Tuesday, 21 February 2017

MedsCheck: How one Ontario pharmacist is changing lives

When Joe Walsh has a day off, it’s not uncommon to find him in the home of a patient reviewing medications and helping him or her better understand their medication therapy. Joe Walsh is the proud owner of Walsh’s Pharmacy, a family-owned business that has been operating in the small community of Arthur for the past 50 years.

Walsh’s home visits are part of MedsCheck, a medication management program launched in 2007 by the Government of Ontario in collaboration with the Ontario Pharmacists Association and the Ontario Pharmacy Council. The service is available free of charge to anyone taking three or more prescription medications for a chronic condition, residents of licensed Long-Term Care Homes, people living with diabetes, and those who are home-bound and unable to visit their community pharmacy.

MedsCheck: At home and at the pharmacy

Walsh says that of the three MedsCheck services his pharmacy currently offers—MedsCheck at Home, MedsCheck Diabetes, and MedsCheck Annual—he enjoys visiting patients in their home the most.

“Visiting people in their homes means that I get to see people in their natural environment,” he says. This allows Walsh to see things his patients may not tell him in an office setting. For example, when arriving at the home of one gentleman, Walsh noticed that in preparation for the meeting this individual had lined up his medications on his dining room table. In the centre, there was a bottle of whiskey. This home visit provided Walsh with the opportunity to counsel the man on the dangers of consuming alcohol while taking medication.

The at-home visits also mean that Walsh can conduct a home safety inspection, allowing him to check for (and safely dispose of) expired prescriptions, and to ensure that people with mobility issues have equipped their bathrooms with safety features, such as a rubber mat on the shower floor, grab bar, transfer bench, and/or raised toilet seat. As most accidents at home occur in the bathroom, pharmacist home visits are an added benefit for people with mobility issues—and Walsh says that 90 per cent of the individuals he visits do not have the above safety features.

It’s not just the at-home visits that are a success. Walsh says all MedsCheck consultations—whether at home or at the pharmacy – are benefitting patients. It’s because of MedsCheck that a patient with diabetes is now properly rotating her needle injection site. The consultations also provide Walsh with the opportunity to spend more time with patients, allowing him to more easily recognize signs of dehydration and malnourishment in other diabetics.

The MedsCheck program at Walsh’s Pharmacy is also having a positive impact on the personal and social lives of patients. Take, for instance, the gentleman who found out that he was using his inhaler incorrectly. Walsh’s intervention means that this man is now able to walk down his driveway to get his mail, something he could not do while inadvertently taking his medication in the wrong sequence.

During a MedsCheck, another female patient expressed dissatisfaction with her inactive and solitary lifestyle caused by the difficulty she was having getting up and down. Walsh recommended a rolater, a walking device equipped with a seat, and the woman is once again able to join her friends for coffee.

MedsCheck: All about the patient

As a pharmacist trained to counsel patients, Walsh says that even before the MedsCheck program came into practice six years ago he was talking to patients about their medications. The difference that the program is having is twofold: it requires pharmacists to sit down with patients for a minimum of 20 to 30 minutes to discuss their medications in detail, and it requires pharmacists to document the outcomes of the visit.

As a result, patients’ medication history is on file, making it easier for pharmacists to provide more holistic care, which includes ensuring that the most common medication-related concern—non-compliance (e.g., not taking medicine with food or at the right time of day)—is adequately addressed.

 “MedsCheck is a review, a sort of tune-up for medicine,” Walsh says, adding that the primary benefit of the program is that patients are learning more about the medications they are taking, and feel better as a result. Additionally, they are staying in their homes—and out of the healthcare system—for longer.

“Patients love the MedsCheck program,” he says. “They have only positive things to say about it. Not one person has turned down the opportunity for a MedsCheck.”

But the program is not without its challenges.

“Pharmacy is not set up for appointments,” Walsh says. “One of the first things I tell my patients during a consultation is that I may be called away. There’s only one pharmacist working at one time in my pharmacy, so it can be difficult to find the time for these appointments.”

In addition to the MedsCheck itself, which Walsh says can often last up to 40 or 50 minutes, time is spent preparing for and following-up on appointments.

