NIP expansion and beyond - exploring the path to a thriving pharmacy vaccination service
The community pharmacy space is currently riding the waves of a dynamic shift in everyday practice. Health services are transitioning from being a valuable add-on to becoming a core part of a community pharmacy’s dispensary offering.
Skilfully riding these waves of change, community pharmacists are embracing an era where professional practice is no longer limited to dispensing and counselling of medication, and they’re now in search of where new, significant opportunities lie.
As pharmacists, to truly discover real value of professional services – and more specifically, vaccination services – it’s time to stop looking to the past, and become more future-focused, embracing a new way of approaching our dispensary operations, professional development, and service delivery.
A pharmacist’s perspective
As a proud vaccinating community pharmacist, I’ve witnessed first-hand the challenges that community pharmacists face when delivering vaccination services without robust processes and procedures in place.
On the flip side, however, I’ve also witnessed the immeasurable value a vaccination service creates for consumers when they’re able to easily access such a necessary health care service. Not to mention the rewarding professional development opportunities for dispensary teams in coordinating, managing, and executing a new clinical service.
As a Partner and Pharmacist at Hummingbird Pharmaceutical Consulting, I lead a team that works closely with fellow pharmacists to realise benefits of services underpinned by our 4 S’s Framework: safe, strategic, successful, and sustainable (which we’ll dive into a bit later on). We use this framework to build capability within pharmacy teams and implement vaccination programs that are safe, strategic, successful, and sustainable.
Given my immersion in the space I wanted to dive deeper into examining the wave our industry is surfing, what this change entails, the associated challenges that come with such change, and how we as pharmacists can overcome them – turning them into opportunities.
The evolution of vaccination in pharmacy
Beginning in 2014, Australia’s first pharmacist-administered vaccine trial began in QLD. Nearly 10 years later pharmacist vaccination became an essential service for all communities ¬–especially during the height of COVID – making vaccination easily accessible for the Australian public in every state.
The recent 2023 Westpac community pharmacy insights report captures the shift across the sector, stating that in store pharmacy services are growing, with consumers seeking their local pharmacist on average 18 times a year in search of products – increasingly requesting health services.
This consumer demand, alongside advocacy from pharmacy groups such as Pharmaceutical Society of Australia and Pharmacy Guild of Australia, has led to multiple state governments announcing the expansion of the scope of practice of community pharmacists within the vaccination space. In some states the changes have already been implemented, while in others the changes will roll out in the coming months.
So it looks like our industry is at the forefront of significant vaccine-related change again, seemingly heading towards the direction of being able to offer the full National Immunisation Program (NIP) in pharmacy across Australia.
For a lot of pharmacists, this change will be monumental in shifting the mindset from simply supplying medications, to being the beacon of light that sits at the heart of delivering quality health services which can reduce the burden on our primary healthcare system.
Meeting the challenges of expanding pharmacy vaccination services
Change is inevitable, and while it often brings about positive outcomes, it isn’t always a walk in the park. Expanding the scope of vaccinations within community pharmacies is undoubtedly a move in the right direction. However, it also means a heightened level of professional responsibility and the need for effective change management.
Assessing the landscape inside your pharmacy
Whether you’re building a vaccination service from the ground up, or reevaluating an existing one, it’s crucial to start with a comprehensive assessment. Consider factors like your available resources, your team’s capabilities, operational requirements, and potential challenges – both current and anticipated.
Successful change management hinges on the integrity of this assessment process, so be proactive in addressing any obstacles or concerns within your team. For instance, some members of the dispensary staff may be hesitant to embrace vaccination services due to lingering stress and overwhelm from the chaos of COVID.
Open, honest discussions and problem-solving are essential. This won’t just help you pinpoint knowledge gaps from clinical and operational standpoints, it’ll also enable you to improve your team’s skills, set clear expectations, and establish manageable workloads.
Involving both management and your dispensary team – including those involved in vaccination and those who are not – is crucial. This integrated approach provides a broader perspective on the everyday workflow challenges your team faces. If you’re an employee pharmacist grappling with challenges, consider sitting down with your manager to chart a path forward.
