TRANSCRIPT: Episode 1 of The Front Porch: "Health in the Heartland," Featuring Pam Schweitzer

The following is a transcript of "Health in the Heartland," the first episode of ScriptDrop's podcast The Front Porch: Where Pharmacy and Healthcare Access Meet.

[LAUREN] Welcome to “Health in the Heartland,” the first episode in ScriptDrop’s new podcast series. In this episode, we’ll discuss rural health, the problem of medication nonadherence, and how innovations like prescription delivery can help vulnerable patients get the care they need. We’re grateful today to be joined by two wonderful industry experts, Perry Lewis and Pam Schweitzer.

But first, for those who don’t know us, a quick intro of ScriptDrop: ScriptDrop is the only healthcare IT company specializing in healthcare access that serves patients in all 50 states. Since 2017, ScriptDrop has been improving drug adherence by delivering medication access opportunities and offering our customers a robust platform, long-term data storage, multiple service levels, and first-in-class customer service.

I’m Lauren Carpenter, the Writer/Researcher here at ScriptDrop, and I’m very pleased to introduce our two guests.

So first we have Perry Lewis. Perry is ScriptDrop’s industry relations consultant. Perry knows everyone and has so much experience that he shares with us. In fact, just a few weeks ago he retired as Chairperson of NCPDP after 4 years as Chair! And he has been on the board for 12 years.

Our other guest today is Rear Admiral Pamela Schweitzer. Pam is the first member of ScriptDrop’s new Advisory Council, which is now about five people strong. If you don’t know Pam, you are in for a treat. She has retired from her positions as Assistant Surgeon General and Chief Professional Officer of Pharmacy for the United States Public Health Service but she’s working harder than ever and she was kind enough to join us today.

So with that, I will hand it over to Perry and we’ll start the conversation.

[PERRY] Well thank you Lauren for that introduction. It’s a pleasure to be speaking with you today, especially with Pam. I’ve known Pam for many, many years and I was trying to think back on that – exactly how many years, it’s got to be 12 to 14. So many years ago, as Lauren said, I began to participate as a board member for NCPDP, the National Council of Prescription Drug Programs, and we began to go to D.C. to talk about actually who we are as a standards development organization because legislators and their staff and agencies didn’t know who we are and what we did when it came to pharmacy and connecting providers and pharmacies with prescription benefit management organizations.

And one of our meetings was with Pam, while she was serving as [Assistant] Surgeon General and Chief Professional Officer of Pharmacy. So her passion was evident way back then, and we’re very excited to have her not only on ScriptDrop’s Advisory Council but also, I came off the board of NCPDP and Pam just came on, so I won’t have that opportunity to work with her on that board, but I’m very excited to be working with her with ScriptDrop.

So this morning we’re going to be talking about rural healthcare, and that’s very broad. And Pam’s had a passion about rural healthcare for as long as I’ve known her. Her hands are in so many different things now that she’s retired. I thought she was busy before – oh my goodness. She is going in so many different directions. And she’s got experience in some rural areas herself with where she’s lived in the past.

So first of all, I’d like to say thank you, Pam, for this opportunity to have this discussion. I wish it were in person where we could have coffee and just sit down for a chat, that’s how I prefer things, but that’s not the way it is these days. So, um, but I’d first like to ask you: how do you define “rural health”?

[PAM] I’ll get to that, but first I just wanted to say that NCPDP, back when I first joined, I joined because I was working in the Indian Health Service at the time and we were looking for the standards and I got assigned to go learn them, and people were so nice! And you, Perry, were so welcoming, especially to a novice like me coming in and trying to figure out how to get started and learn and be engaged, so I appreciate that. That’s how we met, way early on.

And then I don’t know if you knew this or not – I was thinking about this afterwards – how I got involved in just rural living. I grew up – I forgot to tell you – I grew up on a – it was a small little farm. We raised all our own meat, grew all our own crops, we had cattle, and sheep, and pigs, and chickens, so I had eggs every morning for breakfast, and we had chores – we grew all our own crops and had all the fruit trees. So we were pretty self-sufficient. I grew up that way. So it’s not surprising that I ended up liking to go into rural.