Even so, Walsh has never been one to turn down a challenge, and he proudly announces that his record for the number of MedsCheck appointments completed in one day is eight.  For Walsh, “MedsChecks are the most satisfying of my daily duties.”

Veteran John Walsh remains dedicated to country, community

by Chris Daponte  
(November 2, 2012)

On a warm October evening, as he has  done dozens of times before,  John Walsh provides a tour of the Arthur and Area Historical Society’s headquarters on George Street here. He points to photos - including his own - of Second World War veterans from the village lining the walls of what society members have come to call the “military room.”

Now 86, though he looks closer to 70, Walsh has myriad memories and stories to go along with many of these faces. But on this particular day, a sombre and inescapable detail captures his attention.
“You don’t realize how many are gone until you start going through them,” he says quietly of those killed in action and those who have died in the 67 years since the end of the war.

In 1942, one out of every seven Arthur residents was involved in the Second World War (126 from a population of 890), prompting the Toronto Star to publish a now-famous front page story that November entitled “Arthur village gives sons and money to aid the war.”

It was the highest ratio Canada, in comparison to villages of comparable size, leading to the moniker “Canada’s most patriotic village.” By the end of the war, 338 Arthur residents had enlisted and 25 were killed in action.

It was not uncommon for families to have more than one member volunteer for the war - some had as many as three to six - or for those families to experience multiple casualties.
Walsh said he believes a number of factors contributed to Arthur’s overwhelming support for the war.

“You kind of felt as though you were a slacker if you weren’t [in the service],” Walsh recalls of the sentiment in the village, adding he had many friends and several cousins who also volunteered.
“I think that was carried forward from the First World War.”

He noted a lot of locals fought in the Great War, many of whom were killed (Walsh estimates 41), and many of their sons were among those  who volunteered between 1939 and 1945.

The village had also offered great financial support of the first war, becoming the first community in Ontario to reach its war bond quota within a few minutes. Arthur led the communities in Wellington County for every other war and victory bond campaign and surpassed all objectives. In total, Arthur raised $250,000, equal to 64 per cent of the assessed value of the village’s taxable property.
In addition to the palpable obligation to carry on the patriotic tradition started in the Great War, Walsh said the harsh economic reality of the 1930s also influenced a number of local men to enlist during the Second World War.
“It was right after the depression ... [fighting] was a paying job, and for a lot of them, they hadn’t had one,” he said.

That the area was populated by a lot of residents with strong English ties, also spurred on some young men to join the war effort, he added.

Walsh was born on a farm just outside Arthur but moved to the village in 1932, at the age of six, with his mother and four siblings after the death of his father.
He was in high school when the war broke out and decided to enlist not long after his 18th birthday.

It was around the time of D-Day (June 6, 1944) and reports of heavy Allied casualties had flooded local and national media reports for the preceding two years, so Walsh’s mother was very concerned about her son’s decision to volunteer.
“I think most mothers would react the same way - kind of proud that you did it, but at the same time they’d be worried,” Walsh said.
He had applied ahead of time to both the Navy and Air Force and, just days after turning 18, he received a letter from the Navy that was very succinct.
“It just said ‘you will report on this date’,” he said with a laugh.

He was sent to basic training in London, Ontario - it was “quite a change” he said, despite his cadet experience - before advanced training at the Cornwallis base in Nova Scotia. He also received additional training in the use of sonar before being stationed to the HMCS Wallaceburg, a 990-ton minesweeper, in the fall of 1944.
Walsh’s crew completed many “triangle runs” and “mid-ocean meetings” as an escort to various convoys in the north Atlantic that were making their way from Nova Scotia to Europe, and vice versa.
His job, as part of the ASDIC team (the anti-submarine detection investigation committee), was locating submarines. Luckily for his crew, German forces were taking a beating in Europe at the time and submarines were not as commonly detected in the area.
“But there were some in the east coast,” he said, noting another Canadian ship was torpedoed in March of 1945 near Halifax.
According to the Canadian Military History Gateway website (http://www.cmhg.gc.ca), the minesweeper Guysborough was sunk near Halifax on March 17, 1945, killing 44 of its 70 crew members.
Records show several other ships were torpedoed by German submarines in early 1945 off Canada’s east coast.
“No one on our ship was killed, but I know a lot that were,” Walsh said.