Common hurdles to consider
In practice, pharmacists often encounter several common challenges when delivering vaccination services:
Inadequate training resources: A lack of comprehensive staff training resources can breed confusion and apprehension among the team.
Ad-hoc implementation: Rushed implementation can lead to inefficient systems and heightened risk and liability.
Lack of confidence: Team members may lack confidence in navigating evolving practice guidelines, patient eligibility criteria, and varying state requirements. This also increases liability in professional practice and can lead to poor workflows and inefficiency in processes.
These challenges can result in confusion, frustration, and even demotivation within your team. Plus, the cost of ignoring these challenges can be crippling for businesses from both a profitability and ‘team culture’ perspective.
While addressing these issues might seem daunting, it’s essential to acknowledge and tackle them head-on. Only then can you develop a concrete plan to overcome them.
One way we might approach this with a Hummingbird PC client, is to use our 4S’s Framework. Following implementation of the service, we’d review these 4 parameters monthly for the first 6 months:
Strategic – Devise a thorough plan for development and implementation of the service, outlining team members and their responsibilities.
Safe – Ensure the implementation of tools to reduce both financial and professional risk and liability.
Sustainable – Set growth targets over defined periods of time to build on the service.
Successful – Define what ‘winning’ looks like for the internal team as well as for the consumer.
This approach allows our clients to be analytical and continuously improve when building a vaccination service to meet the needs and expectations of their community and team.
Adhering to vaccine guidelines and eligibility criteria
With the expanding scope of NIP-funded vaccination in community pharmacies, one of the most prevalent challenges pharmacists face is keeping up with vaccine guideline amendments and patient eligibility criteria.
Ongoing education is pivotal for maintaining professional excellence, minimising risks, and delivering an efficient and clinically sound vaccination service. However, it’s not without its own hurdles:
The dynamics of vaccine guideline amendments: Vaccine guidelines constantly evolve in response to new research findings, emerging diseases, and public health priorities. As trusted healthcare providers, we’re tasked with interpreting and implementing these changes accurately to provide safe and effective vaccinations to our communities.
Patient eligibility is a moving target: Patient eligibility criteria for vaccines can be equally complex and subject to change. Eligibility is influenced by numerous factors, including age, health conditions, previous vaccinations, and emerging disease outbreaks. The challenge, however, lies not only in understanding the eligibility criteria, but also in effectively communicating these criteria to patients. Pharmacists must be able to educate patients about their vaccination options to ensure they receive the appropriate vaccines, all while considering individual health histories and potential contraindications.
Time constraints in the pharmacy: In the bustling environment of a community pharmacy, time is a precious commodity. We are juggling multiple responsibilities, from ensuring accurate supply of medication, to providing individual clinical consultations and managing our teams. Amidst this chaos, finding dedicated time for in-depth research and training on vaccine guideline amendments and patient eligibility can be exceptionally challenging.
Even though these challenges may sometimes feel overwhelming, addressing them head-on and proactively seeking solutions is the key to success. By navigating these hurdles effectively, you can provide your community with exceptional care while ensuring the prosperity of your business and the well-being of your team.
A new age of vaccination in pharmacy requires streamlining vaccination workflows with new tools
In the upcoming new age of expanded vaccination services within community pharmacies, successful and profitable pharmacies will be those that effectively address challenges, optimise workflows, and leverage modern tools. It’s these tools that are the key to automating time-consuming processes and supporting your team. With the right technology, you can focus on what you do best – delivering comprehensive clinical services – while leaving non-value-adding tasks to software providers.
Transitioning from analogue to digital
Traditionally, vaccination services in pharmacy – including only delivering flu and COVID vaccinations – have been bogged down by analogue processes, involving excessive paperwork and valuable staff hours spent manually managing and recording vaccination appointments. Often this can feel like the biggest hurdle to introducing new vaccinations into your offering in order to grow your business.
The solution, however, may be simpler than you think. The key to streamlining your vaccination service, enhancing workflow, and unlocking profitability lies in identifying non-value-adding steps and automating them wherever feasible. This is the crucial shift, and a software provider like VaxApp can simplify or automate over 90% of the tasks associated with your vaccination service.