So as far as a definition goes, there isn’t actually one – there is not actually one definition. There is – depending on what the focus is, it can be different for grant purposes, it could be different for policy purposes, for research purposes. So if you were to go on to HRSA.gov, and just plug in “rural health definition” you’re going to see three different definitions. One of them is going to be from, you know, OMB has a definition, the US Census Bureau has one, and then the US Department of Agriculture through the Economic Research Service, they have a definition too. So the numbers are all different, so what ends up happening in any projects you work on, you know, as you’re working together to do metrics and what you’re going to measure and make impact… the purpose of all this is that everybody needs to agree on the same definition, because there are variations of it. For grant-making purposes, I know HRSA just changed the definition so it’ll be a little bit different for 2022. And uh, there’s a proposed rule that had come out and took all the comments and then they made modifications up there.

But basically it depends on how far you – all the definitions are a little bit different in how they come about doing it, but the bottom line is the range of the population that lives in rural communities is somewhere, anywhere between 51 million all the way up to 59 million – or 46, maybe 46 to 59 million – usually I say around 50 million, I just remember that number in my head. Of the population, it could be around 19% lives in rural areas, so.

[PERRY] Wow, I didn’t realize it was that much.

[PAM] Yeah, it’s pretty high.

[PERRY] So in regards to the rural areas, there seems to be, from what I’ve read, fewer pharmacies, fewer clinics, fewer physicians, fewer specialty offices. What is the root cause behind some of that? Why there is less healthcare in some of the rural areas.

[PAM] That’s a great question, and over time, this is – I remember when we first lived – because we’ve lived in South Dakota for a little while, and so we lived it, and we saw that we had a hospital – the same hospital our daughter was born in – it’s no longer there, it closed down. But I remember our little community, you know, we loved our little hospital. And then what ends up happening – there’s a lot of reasons, and part of it is the way the payments, the reimbursements work, it’s providers – not having a provider was actually a big deal. Because the family medicine, you know, it’s easier, they go to the big city because the reimbursement’s a little bit better there. The reimbursement mix impacts it. If you have too many Medicaid and Medicare in a community, or uninsured, it makes it really hard to be sustainable. And then if you’re in a small community and you have private insurance, and you want the best care, are you going to go to the small facility there where they don’t have the specialties, where if you go to the big city, you can get all of it. So it just sort of, like, progressively gets worse. But part of it is lack of providers, and then, um, just it’s not sustainable to have a big facility. So a lot of the facilities that we worked in or the folks that we knew in the small facilities – small beds, small bed numbers. You can’t have a lot of specialty areas. So if you need a certain test, or you need something diagnostic, or you need anything, it’s going to be very challenging.

[And as far as pharmacies go, what’s happened with the pharmacies is there’s just a whole bunch of areas and reasons why the margin for pharmacy – the dispensing piece – is becoming less and less and less. I mean they basically for a Medicaid patient the reimbursement is basically the cost of the drug plus the time that it takes to fill the prescription, and that’s just, you can’t make any money off of it, it’s just covering basically the cost. And, um, it’s just the margins. So it’s really hard to be sustainable and, if they are in a rural area, they’re so busy, they’re super busy. It’s just everybody goes to them, they’re really really busy, they can’t even breathe. And so what ends up happening is the person who may have owned the pharmacy, they get up to retirement age, and it’s just easier to just close down.

[PERRY] Well I definitely understand that retirement age scenario!

[PAM laughs]

[PERRY] I’m definitely in that. So do you, do you think that – I would think the case would be – in the rural areas that patients are more non-adherent to their prescriptions than in urban areas. And if so, why is that?

[PAM] Okay, and that’s a good question too. So, in a rural area, um, there’s a lot of – you know, the weather’s not as good – I’m just going to go through some of the reasons in there –

[PERRY] Sure, sure.

[PAM] The weather’s not as good. It’s harder to get to the doctor. So let’s just say I’m trying to get my care and I have to get an appointment, and I have to go a couple hundred miles away to get my appointment. You know, it’s going to be easier to go without my medication. And so it’s really, really tough.