He was discharged in December 1945 and went to “rehab school” in Kitchener to complete his high school education.
He wasn’t sure what he would do for work, until town druggist Maurice Douglass asked if he would be interested in working at the pharmacy.
“I never gave it much thought before that,” said Walsh.

He served a three-year apprenticeship with Douglass Drugstore in Arthur, followed by two years at the University of Toronto, and graduated in 1952.
Later that year he purchased the inventory and fixtures of Russells’ Pharmacy in Arthur, located where the L&M Market parking lot is today.
Walsh also married his wife, Mary Teresa, in 1952 (she passed away last year), and they had eight children.

In 1955 Walsh built a larger store further north on George Street. The store, which has undergone two major renovation projects, celebrated its 60th anniversary earlier this year.
Though his son Joe took over the business several years ago (two of his grandsons also want to get into the field), Walsh still works about 12 to 15 hours per week at the iconic store on the corner of George and Charles Streets.
Walsh, whose face is as familiar as they come to area residents, dedicates much of his time now to the Arthur and Area Historical Society.
“I was always interested in it,” he said of local history.

Walsh is currently writing his third book on the history of the village, and he donates the proceeds from book sales back to the society.
His dedication is certainly not lost on those in the community - particularly members of the historical society.

“He’s not one to boast about it, but the society just wouldn’t exist without him,” said Mabel Henderson, of Arthur, an active member of the society.
Walsh explained both he and fellow Arthur resident Dave Stack had for years discussed aspects of local history and the possibility of a group dedicated to its preservation.
“We finally decided to call a meeting,” Walsh said with a smile.

Both he and Stack were founding members of the society, which was officially established in January of 2003.

Also at the first meeting was Henderson, who credits Walsh with the impressive collection of books, photos, artifacts and photos displayed in the historical society rooms.
“Everybody’s been behind John the whole way,” said Henderson. “He certainly is the heart and soul of the historical society, and he’s done so much to remember the veterans.”
In recent years, Walsh and the historical society have taken on a number of local projects, including:

- three murals, two of which are completed (Walsh actually posed as the saluting veteran for the mural on the side of Sussman’s);
- several Memories of World War Two books (900 sold to date) and DVDs featuring firsthand accounts of local veterans;
- unveiling of historical plaques in smaller communities in Wellington North Township; and
- various tours and lectures, including a recent trip to the Niagara area to commemorate the bicentennial of the War of 1812.
Walsh is also on the committee - composed of Legion and historical society members - in charge of restoring the village’s cenotaph, which was built of stones gathered from local farms and unveiled in 1923.

“It needed some work,” Walsh said. “We hope to have everything finished by Nov. 11.”

The restoration will include stone pointing, repair and cleaning of marble panels, and removing and cleaning two plaques that Walsh says were “almost impossible to read.”
In what some might characterize as a modern-day validation of Arthur’s “most patriotic village” status, local service clubs, businesses, organizations and individuals have rallied to raise funds for the project (and two local tradesmen have also volunteered their services).

“The response, financially, has been amazing,” Walsh said. “People have been very generous.”

He explained the committee is still about $12,000 short of covering the expense, but he adds, “I’m quite sure we’ll get it” (donations can be made at the Royal Bank in Arthur or be sent to the Arthur Legion Cenotaph Fund, Box 341, Arthur, ON, N0G 1A0).
In the meantime, Walsh will continue his work with the historical society and serve as a guide for tours of the rooms at 146 George Street (the former Arthur village municipal building is owned by Wellington North Township and is also home to the chamber of commerce, the OPP and the local food bank).
Some visitors stop by to research pieces of local history, while others are looking for clues to complete their family trees.
For Walsh, one of the most rewarding aspects of his role is the visits by students from various local schools.

“You never know ... out of a class of 25 or 30, you may get one or two that show an interest and they may carry on with that,” he said. “It’s worth the effort.”

Walsh’s Pharmacy’s virtual store kiosk brings more home health care options

 Accessible health care – BIOS medical sales vice president Jennifer Pulis, left, BIOS sales and marketing manager Stuart Horowitz, Cheryl Walsh and Joe Walsh unveiled a new Virtual Store Kiosk at Walsh’s Pharmacy in Arthur on Sept. 12.  photo by Meagan Leonard

October 3, 2014
by Meagan Leonard

ARTHUR - Initiatives to bring health care closer to home have been rolling out across the province and Walsh’s Pharmacy in Arthur is leading the pack.

