It’s always something

It’s always something

Back in the early days of Saturday Night Live the late Gilda Radner portrayed one of the funniest characters ever to appear on the Weekend Update segment – Roseanne Roseannadanna. After blathering on about one thing or another her segment always ended with her classic line – It’s always something. Diabetic Investor was reminded of this when we read that Walgreen (NYSE:WAG) is being investigated by a federal agency over whether the company violated patient privacy.

According to several news reports the U.S. Department of Health and Human Services Office of Civil Rights is investigating the new “Well Experience” stores. Like many pharmacy retailers Walgreens has been experimenting with expanding the role of the pharmacist from just filling prescriptions to becoming more of a health and wellness coach. The Well Experience stores are designed so that the pharmacist is not behind the counter but out front actively engaging patients. It is here where the investigation centers.

Last fall a group called Change to Win Retail Initiatives filed a complaint with the HHS which stated the following

“CtW’s investigation details significant problems with Well Experience, including:

Violations of patient privacy. In 80 percent of stores visited, sensitive, HIPAA-protected patient information, such as medical histories, was left unattended and visible to customers in the pharmacy area.

Inadequate medication security. Prescription medicine—in one case hydrocodone—was left unattended and within the reach of customers in 46 percent of stores visited.

Increased pharmacist distractions. Field researchers observed nearly 150 distractions and interruptions to pharmacists that were unique to the Well Experience pharmacy model’s design —over one third of the total number observed. Interruptions and distractions are associated with increased medication errors.

Low rates of patient counseling. Field researchers observed an average consultation rate of 8.2 percent in surveyed Well Experience pharmacies, despite Walgreens’ claims that the model increases counseling. Academic studies of chain pharmacies using secret shoppers found rates of 27 to 53 percent, Pharmacists are required by law to offer counseling for new prescriptions.”

Now Diabetic Investor knows nothing about this group although according to an article that appeared in today’s Wall Street Journal this group “is a frequent critic of retail drugstores and is funded by labor unions.” Regardless this compliant and subsequent investigation is not just a mere nuisance to Walgreens nor should the results be ignored by the company’s competition notably CVS, as they too are experimenting with this same model.  Depending on the outcome of the investigation the company could face a fine, be forced to redesign their stores or make changes to how patient information is handled.

At this point everyone is probably wondering what this investigation has to do with diabetes, a lot actually as diabetes is one of the major diseases that Walgreens and other pharmacy retailers want to manage. Ever since the Asheville Protocol was proven to be effective at improving patient outcomes the major pharmacy chains have been struggling as to how they can apply scale to this costly but very effective protocol. Walgreens, CVS and Rite Aid all know that the healthcare landscape is changing and the day is coming when physicians/pharmacist/health coach will be incentivized for helping patients achieve better overall outcomes. These companies also know that employers are looking for cost effective solutions to managing their employees with diabetes, employees who not just cost more to insure but also are less productive when their diabetes is not properly managed.

As Diabetic Investor has noted on several occasions the future of diabetes management, a future which will likely include interconnected mobile devices and sharing of patient data using the cloud, is replete with obstacles and patient privacy is a big one. The simple fact is no matter who’s coaching the patient this data is vital if they are to do their job effectively. It’s also vital as the information verifies whether or not the health care provider receives their incentive. Based on most patient surveys Diabetic Investor has seen on this subject patients with diabetes appear comfortable sharing their data with their healthcare team and don’t seem overly concerned that this data would be used against them.

Even so the fact that HHS is investigating Walgreens is cause for concern as if there is one thing our government loves is the need for regulating an area that really doesn’t need more regulations. It also concerns Diabetic Investor that HHS just doesn’t understand not just where healthcare is but more importantly where it is going. This is the reason Diabetic Investor has been encouraging industry to take the lead here and not let Big Bother take the lead. The simple fact is this is not just about making money, although any company who can figure this out will make a fortune, this is also about helping patients. Patients who want to be helped and know they need help.

While we hate to do this as it’s becoming redundant the epidemic growth rate of diabetes is not just a healthcare crisis but an economic disaster. It’s also true that the number of endocrinologists is decreasing as are the number of primary care physicians, who now treat nearly 80% of all patients with diabetes- Type 1 and Type 2. PCP’s who are overwhelmed with patients and paperwork. The same can said for Certified Diabetes Educators, as the number of CDE’s just can’t match the growing number of patients. The harsh reality, the 800 pound pink elephant that no one sees, is that healthcare either changes or the situation in diabetes will get worse.

Simply put this move by retail pharmacy chains into diabetes management is not just good for business it’s badly needed to keep up with the growing patient population. Let’s hope the folks at HHS recognize that and ask for common sense reforms not the usual over the top kill a misquote with a nuclear warhead regulations we’ve become accustomed too. As Roseanne Roseannadanna used to say – It’s always something.