The other thing is if I’m homebound, or if I don’t drive, or the weather’s bad, I’m not going to be able to get out, I can’t always get into town or go into the city to go get my medication. And the way the mail works there is a little bit different. You know, in the city you usually get your mail delivered to your home, a lot of times. But in the rural areas, sometimes you have to go into town to go to the post office box. I know that’s what we did for many years. Or you go to the end of the road, you know, there’s a bunch of mailboxes there and you pick it up. But when the weather’s bad you don’t really want to go out there. So you have to organize your life differently, because, you know, okay, we’re going to go into town the week after next and you organize everything to go into the city, to go get everything. You have to get all your errands done. So if there’s a gap in time when you’re not able to get the med or you can’t get to the appointment… and the other thing is that it’s really hard to do the follow-up. Because let’s say I go in and the care’s not coordinated really well when I go into the city, so I go in one week to get this test done, and then I have to drive back in to get something else done. If it was coordinated different, it would be a lot easier to get everything done at one time but in the city, in the urban areas, they don’t always coordinate that way. So it’s very very challenging, and it’s just – it makes it difficult. And then reimbursement. A lot of the folks are under-insured in these rural areas or they’re on – here’s a big kicker thing – is that patients with Medicare, they didn’t sign up for Medicare Part D. And so they don’t really do managed care out in these rural areas but they didn’t, they don’t always have Medicare Part D, or they don’t have this Medicare coverage for their drugs, so they’re paying cash, too, for a lot of this. So there’s just a lot of reasons… they’re not ingrained into the care as much. And so –

[PERRY] Is that what you’ve seen in, like, your past experiences with Indian Health? All of these situations really contributed to non-adherence?

[PAM] Yeah, exactly. So they have to get their medication – they have to come into town, and if they don’t come in… I’ll tell you what they do, they start cutting doses in half, or they just go without until they can get in. And then that’s what ends up happening. The same thing – the delivery of getting the medication out to them in these rural areas is very challenging. And, you know, we had other solutions that we had to put together, a lot of the solutions were related to delivering to them, and getting community health representatives to go out there and drop them off when we knew we had somebody that had those challenges.

[PERRY] Y’know, I would think that would be a really big problem with delivery of prescriptions in rural areas – I’ll give you an example. This week I had a specialty drug that it was time for my refill, and it has to be kept cool, so they ship it in a container that, you know, has the packs of ice in it. And I knew it was coming but I forgot about it. And my wife went out the next – like two days later, after it was shipped, and saw it out on the front porch. Well it was 90 something degrees for two days. Luckily it contained the coldness that it needed, but – and I feel like I’m an educated consumer, and it let it slip. But if I had not – if my wife had not caught that, that drug would not have been efficient in another day or so. I would think that would be even more problematic out in the rural areas, where – how do they get this type of drugs to the individuals? I mean, do they send it to the P.O. box and send notice to the patient that “Hey this is there, you need to go get it”? I mean, these are just – they’re just off the top of my head, I don’t know.

[PAM] Right, well, and then the other – let’s say you know you have a medicine coming or just chronic care medicines that you need to end up getting – you know, some of the senior folks, I just think, we all have a parent or knows somebody senior, it’s like they can’t drive, or driving’s not safe –

[PERRY] Right. [laughs] Been there, yes.

[PAM] Then they have to find – you have to get a neighbor, or you have to find somebody else that’s going to go. Or you have to wait for your son or daughter to come visit you to go get the medicine, to pick it up for you. They have to come out every week, and that may be an inconvenience. Then you feel like a burden, because… Like my mom would feel like a burden. “I don’t want to burden anybody!” So, um, it’s a different culture in rural areas. You know, when we go in to town – ”in to town” could be wherever we’re going to be driving – we check with the immediate neighbors all the time. “Hey, we’re going in, do you need us to pick anything up for you?” And that’s just, it’s a different kind of culture in there. But if people are really rural, and they don’t have access to even neighbors down on the road, they’re just alone. And they – it makes it challenging. So it’s hard to be adherent, um, with all of that.

Now, there’s some changes going on. If you track and see what’s going on, there’s a lot of emphasis being put on rural now. You probably saw the funding that is going to be – there’s a lot of pilots and projects out there to put money into rural areas. I know the infrastructure, they’re working on that to do more telehealth. There’s a big push for telehealth in these past six months, maybe.

[PERRY] Right.

[PAM] Big, big push. So now we’re going to be able to have that access – not being able to go to the doctor – but we still have to figure out how to do the tests, how to do the labs, and how to deliver medications and supplies. And we still need that infrastructure, still needs to be in place. So 20% of the population is in rural areas, that’s a large number, and that’s a whole opportunity right there to figure out and do create – find creative ways to improve delivery of medications, improve transportation, and improving health.

[PERRY] Right, right. I would think, especially after the last year and a half with the pandemic, you know, telehealth just rose to the occasion.

[PAM] Mmhm.