VaxApp's Eligibility Engine simplifies complexity
VaxApp has built the world’s first vaccine Eligibility Engine.
The Eligibility Engine takes into account over 30 data points from the patient’s profile and automates the suggestion of vaccines they’re eligible to receive and when they can have them throughout their lifetime.
It helps patients stay on track with NIP vaccinations by providing customised and personalised reminders based on their specific medical profile. The great news is, the Eligibility Engine also prompts the purchase of paid vaccines where appropriate, and you’ve got the flexibility to customise which paid vaccines you’d like to offer your community, adjusting them seasonally as required.
The Eligibility Engine ensures that patients are receiving the right vaccine at the right times, setting clear expectations from the moment of booking – including giving patients access to pre-immunisation information, side effects fact sheets, and pre-immunisation checklists – regardless of whether they’ve opted for NIP vaccines or non-NIP vaccines. This makes the entire process more efficient and user-friendly for both pharmacists and patients.
Beyond eligibility: Streamlining the rest of your vaccination service
While the Eligibility Engine sits at the heart of VaxApp – powering the online booking and consent portal in order to customise eligibility notifications and reminders – the rest of the platform reduces, simplifies, or automates the majority of the remaining actions it takes to plan, deliver, and report on your vaccination service.
VaxApp fully automates a range of typical administrative functions throughout the immunisation workflow:
Patients manage all their own information during the registration and booking process.
Vaccine selection at encounter is pre-filled with the brand, batch and expiry date from vaccine stock at session.
Dose numbers are automatically allocated according to a client’s vaccination history.
Automatic upload to Australian Immunisation Register (AIR) once a vaccination encounter is complete.
Vaccine inventory tracking (digital batch sheets) – including both central vaccine holding and any vaccines taken off site (e.g. to a workplace vaccination service).
VaxApp is cloud based – ensuring secure access that isn’t limited to any particular device.
Automated patient SMS and email reminders regarding missed and overdue appointments – reducing no-shows and ensuring patients vaccinate on time.
Payment processing, receipts, and reconciling is all performed through the platform.
Automated PPA claiming via the platform.
And so much more…
Boosting impact – and revenue – by expanding pharmacy vaccination services
Throughout our discussion so far, we’ve seen that as the healthcare landscape continues to evolve, community pharmacies find themselves at the forefront of a significant opportunity to expand their services and boost both impact and revenue.
This evolution is not just about meeting changing healthcare needs; it’s about capitalising on a growing demand for accessible primary health services that consumers increasingly seek from their local pharmacies.
Therefore, it shouldn’t take much to imagine the transformative power of broadening your pharmacy’s vaccination services. It’s not merely a hypothetical scenario; it’s a strategic move that can significantly enhance both profitability and the quality of healthcare services provided to your community.
To grasp this potential, let’s dig further into the nuts and bolts of what makes a successful vaccination service, and how the practical application of innovative tools can lead to exponential growth.
Unleashing profitability with four key levers
When evaluating the profitability and growth potential of implementing a vaccination service in your pharmacy, it’s essential to understand the four primary levers that drive success:
Cost of goods sold: The expenses related to procuring vaccines and necessary supplies.
Resourcing: Including wages for staff and the cost of consumables.
Price point: Setting competitive prices for your vaccination services.
Scheduling: Efficiently managing appointments and workflow.
The workflow of your vaccination service hinges on the effective management of these four factors. To optimise efficiency and generate growth and profitability, it’s imperative to analyse your workflow. This means identifying processes that add financial value and those that do not. This isn’t a one-time endeavour, either, but an ongoing process that requires measurement and continuous improvement over time.
A sizable leap in profitability
For those pharmacies that excel in maximising scheduling, maintain competitive pricing, control costs, and have a motivated and skilled team, the potential for growth is staggering.
When supported by an efficient workflow aided by innovative tools such as VaxApp, profitability can improve in leaps and bounds…
Scenario 1: Flu and COVID vaccinations only
Let’s begin by looking at the familiar example of a pharmacy’s potential profitability when limited to offering only Influenza and COVID-19 vaccinations with a manual, paper-based system.
