Rural Rx Alliance assists those advancing pharmacy services in rural health systems

Dr. DeeAnna Hanson at the Lake Region Healthcare office in Fergus Falls, MN.

Every eight weeks, pharmacists from rural practice settings across Minnesota gather to tackle barriers to integrating pharmacists and medication therapy management (MTM) services into rural health systems. The workgroup, called the Rural Rx Alliance, offers a virtual space for practitioners to find resources, give each other guidance, and bring forward questions. 

Dr. Alison Knutson, organizer of the workgroup and a consultant for the College of Pharmacy in the Center for Leading Healthcare Change, has recruited roughly 12 pharmacists from ten different practices so far. Typically, participants are from health organizations with only a single clinic or hospital. 

“There was just a need for a different type of support for rural practice,” Knutson said. “I did a quick survey of the participants and universally they said the focus on rural practice and having a community of pharmacists who are in similar situations has been very valuable…This has met a need that they didn't have elsewhere, which has been really exciting to hear.”

Workgroup meetings mostly consist of collaborative group sessions, but the Rural Rx Alliance also offers a lot of one-on-one coaching to meet participants where they’re at in the process of integrating MTM and pharmacy services into their health system’s primary care team. Some rural health systems don’t currently have access to pharmacy support, Knutson said, so the team is also working to identify other access points to utilize pharmacy resources already available in the community. 

“How do we consistently provide interprofessional practice and expand opportunities for pharmacists within health systems throughout the entire state of Minnesota?” Knutson said. “We've also connected knowing that everyone is at a different stage in their journey with integrating a pharmacist…It's kind of a vulnerable place to say ‘I don't know how to do this,’ or ‘I don't even know where to start.’” 

Dr. DeeAnna Hanson, a pharmacist at Lake Region Healthcare in Fergus Falls, MN, said Knutson and Rural Rx Alliance have helped her to grow her clinical practice. Connecting with Knutson and the rest of the group has helped Hanson answer questions about efficacy, marketing her services on a larger scale, enticing providers to participate, tracking metrics and patient numbers, electronic health record technology tips and tricks, and more. Joining a group like Rural Rx Alliance can help rural pharmacists become more innovative, better reach patients, and establish more ambulatory roles in their clinics, which is a “big undertaking,” she asserted. 

“When I started [at Lake Region Healthcare] after I finished my residency, I really felt like we had space and a need for a pharmacist to be involved in the ambulatory setting with patients, providing education and being that drug expert link between our patients and providers,” Hanson said. “The group as a whole has been awesome to network with individuals across the state and see that you're not alone in some of the struggles that you feel have taken you so long to get established. It's been really cool to be able to collaborate with them, learn from their successes and failures, and share my own successes and failures.”

Particularly for rural sites, Hanson believes that one of the most significant challenges within the pharmacy profession is making a pharmacist’s capabilities known to the public, which is why a workgroup can be an instrumental resource. 

“Traditionally, a lot of people see a pharmacist as just a white coat standing behind a counter counting pills, but there's been so much advancement in the past ten to 20 years. Pharmacists are doing so much more and really becoming a part of a health care team for a patient,” Hanson said. ”Being rural… we don't have the support, the backing, or even the staff sizes to pursue some of these non-traditional roles of a pharmacist, so having a network outside of our facility to help brainstorm ideas and bounce suggestions off of has been super beneficial.”

Though the group is currently composed of only pharmacists, Knutson considers Rural Rx Alliance to be interdisciplinary in nature and open to physicians, for example. Nearly all family medicine residencies within Minnesota now have a pharmacist role in the clinic setting, she said, which often leaves new medical graduates who migrate to rural settings missing the support of an interprofessional team. 

The alliance was intended for Minnesota pharmacists, since each state has specificities when it comes to practice models, but Knutson said she would love to see other states recreate the model of Rural Rx Alliance to suit their own state-specific practice challenges and opportunities. 

“I am unaware of other states having collaboratives similar [to Rural Rx Alliance] and we are looking forward to watching this group grow in order to meet the unique needs of pharmacists in rural Minnesota,” Knutson said.