[PERRY] And as you said, you’re seeing more and more emphasis put on telehealth, funding behind that, so there’s – like you said – there’s a wave of change going on. I think that’s why it’s so important right now for us to be having these conversations. We don’t have all the answers for, you know, the rural areas for delivery services, but we’ve got the conversations going on. You know, ScriptDrop is very unique, they’re in 50 states – um, you’ve got other organizations like Amazon and other groups that are more into urban areas for delivery – how do we bridge some of the services like ScriptDrop to be able to manage same-day delivery? Or coordinate those deliveries with the pharmacist in that area so that, like you said, if my neighbor’s going in, they could pick up prescriptions and medical supplies and, um, food services, all at one time. I think there’s a lot more attention on this right now than ever before, because of the pandemic. I mean, there’s got to be something positive that comes out of what we’ve gone through, you know, through the whole universe in the last year and a half.

[PAM] Yeah, so transportation in rural areas is actually considered a social determinant of health. In other words, it impacts the health, not having access. So I actually think what’s going to help make it work is if there’s a broader use of when you have a transportation service besides for medications, maybe used for other things, it might be – it may not have to be every day, remember in rural areas they’re not used – they’re used to not having everything in one day. But if they do, maybe the capacity to do it. For the most part, it’s going to be two or three days, whatever’s reasonable. People just change their expectations.

[PERRY] Right.

[PAM] But things like – what about food? That’s another challenge, having access to healthy food. And being around people, being able to communicate around people, too. You know, having conversations with people and not feel isolated – I mean, that’s an important part of mental health, especially if you’re alone, if your spouse has passed away, you’re all alone. And if the family member lives in a city six hours away – those are all big challenges.

And then the telehealth. Telehealth, there’s some technology that people need to learn how to use, and someone’s got to help them with all of that. You know, um, I didn’t realize, I thought by now it would be getting better… You know, just recently we had a friend that was in the hospital in a rural area. We were out of state at the time, and he came home, and we were like, we love him so much, we wanted to order and have dinner delivered to him, and have some food for a few days because we knew he was alone, his daughter couldn’t make it up. And I couldn’t find anybody to deliver it to him! I called everyone.

[PERRY] Wow!

[PAM] I know, I know. So I felt awful.

[PERRY] Well, these are definitely gaps that need to be filled. I think if we could prove by getting these prescriptions delivered on a daily basis when they need to be, in rural areas, and also urban, that adherence is better, then the health plan – we’ve got the data to show health plans and Medicaid and Medicare that the adherence levels are much better, the social determinants of health have improved – are they willing to pay for the services of having these delivery services paid for themselves rather than by the members? And I think overall the expenditures of healthcare would go down. It’s just a matter of getting that data that we’re looking for.

[PAM] Yeah, and I – if they – if somebody’s looking at the whole person, you know, looking at the whole person, and they’re looking at the data for the whole person, and then you see the big picture of all of it, then it definitely is. Because let’s say otherwise, let’s just talk about the amount of time that you spend on going to town to get this, and then next day I have to send someone in to go get this. But if it’s a little more coordinated, and I’m not sure who does the coordinating, but for the healthcare piece... I watch people in rural areas, they have to drive in an hour, or an hour and a half to go get a lab test and go get X-rays or whatever, and then the next day they go in for another appointment. Then they have to get their prescription, they have to go back up and it’s a special prescription, so it’s not like it’s at the local pharmacy, so they got to drive way in to get it. But it would be so nice if somebody could help. And this is probably on the plan side, or healthcare provider side, but helping to coordinate some of this to make it more efficient.

[PERRY] Well, you know that, um, NCPDP, you know, they’re known in the industry, it’s what they do, it’s their mission, are standards. And part of the standards, especially with SCRIPT, is that physicians have the capability of saying – there’s a flag, that when they’re sending this electronically to the pharmacy, they could have a discussion with the patient right then, “Do you need to have this prescription delivered to you?”

[PAM] Oh, that’s good.

[PERRY] And that’s unique in the fact that in the network of pharmacies within ScriptDrop, if that flag comes through, ScriptDrop is notified and one of their pharmacies has that capability of getting that notification to go to that pharmacy, to get that prescription and have it delivered either the same day or have it scheduled, which is even, I would think, preferred for those in rural areas so they can make sure that they’re there. Now, in the rural areas, it may be that there’s a little more cost involved in that, because it’s not urban. I mean, they may have to drive, like you said, an hour or so. But I think what we’re seeing is more discussions around how to get these services to the rural individuals so that they don’t have to keep going back every day. And maybe there is some consolidation in some of these deliverables that, um… and maybe even some of the people we’ve got listening to this podcast have additional thoughts and services that we could have some other dialogue in the future about, how can we bridge some of the gaps that are happening here. This is just a dialogue of how do we change some issues going on here.

