Shop Alto Essentials to add pharmacy products to any delivery!

Your partner in navigating the ins and outs of prescriptions — at no extra cost.

Alto Pharmacy Technician

Alto Pharmacist

It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community of Great Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy. 

Be Part of a Great Place to Work — Join Our Team

Hear first-hand from members of the Alto technology teams.

Read the latest Alto blog posts covering healthcare, family health, managing diseases, and other Alto highlights.

Blog | Alto Pharmacy

Not all headaches are created equal. In contrast to the standard tension headache, migraines — which affect 38 million Americans — can cause severe pain, in some cases interfering with day-to-day activities.

While migraines can be debilitating, there are a variety of treatment options to help alleviate acute pain and prevent or reduce the severity of future episodes. Here’s more on the difference between migraines and other types of headaches as well as common treatment options.

How to Treat and Prevent Migraines

Not all headaches are created equal. In contrast to the standard tension headache, migraines — which affect 38 million Americans — can cause severe pain, in some cases interfering with day-to-day activities.

While migraines can be debilitating, there are a variety of treatment options to help alleviate acute pain and prevent or reduce the severity of future episodes. Here’s more on the difference between migraines and other types of headaches as well as common treatment options.

Migraines are recurring, often severe headaches caused by nerve activity and the release of chemicals in the brain. They vary in both duration and frequency, lasting anywhere from hours to days and occurring from once a year to once a week. (The average migraine lasts four hours and occurs about two to four times a month.) Preventative medications can help lessen the frequency and intensity of migraines.

A migraine’s defining symptom is a throbbing, pulsing headache on one side of the head. Other common symptoms include:

Migraines consist of the following four phases, though not everyone experiences all of them.

This pre-headache phase may last from hours to days. Common symptoms include difficulty concentrating, irritability and/or depression, nausea, fatigue, and sensitivity to light and sound.

15-20% of individuals affected by migraines experience auras, or sensory, motor, and speech symptoms that indicate the onset of a migraine. They typically occur before the headache but can also happen during or after.

Visual disturbances such as seeing bright flashing dots, lights, or wavy lines; blind spots; and/or temporary vision loss

The headache that we commonly associate with migraines is the third stage in the progression. For those who do not experience auras, it may occur suddenly without warning. It can last from four to 72 hours.

Individual experiences of a migraine headache can vary. While some people feel only mild pain, many experience a throbbing sensation. It often starts on one side of the head before spreading to the other. It can also affect the front or back of your head — or even the whole head — and may cause pain around the eyes and temple and, less commonly, in the face, sinuses, jaw, or neck.

80% of those affected by migraines experience the postdrome phase after the headache. Typically lasting a day or two, this migraine “hangover” can cause concentration issues, fatigue, and shifts in mood (depressed or euphoric).

While migraines can affect anyone, some individuals are more prone to them. Key risk factors include:

Genetics: Migraines often run in families. According to Cleveland Clinic, up to 80% of those affected by migraines have a first-degree relative with the condition.

Sex: 3 in 4 migraine sufferers are women, and the condition is especially common in women between the ages of 15-55. This is likely because of female hormones related to menstruation and menopause.

There are also manageable risk factors such as chronic stress and smoking.

Individual migraine episodes can be triggered by factors such as the following:

Consumption of certain foods and beverages including aged cheese; fermented or pickled foods; alcoholic drinks; chocolate; and food additives like nitrates (pepperoni, hot dogs, and deli meats)

Exposure to loud noises or specific sources of light (flashing or fluorescent lights; light from TV, computer, and other electronics; and sunlight)

Migraines can be managed with medication. Treatment is twofold, consisting of pain relief medications, which treat acute symptoms, and preventative medications, which reduce the frequency and intensity of migraine episodes.

Over-the-counter (OTC) pain relief medications including acetaminophen (Excedrin®, Tylenol®) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil®, Motrin®), and naproxen (Aleve®) help alleviate migraine pain. There are also OTC medications specifically formulated for the treatment of migraines: Excedrin Migraine, and Motrin Migraine.

Overuse of OTC pain relief can lead to rebound headaches or dependency. Tell your provider if you are taking OTC medications more than two to three times a week so that they can recommend more effective options.