To celebrate its 62nd anniversary on Sept. 12, resident pharmacist Joe Walsh and his team unveiled a new “virtual store kiosk” that will become a permanent fixture in the store.

The whole idea, says Walsh, is to “keep people in their homes longer” and make pharmacies a go-to health care destination within the community.

The goal of the health care closer to home campaign is to see more Canadians going to local pharmacies for their primary health care needs, thereby allowing physicians to care for more serious or complex conditions.

“There’s all kinds of studies that show if you’re in a home you heal easier and you’re healthier,” says Walsh. “That’s the whole idea of the home health aspect.”

The kiosk is easily accessible to customers and patients, providing personal aids and assistive device details, along with product suggestions and demonstrative videos.

Walsh’s is only one of two stores in the province to have the interactive station.

“Say your father or mother has been diagnosed with Parkinson’s and you come in wondering what you can do for them,” says Walsh. “You click on ‘medical condition’ and then ‘Parkinson’s’ and this has all the products that will help a Parkinson’s patient, so it takes out all the guesswork.”

To use the kiosk, customers simply search for a particular ailment, or if a condition is unknown other options include selecting a body part or room of the home they require assistance in.

Often times this means discovering useful products they weren’t aware were even available.

“People go ‘Wow, I didn’t realize there’s that for me or something to help me do this,’” BIOS Medical sales vice president Jennifer Pulis says.

It also provides discretion for those who may shy away from asking about or purchasing certain products.

“Someone may come in to pick up their prescriptions … and realize they need some help with incontinence,” says Pulis. “They can come on here, buy their briefs and order them and have them delivered. They have the ease of having it sent straight to their house.”

Another bonus of the kiosk is the increase in available products – an addition of some 6,000 items that previously would have been impossible to house in the small store.

“It gets rid of all the questions you have,” says Walsh. “I can only show you so many products in my flyers. This computer system has 6,000 items, so the whole idea is getting the information to Mrs. Smith who’s 86 years old who doesn’t know there’s a (product) that can help her.”

Added Pulis, “Ultimately what we’d like to do, is have this become a home health care store-within-a-store concept.

“This allows the customer to look at it and Joe can order it for them and they can pick it up or have it delivered right to their home.”

Walsh’s Pharmacy is located on George Street in Arthur.

Healthcare Closer to Home

Wednesday, August, 20, 2014 

Healthcare Closer to Home
By Kelsey Dunbar
Enterprise news Express Staff

Ontario pharmacists are now encouraged to expand their practice into home visits, medication counselling, flu shots and vaccination, to name a few, as part of the national initiative ‘Healthcare Closer to Home’.

On August 15, MPP Ted Arnott and MPP Randy Pettapiece visited Walsh’s pharmacy in Arthur to discuss the benefits Joe Walsh, local pharmacist, has seen in his patients while providing and enhancing access to care within the Healthcare Closer to Home initiative.

“We (pharmacists) have the ability to come together and help keep people in their homes and healthier longer,” Walsh said.

An important part of the healthcare initiative is to connect pharmacists, like Walsh, with their members of provincial parliament to discuss the benefits of the initiative as well as what can be done to make healthcare more affordable and accessible.

A common concern among all Canadians is the accessibility of our health system in doctor’s offices and wait times in hospitals across the nation. This healthcare initiative has been designed to allow pharmacists to treat minor ailments and administer vaccines. In three years the goal is for the initiative to prevent up to 600,000 ER visits, 1,500 hospitalizations and free up 2.4 million physician hours, nation wide, to allow doctors to focus on more critical care, all by simply broadening the horizon of practices administered by pharmacists.

“This is what I was trained in school for,” Walsh said. “I never took a course on trying to figure out a person’s insurance, counting tablets or answering the phone. What I learned was counselling patients on their medication and that is what we are supposed to be doing.”

The Healthcare Closer to Home initiative has four major ways through which pharmacists can expand their practice and deliver front-line care.

Medication Counseling

Pharmacists can provide advice through medication counselling and help those suffering from chronic conditions and protect Canadian patients from adverse drug reactions.