[PAM] Yeah, so you know, I just thought of something while you were talking here. You know, I know for some of the items being delivered – this is right where I’m living in – when I’m in those rural – living there – and this is all recent, I live part-time there, part-time, you know, in Arizona. But when I’m there – I get a phone call or a text when they’re within an hour away so that I could provide any special instructions, if I need to, to them, but I would think that kind of service – or even like when you have an app so you sort of know where they are, so you can be ready for it when it comes – would be critical. Especially for the high-cost medications.

[PERRY] Right.

[PAM] But if a health plan were looking at the overall big picture, what they’re going to see is they’re going to save money overall. And I have a quick story for you. When I was, um, managing more the medications, there was an instance where a child was discharged from the hospital and had to go – their parent had to go get a prescription filled when they got home, they were written a discharge prescription. And it was something that needed to be compounded, so it’s a little bit of a special type of drug. They went to the pharmacy, and the pharmacy didn’t have it. So then they decided, well, I’ll go back to my hometown, and they went to the pharmacy there, and the pharmacy didn’t have it. Now, they have all these other little children that they’re taking care of, and the pharmacy didn’t have it. But the follow-up didn’t happen, they fell through the cracks. So they ended up, for this child that got discharged, they never got the medicine. And guess what happened? Two weeks later, they got admitted again. So then – we’ve got to make a point of getting this medication, because this could’ve been prevented. This hospitalization could’ve been prevented because they couldn’t get their medication. And part of it was just – she had the other kids she had to take care of, and so it was just too hard and the pharmacy couldn’t get it, and it fell through the cracks.

[PERRY] Yeah, I think that probably happens a lot more than we even realize or even hear. You know, we had a conversation at one point about some of the issues that rural areas are faced with, and one of those that you mentioned was that a lot of individuals in rural health, they might not even have a phone to get those text messages, or they may not have access to the internet, or if they do – good internet connections. And these are things that – it’s hard for me to comprehend. I’m in an urban area, and I’ve had – granted, I remember the dial-up, you know, with the tones going, with Earthlink you know – and look where we’re at now with 5G networks. But in rural areas, there’s more to getting the services to them other than delivery, because they don’t have access to a lot of the tools we have.

[PAM] Yeah, and that’s exactly right. I know there’s a lot of efforts in the last few years, trying to get internet. And we just, at our place in South Dakota, we just got internet. But here’s how it works: so I have internet and I have phone service when I’m in my house and maybe right around the house. But if I go a couple hundred yards away, there’s nothing. So it’s just right at the house. And so it’s no service if I go, you know, there’s no service if I’m driving. So it’s really weird crossing the country and going to these places that are no service, no service. And then you just get to the town and you know how many times I’m working away, trying to get work, I have to wait until I get to a town and find enough bars to get a message out or something. So there’s a lot of the country that still does not have access to wifi, or internet – good internet. And so that’s what some of the effort is being worked on. And then once you get, then, then how do I use it? Because I’ve never had to use it before. And so what are – even knowing how to use it the best way, and how can I use it for my healthcare. So that’s part of the project that I’m hoping this extra funding can do, is to help people learn how to even use it. Because they haven’t used it up to now, they’ve been without it.

[PERRY] Right. We’re brainstorming all these different ways that we could try to get these services and these prescriptions that are needed so like this individual, Pam, that you talked about, this child, they get the script so they’re adherent. It’s all about improving adherence, and with ScriptDrop we even have someone on our Advisory Board who’s working in D.C. and is totally focused on adherence. So I think we’re going to be having even further discussions as we move this Advisory Council, you know, farther as to how can we, as an organization, improve the adherence.

[PAM] Well I think COVID, you know… there’s a lot of innovation that’s occurred because of it. And you see a lot of relationships now between the Uber, Lyft, the shared driving services that are out there, and doing more delivery out there. Either bringing people to the pharmacy or delivering to, you know, whatever the arrangement is. But I actually think that’s a great way to go because it gives people jobs, and it provides a really great service, and it’s just figuring out how do you make a business case for it to keep it going, keep it going.

And I have a son-in-law, just so you know, that's in this space – autonomous vehicles. So anyway, he’s working on that right now, and it’s pretty impressive. And so because of that, I keep up on all the technology and where everything’s going in that space. And I know worldwide there’s other countries in different parts of the world, I think Germany, Japan, you know you take a look at the number of senior, elder people in rural areas, and they’re working on solutions right now, because transportation is such a critical issue. So there’s a lot of energy being put into autonomous vehicles in those countries. Probably eventually it’ll be here in the United States too, but there are efforts underway, because we’re trying to figure out ways – how do we get this transportation issue in rural areas is critical right now.