Pharmacy A
In this scenario, Pharmacy A generates an annual revenue during peak season (April-July) of approximately $33,000 from a total of 1300 vaccinations (including both influenza and COVID vaccines) – with an annual profit of approximately $14,000.
Scenario 2: Looking to the future with comprehensive vaccination services
Now, let’s look at the transformative potential of offering comprehensive vaccination services with a supportive digital system to streamline operations.
In this scenario, the pharmacy expands its vaccination offering to include a full scope of vaccines, making the most of the NIP funding changes at the beginning of 2024. However, to keep things simple, we’ll only look at Pneumonia, Shingles, Meningococcal and dTpa as the additional vaccines to Flu and COVID.
When looking at this example, it’s worth keeping in mind that foot traffic in Scenario 1 mostly occurs during the Flu season peak, whereas in Scenario 2 the foot traffic is steady all year round.
It’s also important to highlight that the software program used by the pharmacy in this example is VaxApp – which can support automatic claiming through PPA. (Note: Ask your vaccination software provider whether they have the capability to support your pharmacy with auto-claiming through PPA when this additional revenue stream becomes available to you.)
Pharmacy B
NIP expanded scope encounters:
Total annual profit from all vaccinations delivered in this scenario: $44,477.20
In this scenario, Pharmacy B administers a total of 3500 vaccinations and reaps an annual profit of more than 3 times that of Pharmacy A from Scenario 1.
This variation in profit is namely the result of a reduction in costs and an increase in capacity due to more efficient workflows associated with a digital, paperless system with tools such as VaxApp. Plus, it also includes additional remuneration from NIP administration funding that’s available from the beginning of 2024. It’s also worth noting that the pharmacy in this example is able to auto-claim directly through VaxApp to access this additional revenue stream.
Scenario 3: Off-site vaccination service
Finally, let’s look at how introducing an additional off-site vaccination service would benefit the pharmacy if it were to implement more streamlined, paperless workflows via digital tools.
Manual paper-based process
Digital, automated, and completely paperless process
We can see from these two examples, that there is a difference in profit of $375 per clinic.
If this pharmacy coordinates 10 off-site vaccination clinics throughout the year, the difference in profit annually for using a digital paperless based system is estimated at $3750.
When looking further into why and how VaxApp supports a more efficient workflow for an off-site pharmacy vaccination service, there are significant additional benefits in workflow efficiency during the administrative elements of running the service.
These include:
The ability for consumers to book online, complete the pre-screening form online, and submit answers online for the pharmacists’ review at the appointment.
The elimination of any patient on vaccination day.
Stock allocation and automated procurement management.
Automated recording to AIR with prefilled data via a 1-step process.
In-built automated claiming to PPA.
Embracing the changing healthcare landscape
The trends in consumer behaviour are clear: people are increasingly turning to pharmacies not just for medicines but also for primary health services.
Positioned as one of the most accessible healthcare professions we, as community pharmacists, are ideally situated to help alleviate the burden on general practitioners (GPs), hospitals, and the broader healthcare system.
In post-COVID times, we have an opportunity to gain experience from the services implemented out of necessity and refine our operations for increased profitability and growth.
By embracing a forward-thinking mindset, analysing dispensary operations, and redefining our offerings, we can emerge as champions of vaccination services, providing an indispensable service to our communities.
If you’re a community pharmacist, the time is now to embrace the evolution of your practice, integrate new tools, and enhance operational efficiency.
This transformation will enable you to focus on what you do best: deliver excellent primary healthcare to meet the diverse and evolving needs of your local community.
This guest blog post was written for VaxApp by Chrysa Giannellis, Managing Director of Hummingbird Pharmaceutical Consulting.
With over a decade of experience working in the community pharmacy landscape, Chrysa is a fierce advocate for the community pharmacy industry. Chrysa has a unique vision and critical understanding of community pharmacy. Hummingbird was founded on her vision to elevate the community pharmacy industry into a higher stratosphere, one which places clinical governance, quality of patient care, and medication management at the forefront.
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