It is said that 37 per cent or more than 12 million Canadians are living with chronic conditions.

“I have done, I would say 325 to 400 in home medicine checks, and I have found something wrong in every single one of them,” Walsh said.

With the combined support of physicians and pharmacists, effective treatment can be delivered via medication management. During a counselling session the Pharmacists can offer expert advice on how and when medications can be taken to make medication and therapy most effective.

Walsh told the MPPs about a man he had met on a counselling session who had been washing down his medicines with whiskey and had no idea the health risks that could have occurred.

“He would have never got that information if I hadn’t gone and visited him,” Walsh said.

Flu Shots and Vaccinations

More accessibility to flu shots will mean higher per cent of doses administered. In 2010, flu shots in the United States was 43 per cent of the population, while in Canada it was only 30 per cent. This is because Americans have more access to flu shots at their local pharmacies.

“You get more people vaccinated more quickly, more effectively and that cuts down on the spread of the disease through the population and it also takes strain off of doctors offices,” director of communications for the Canadian Association of Chain Drug Stores, Allen Austin said.

Walsh expects to administer 200 flu shots this coming season, up from 150 last season.

Minor Diagnosis and Prescribing
Studies show that 15 per cent of all visits to physicians are for minor ailments such as cold sores, dermatitis, hey fever, back pain and minor infections. Patients can wait up to three weeks to see a doctor, while pharmacists with the skill and knowledge may be able to deliver treatment easily and most importantly more efficiently.

Wellness Counseling

Providing pharmacists with the ability to demonstrate to patients how to properly use their medical devices, such as inhalers and epi-pens, will ensure patients are properly taking medication and lower the ricks of emergency healthcare or specialized treatments.

A counselling session can also demonstrate to patients how to make their homes safer and more accessible for wheel chairs, scooters, walkers etc. Pharmacists can go over bathroom safety with the patients on their own schedules and closer to home, in fact sometimes in their own home.

There is a catalog at the Arthur pharmacy that shows 3,000 items, everything from a battery operated jar opener to plates with a lip to make it easier to feed yourself, all that can improve the way of life for someone with mobility issues.

The number of Canadians with diabetes is expected to increase 35 per cent or from 3.1 million to 4.2 million Canadians. Pharmacists can play and essential role in diabetes education and care with wellness counselling.

Pharmacists with expanded scope of practise will better serve patients, providing much needed on-demand access to care, ensuring patients receive the support they need to stay at home and healthy.

Monday, 20 February 2017

Pharmacists Welcome Expanded Services

Wellington Advertiser
August 22, 2014
by Kris Svela

ARTHUR -  Pharmacist Joe Walsh believes people in his business can help save money in frontline health care.

“The government doesn’t ask the people on the front line how to save money,” Walsh told Wellington-Halton Hills MPP Ted Arnott and Perth-Wellington MPP Randy Pettapiece, who visited his store in Arthur on Aug. 18.

The visit was part of a recently launched “Healthcare Closer to Home: Improving Access to Quality Care, Across Canada” campaign.

Walsh points out regulations that now allow pharmacists to give flu shots have already saved money with patients not needing to take up a physician’s time for flu shot appointments. The pharmacist said the procedure could be expanded to include travel vaccines.

The focus of the campaign is to expand services provided by pharmacists in their local communities at less cost to the overall health care system.

“It’s one-stop shopping,” Walsh said of the services his business provides.

A campaign press release from the Canadian Association of Chain Drug Stores states, “The specialized training of Canada’s pharmacists makes them a knowledgeable, regulated and most importantly, accessible, resource.”

Walsh said about 150 residents were vaccinated against the flu last year at his store and he expects that number will climb to 200 this year. Across Canada the number of patients receiving flu vaccinations at pharmacies, as opposed to doctors’ offices, has climbed from 125,000 to 750,000.

Walsh said assisting his customers at the pharmacy with advice on medicine use is important.

“That gives seniors the independence so they can stay at home,” he said.

Walsh estimates he makes about three home visits a day to look in on his customers and give them any health-related advice. During the visits he can discuss medications used by the individual and check blood pressure and blood sugar levels.

“It’s about getting the information out to seniors,” he said.