Triptans such as sumatriptan (Imitrex®, Tosymra®), and rizatriptan (Maxalt®) reduce migraine symptoms by blocking pain pathways in the brain. They may be administered as pills, injections, or nasal sprays and are only available by prescription. They may not be an appropriate option for individuals at risk of stroke or heart attack.

Dihydroergotamine (D.H.E. 45®, Migranal®) may also be used to reduce migraine-related pain. It is often used to treat symptoms that last beyond 24 hours and is most effective when taken at the beginning of an episode. It is available as a nasal spray or injection. In some cases, it may cause side effects like nausea or vomiting.

Lasmiditan (Reyvow®) is a newer oral medication for migraine pain. It may bring a feeling of sedation or dizziness so it’s important to avoid driving for at least eight hours after taking this medication.

CGRP antagonists such as ubrogepant (Ubrelvy®) and rimegepant (Nurtec® ODT) are oral medications that can relieve a variety of migraine symptoms including pain, nausea, and sensitivity to light and sound. Common side effects include dry mouth and excessive sleepiness. In some cases, these medications may cause or worsen nausea.

Anti-nausea medications such as chlorpromazine, metoclopramide (Reglan®), and prochlorperazine (Compro®) are commonly used to address nausea and vomiting. They are typically taken in tandem with pain relief medications.

Opioids are reserved for severe, treatment-resistant cases due to their potential for dependency.

Some of these medications are unsafe to take during pregnancy. If you are pregnant or planning to conceive, speak with your doctor about medication options.

The following medications can reduce the frequency, severity, and duration of migraines.

Blood pressure-lowering medications including beta blockers such as propranolol (Inderal®, InnoPran® XL) and metoprolol tartrate (Lopressor®) and calcium channel blockers such as verapamil (Verelan®)

Tricyclic antidepressants such as amitriptyline

Anti-seizure medications including valproate and topiramate (Topamax®, Qudexy® XR) — potential side effects include dizziness, weight changes, and nausea. These medications are not recommended for those who are pregnant or trying to conceive.

CGRP monoclonal antibodies — a more recently approved treatment option administered as monthly or quarterly injections

Managing migraines is easier with a reliable pharmacy partner by your side. We offer free, same-day delivery and medication management tools like reminders and auto refills in our app to help you stay on track with your treatment. And our pharmacists are available to answer any questions you may have about medications or side effects.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

No industry is immune to burnout, including pharmacy. At many traditional retail pharmacies, individual pharmacists are often asked to do more than is possible on any given workday. Not only does this deprive talented and extensively trained health professionals of a manageable working environment, it deprives patients of the exceptional care they deserve.

pharmacists-spotlight-roni-hein

The better pharmacy model we’ve created at Alto makes life easier for everyone involved in the prescription process: patients, physicians, and pharmacists. And in restructuring how pharmacists work, we haven’t just separated fulfillment and patient care responsibilities into different roles — we’ve ensured that there’s ample support for each specialization, as there should be in any profession.

To wrap up our series of pharmacist profiles in celebration of American Pharmacist Month, we spoke to Roni Hein, a patient care pharmacist lead who takes care of her team so that they can in turn care for patients.

What motivated you to pursue a career in pharmacy?

It all began with my high school and college job at Target. I interacted a lot with the pharmacy team while working in the health and beauty section and eventually moved into that department.

I never expected it to be more than a college job, but it turned into the beginning of my professional path. As I worked there, I was able to see the impact pharmacists made in customers’ lives each day. It really struck me that in many communities, including mine, pharmacists were the most accessible healthcare providers. That accessibility is so impactful on a person’s well-being.

What challenges have you encountered as a pharmacist?

Limited time and isolation behind the counter, without question. In retail pharmacy, more and more responsibilities were added to my job description, with fewer resources to accomplish them.

All pharmacists value the personal connections we make with patients. I think many of us would say that making an impact through patient counseling is the best part of our day, but that is often what gets lost when pharmacists are asked to do more. Our primary driver for entering the profession is the first thing to go. I found a very refreshing change at Alto.

Everyone at Alto, no matter their department or role, has the same shared goal of improving patient lives by transforming the pharmacy model. As a patient care pharmacist lead, I do that by supporting my people. I create the space for our pharmacists to do their best work. They are able to have better interactions with patients because they are taken care of.

