Joanna Ferraro, Pharm.D., BCACP, currently serves as the director of pharmacy at the Cass Lake Indian Health Service in Cass Lake, Minnesota. She earned her Pharm.D. degree from the University of Minnesota – Twin Cities in 2004 and is currently working toward an MBA in rural health care from the College of St. Scholastica in Duluth, Minnesota. She was introduced to federal pharmacy practice, the Indian Health Service (IHS), and the United States Public Health Service (USPHS) as a pharmacy student. These experiences, coupled with her interests in promoting public health and providing care in underserved communities, encouraged her to begin her pharmacy career with the USPHS as a staff pharmacist working with the IHS on the Leech Lake Indian Reservation in Northern Minnesota. Since starting with the IHS, she has served in various roles, including clinical pharmacist, assistant pharmacy director, and pharmacy director.
Captain Ferraro strives to improve patient health outcomes through clinical pharmacy practice and relationship building. Her current practice, like many rural practices, is often affected by long-standing provider vacancies that limit patient access to care. Ferraro realizes the value of clinical pharmacy as a resource to support providers working through these situations to increase patient access to health care. She has worked to develop a clinical pharmacy practice where clinical pharmacists are integrated into multidisciplinary primary care teams providing chronic disease state management through patient-centered care models that continue to expand in scope of practice, supporting public health initiatives and helping patients achieve better health.
Providing specialty care in an otherwise underserved rural community is particularly challenging. Ferraro continues to work toward maximizing resources and thinking outside the box to bring vital health care resources to the community she serves. As director of pharmacy, building partnerships has been a major focus in creating solutions that improve access to care for her patients. She has worked to build collaborations with larger health care systems to expand access to care and close some of the gaps in care the community currently faces. These collaborations provide much-needed surgical consults and bring in support for nephrology and OB/GYN services. She has also established telebehavioral health services and hired a shared audiologist. She has facilitated the development of an interprofessional hepatitis C treatment program, where pharmacists present patient cases to GI or ID specialists through Project ECHO (Extension for Community Healthcare Outcomes) and gain medication access for patients through existing patient assistance programs.
Project ECHO is a learning practice model that revolutionizes medical education and access to specialty consultation. Project ECHO exponentially increases health workforce capacity to provide best practice specialty care and reduce health disparities. At the heart of the ECHO model are its hub-and-spoke knowledge-sharing networks. Led by expert teams at the hub, Project ECHO uses videoconferencing to conduct virtual clinics with community providers who are often thousands of miles away. In this way, primary care physicians, nurses, and other clinicians learn to provide state-of-the-art specialty care to patients in their communities.
Ferraro feels strongly that establishing multidisciplinary care teams to partner with the patient through patient-centered care models is an essential aspect of care in these settings in order to meet patient needs in nontraditional ways. These teams and collaborations, where members practice at the top of their license, provide more efficient and accessible patient care. Health care that focuses on preventing and identifying the resources that can most influence the social determinants of health is critical, especially in rural, underserved communities. Moreover, addressing the basic social determinants of health (housing, food, safety, employment) can positively affect overall health outcomes.
One strategy to reduce health disparities, according to Ferraro, is to increase awareness of the health disparities that affect the community:
I seek opportunities to respectfully bring awareness to the issues that impact the community I serve so that it may bring about conversations in others. I cannot speak for the community, but I can share what I know to address disparities and the impacts these disparities have on patient outcomes.