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MHS pharmacies adapt services amid COVID-19

A pharmacy technician stands at a car window delivering medications while wearing a mask and gloves. PETERSON AIR FORCE BASE, Colo. – Airman 1st Class Grant Alvarez, 21st Logistics Readiness Squadron (left) and Capt. Lorna Neeley, 21st Medical Group, assist customers at the new drive-thru pharmacy located at the Peterson base exchange parking lot. This new procedure is being used to help prevent the spread of COVID-19. (Air Force photo by Craig Denton)

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Pharmacies across the Military Health System are adapting their prescription services to protect high-risk patients and pharmacy customers and staff from COVID-19 exposure. Responding to Defense Health Agency guidance on prescribing during COVID and state and local stay-at-home and social-distancing requirements, pharmacies are finding ways to get patients their prescriptions with minimal patient-staff interaction. Each pharmacy tailors solutions to fit their physical layout, staffing capacity, and patient populations, resulting in what one patient described as “great, innovative ideas for short-term solutions.”

In Florida, Naval Hospital Pensacola added four staff per lane to its drive-thru pharmacy. Two of these gather information at car windows and radio inside to two filling prescriptions. This process allows the busy pharmacy to safely dispense up to 1,200 prescriptions a day. And Naval Hospital Jacksonville uses a “parking lobby” system to assign cars a numbered spot where patients can park until the prescription is delivered to them. 

Female soldier wearing a mask handing a bag to a woman in a car
SrA Reanne Kohlus, a dental technician assigned to the 59th Dental Group, hands a prescription over to a beneficiary March 30, 2020, at Joint Base San Antonio- Lackland, Texas. 

At Naval Hospital Guantanamo Bay, Cuba, patients pick up prescriptions curbside in the loop in front of the hospital, or they can have their prescriptions delivered to the bus stop close by, which offers a shaded area and a view of the Caribbean.

Facilities worldwide worked quickly to change services as the pandemic progressed. For example, Brooke Army Medical Center at Joint Base San Antonio created a curbside pharmacy in less than 48 hours. 

“My team took this crisis very seriously and stepped up to do what was needed to ensure the safety of the patients visiting the pharmacy,” said Army Col. (Dr.) Stacey Causey, chief of the pharmacy department at Brooke Army Medical Center, Texas

Joint Base Andrews in Maryland set up a parking garage staging area. Patients turn on their car blinkers to let staff know they are picking up prescriptions. Staff “runners” then take the patient’s information and retrieve prescriptions from the staging area. And after base access was restricted for retirees at Cannon Air Force Base in New Mexico, the pharmacy began holding point of dispensing days in the visitor control center. Staff and volunteers help with the “contactless” process of putting prescriptions in a bag on the hood or roof of retirees’ cars. 

Regardless of the method, each facility finds ways to maintain prescription safety protocols. At Jacksonville, parking lobby staff compare the prescriptions to the patient’s electronic health record in the pharmacy, confirm the patient's location in the parking lobby at a staging tent, and then take the prescriptions to the patient’s car for dispensing. Before dispensing, staff ask patients for two patient identifiers and use a portable cart to perform the “show and tell” method, showing patients the medicine as they explain directions for how to use.

Many pharmacies also added enhancements for efficiency, such as text messaging to notify patients when their prescriptions are ready or, in the case of Naval Hospital Pensacola, an app to submit refill requests. 

Patients across the MHS are sending their appreciation for the “super service” in customer evaluations and in comments on hospitals’ Facebook pages. 

Walter Reed National Military Medical Center in Maryland has received “great feedback” on their curbside refill pharmacy which has served nearly 1,500 beneficiaries since they implemented it on March 27. 

"We've had great feedback in the utilization of our CSA [Centralized Screening Area] tent, as well as our curbside refill pharmacy, which moved from the NEX [Navy Exchange store] to the horseshoe driveway in front of the America Building," stated Army Col. (Dr.) Andrew Barr, director of WRNMMC.

And on Guantanamo’s Facebook page, a patient posted “thanks, and shoutout to the pharmacy, that’s a well-oiled machine … my pickup was painless. It made my self-quarantine possible just having to go from house to car back to house. Thank you, Hospital!”

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This Defense Health Agency (DHA) Interim Procedures Memorandum (IPM), based on the authority of References (a) through (d), and in accordance with the guidance cited in References (e) through (aa), establishes the DHA’s procedures to implement instructions, assign responsibilities, and prescribe procedures for the COVID-19 Vaccination Program. This DHA-IPM applies to DHA, DHA Components (activities under the authority direction, and control of the DHA), Military Departments (MILDEP), and the United States Coast Guard (CG). This DHA-IPM cancels and replaces DHA-IPM 20-004, “Department of Defense (DoD) Coronavirus Disease 2019 (COVID-19) Vaccination Program Implementation,” December 13, 2020.

Supplemental Guidance for Providing DoD Coronavirus Disease 2019 Vaccines to DoD Contractor Employees and Select Foreign Nationals

Policy

This memorandum provides supplemental guidance on the provision of coronavirus disease 2019 (COVID-19) vaccines, in accordance with reference (a). The Defense Health Agency (DHA) is the lead coordinating DoD Component for executing this guidance, in coordination with the Military Departments and other DoD Components as appropriate.

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