Provide a range of medication and other health services to patients in their homes, including:

1. Delivering medication related support, including reminders and monitoring services, that increase adherence and safety
2. Partnering with other providers in delivering in-home care services for patients that require intensive support or are transitioning between care settings
3. Delivering medicines and front of shop products direct-to-home (see also digital enablement pathway)

Australia’s ageing population will need progressively higher levels of in-home care, including medication support and broader health and community services. Community pharmacies can help older Australians live at home longer by providing personalised medication support, working in collaboration with GPs and the broader health team. Community health hubs physically located in pharmacies can be extended into in-home settings. Pharmacies can build on their reputation for convenience through home delivery of medicines and other products.

Personalised medication support can be provided to patients in their homes as well as to aged care and supported residential accommodation facilities. As ‘baby boomers’ age, they will demand in-home services that meet their individual needs. The focus on consumer directed care provides the opportunity to partner with community care providers to deliver comprehensive in-home support packages. There may be initial uncertainty around consumer responses and whether adequate fees can be charged. However there is likely to be a significant private market, with families willing to pay for personalised care that enables frail aged relatives to stay at home longer. Technology enabled start-ups are also entering this space and may be potential partners for pharmacies.

Private equity investors and large not-for-profits are entering the community care space, given the compelling market dynamics of an ageing population. These competitors will see medicines care as a natural extension of their offerings. If these models take hold, community pharmacies may be confined to in-pharmacy medicines supply, which will be increasingly susceptible to online providers delivering directly to patients’ homes.

You are not alone – champion story
Jason Harvey – Outback Pharmacies, Broken Hill, NSW

Jason acknowledges that in-home services are not currently a priority for many pharmacies. However he believes that this is an area that most community pharmacies need to examine as a potential source of future growth.

Partnering with the Royal Flying Doctor Service, Outback Pharmacies sends scripts to one quarter of New South Wales. Serving the needs of his rural community is important to Jason's values.  He sub-contracts his pharmacists to the local Aboriginal Community Controlled Health Organisation and delivers 800 dosage packs a week to the Broken Hill aged care facility, setting pharmacy up as a central element of the local health system.

“There was a need in the community for pharmacists to take the leap to provide their expert medicines knowledge outside of pharmacy. Identifying and serving the in-home care needs of patients has improved health outcomes in Broken Hill."

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In-home care had the most patient support of all the pathways. Only 4 per cent of patients were strongly opposed and most (53 per cent) say that they would probably or definitely use pharmacies for in-home services. The majority of patients believe that in-home services would provide sufficient value and would be willing to pay for them. The most popular elements of in-home services include home delivery, in-home tests and assistance with monitoring equipment and devices.

Orima Market Research Report - September 2018 (members only)

Undertake initial research to identify individuals or groups in the local community who would potentially be most interested in receiving, contracting or partnering with your pharmacy to provide in-home services.

1. Research the opportunity for in-home services that your pharmacy can provide now or consider offering in the future, including potential funding sources.
2. Talk to your patients and their carers about services they would like to have provided to them in their homes.
3. Identify existing providers in the community who would potentially be interested in partnering with your pharmacy in coordinating, delivering and promoting services.
4. Undertake some initial planning. Establish a budget. Talk to potential third-party funding sources and reach agreement on how you will work with them, including proposed pricing.
5. Talk to your team and ensure they are aware of your plans, their role and that they advise your patients.
6. Start with a personalised medicines reminder service, a home delivery service or in-home medication reviews.
7. Provide training so staff have the skills to deliver in-home services in addition to their other pharmacy roles.
8. Revise business operations and workflows to accommodate in-home services, including scheduling, travel arrangements and opportunities for the use of online booking, recording and fulfilment to support the services.
9. Explore the business case for investment in technologies such as point-of-care or patient monitoring devices, taking into consideration their suitability to be used in the home, and electronic recording and follow-up.
10. Begin research into longer term opportunities, including personalised in-home medication support packages.

Make contact with GuildLink about a medicine reminder service and Gold Cross about home delivery support.