Pharmaceutical Care Center, or EPCC--in fall 1998. Since unveiling that practice site at its University Mall store near the University of North Carolina, the chain has added two more fully equipped EPCCs at "hub" stores in Charleston, S.C., in conjunction with Medical University of South Carolina, and Benson, N.C., with Campbell University--as well as three smaller-scale "spoke" centers in Asheville, north Raleigh and Greensboro, N.C. Other stores--including the chain's newest store in Wakefield, N.C.--are being considered for EPCC elements or are already playing host to periodic health care screenings in coordination with local communities.

"There are now six centers of activity ... including the satellite programs developed in three stores," Petri explained during a recent interview at the University Mall EPCC. "This is a learning process for us."

Fully equipped care centers include an entrance with a patient reception desk, private rooms for disease management counseling and testing, a separate classroom and a large waiting room stocked with educational brochures, magazines and toys to keep kids busy. Smaller satellite patient-care centers consist of private counseling rooms adjacent to the pharmacy.

With six centers--and more on the way--Kerr clearly is ahead of most pharmacy providers on the patient-care front. Petri, however, characterizes the chain's expansion of the concept as slow and deliberate. Kerr's pharmacy team, he indicated, has followed a gradual but progressive learning curve in its efforts to link up with and gain support from educators, health plan sponsors, local physician and nursing groups, pharmaceutical suppliers, community organizations and patients themselves.

"We had to step back and be patient and let this evolve," he said. "One of the reasons we're going as slowly as we are is because we are absolutely committed to quality of care. We'll continue to do this step by step."

Eventually, he said, "We're confident there will be an overwhelming need for this kind of care."

"We are very confident this type of operation will evolve to where it's a core part of pharmacy," added Rebecca Chater, group manager of clinical services for the chain. Chater recently became the first female chain pharmacist elected to the North Carolina Board of Pharmacy.

Under Chater's direction, Kerr's three "hub" EPCCs are staffed with a team of pharmacists who have advanced clinical training and who are skilled in relating to patients. Each of those three sites can include one or more shared faculty members from the respective universities' pharmacy schools, as well as one or more Pharm.D. graduate students in residence. "We've had a lot of interest from faculty," Chater told Drug Store News. "It's an opportunity to integrate what we do with the clinical teaching in the pharmacy school."