[PERRY] So the flying drone and deliveries is not out of the question?

[PAM] Yeah, they would be tougher in a rural area. I think an urban area, it’s a lot easier. I can’t imagine it, because I think you have to be – I mean, who knows – it probably could – you know, you never know. The technology moves so fast. I don’t want to say no, because I love innovation and people are so smart out there, you know, creating and making things. But it potentially could be in certain areas, I’d imagine it could be. Especially if you start in a small community, yeah.

[PERRY] You know, there’s so much focus on what we’ve talked about here: new technology and innovation. What I’ve been reading an awful lot about too, and we’re seeing it also through organizations, is consumer-driven healthcare. And the access, patients, they want access on their phone to be able to make decisions as to when are they going to schedule their appointments to the doctor, and when are they going to get their prescriptions delivered. And we’ve – I think the industry’s kind of struggled with that in previous years, but now things are moving so rapidly that we’ve got to have more conversations like this as to what’s going on in other countries that we could embrace here to improve the quality, you know, of health. So I’m really interested to have a conversation with you in the future as to what your son-in-law’s bringing forth to the United States here and how we could improve things, especially for rural health. Sounds interesting.

[PAM] Yeah, in autonomous vehicles they’re already doing a lot, they’re here in Arizona, all over, and they’re in San Francisco. So they already are here, but the rural areas, they haven’t delved into that yet.

[PERRY] Right, right.

[PAM] The other thing about driving in rural I should probably mention – it’s actually – the mortality rate. Even though there’s less people on the road, the mortality rate is higher in those areas. I can tell you from living there, I don’t know anyone who was living there for any length of time and driving the roads – these long roads, just a long time, on these – especially I remember driving in blizzards, too. At some point, there’s going to be an accident. We’ve all had scary times when we slipped or twirled around or gone off the road. The more we can, you know, keep people from being on the road that shouldn’t really be on the road, the better it is.

[PERRY] I agree. One of the hardest decisions as a caregiver for my parents was taking the car keys away.

[PAM sighs sympathetically]

Yeah, I don’t – that is something I don’t wish upon anybody. But you gotta make those decisions as caregivers, sometimes.

[PAM] Right, but then they need a way to be connected.

[PERRY] They do. It falls upon the caregiver to do it then, in most cases.

[PAM] Right, I know.

[PERRY] Or you arrange it.

[PAM] If you can arrange it. If there’s somebody to arrange it with.

[PERRY] Right.

Well this has been a great conversation. We obviously don’t have all the solutions, but I think with what we’re talking about with ScriptDrop and their capabilities, you know, for same-day delivery or scheduling it – we may not have all the solutions for rural, but I think we’ve got the conversations going. I’m interested to see for those who are listening to this podcast today, if there’s any other opportunities for collaboration. So I’m going to now turn this back over to Lauren and see if she’s got some closing remarks and maybe some next steps for us.

[LAUREN] All right, so – that was a great conversation. I learned a ton of things. But before we go, I’m going to reiterate some of the main points for our audience.

Um, so it seems like point number 1 is that there are just vast sections of the country and a large percentage of the population where patients have very little access to any healthcare due to a loss of hospitals and pharmacies, poor infrastructure, lack of internet coverage. And because that access is limited, transportation has become an important social determinant of health in rural communities. And while innovative solutions like prescription delivery and patient rides can help mitigate some of the problems, it seems like there just needs to be a greater coordination of care to make meaningful change for rural patients.

But regardless of what the future holds, ScriptDrop plans to be there to help.

And with that, thank you, Pam and Perry, for your wonderful insights. It’s always a pleasure getting to hear you guys just bounce ideas off each other. Your expertise is a gift – to ScriptDrop and to our audience.

Thank you to all of you for tuning in! If you’d like to learn more about prescription delivery and its impact on adherence – or about adherence in general – check out this year’s industry report at report.scriptdrop.co. That is free to read, you don’t have to give us any of your information if you don’t want to.

But that said, if you are interested in working with us or just learning more about ScriptDrop’s many healthcare access opportunities, you can reach out to us at info@scriptdrop.co.

Finally, if you liked what you heard today, please click “like” and “subscribe” so you’ll be sure to catch our next podcast episode coming in the fall. We have many other exciting guests to speak to with a lot more expertise about the pharmacy industry.