The pandemic has been a trying time for many companies and teams, including mine. I am constantly looking for new ways to ward off burnout and maintain a sense of camaraderie, not only for the pharmacists I manage, but for the benefit of our customers as well.

The individual locations of many retail pharmacies can feel very separate from each other. Each one often serves a single population.

The centralization of Alto’s patient care team is a contrast to that model. We have a cohesive, unified team serving all patients. That means there’s a depth of resources available to each pharmacist, which is also really important for retaining great talent.

Our pharmacists have a great support system in their colleagues. There’s other smart, driven pharmacists to bounce ideas off of. Unfortunately, you don’t always get that in our profession.

It also means that you don’t have to worry about anything falling through the cracks if something comes up outside of work. It's a game changer to be able to take time to grieve a loved one or to care for your child if they’re sick while knowing that your patients are still in expert hands. I never had that in retail pharmacy.

Finally, what is one thing people would be surprised to know about life as a pharmacist?

At a tech-oriented pharmacy like Alto where there’s so much innovation, you’re constantly thinking of new and creative ways to problem solve. It’s challenging in the best possible way. There isn’t a day when I don’t have to put my critical thinking skills to use.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. Meet the other pharmacists featured in this series: patient care pharmacist Travis Allison, specialty patient care pharmacist Gabrielle Kaplan, and medication therapy management pharmacist Wei-Lin Chang.

National Pharmacists Month Spotlight: Roni Hein

 Stress doesn’t simply spill into our personal lives, it affects the body in many ways. And it isn’t only short-term ailments like tension headaches or muscle pain to be mindful of — ongoing stress can take a heavy toll on your long-term heart health. In recent years, numerous research studies have found that stress can increase a person’s risk for heart disease, the leading cause of death in the United States.

Understanding the Stress-Heart Health Connection

While many people know that high blood pressure, high cholesterol, genetics, and smoking are all key heart disease risk factors, stress isn’t always included in conversations about heart health. As you prioritize a heart-healthy lifestyle, regularly evaluate your stress levels, taking steps to reduce stress and manage it positively when it does arise.

Here’s more on the stress-heart health connection, including coping strategies that will benefit your heart as much as your mind.

Stress triggers physiological changes in the body that can influence heart health. It all starts in the brain. When you encounter a stressful trigger, the amygdala — a portion of the brain responsible for emotional processing — communicates that you are in distress, activating your nervous system.

As part of this process, the stress hormones adrenaline and cortisol are released, which can temporarily increase blood pressure and insulin resistance. Sometimes the body’s experience of stress also leads to inflammation in the arteries. Over time this can affect the function of your blood vessels, potentially resulting in atherosclerosis, or the accumulation of plaque in the walls of your arteries.

Less directly, stress has a ripple effect on lifestyle factors related to heart health. Everyone responds to stress in different ways. For some, exercise might be a positive outlet during challenging times. But for others, stress makes it difficult to fit in consistent exercise. (The American Heart Association recommends 150 minutes of moderate-intensity aerobic activity per week.) And stress frequently goes hand in hand with unhealthy behaviors like smoking and heavy alcohol consumption or other substance use.

There is also the link between stress and sleep, another less discussed heart health risk factor. The overactive nervous system created by chronic stress — and its continuous output of hormones — can create a vicious cycle of anxiety-fueled insomnia and insomnia-fueled anxiety.

Stress presents differently from one person to another. If you are experiencing any of the following symptoms, talk to your doctor about stress management techniques and other resources.

Stress relief doesn’t have to be a big endeavor. Look for small opportunities, like the following, to engage the body and mind in your daily or weekly routine. (Your heart will thank you!)

Exercise is fundamental to heart-healthy living, and it also happens to be a powerful source of stress relief.

Like the stress-heart health connection itself, the soothing effects of physical activity are grounded in hormones. Exercise is known to lower your levels of adrenaline and cortisol while stimulating production of endorphins, the body’s feel-good chemicals.

Longer blocks of regular exercise are important for your long-term heart health, but in moments of high pressure you’ll feel some stress-relieving benefits from even a quick burst of movement.

As you get moving, find ways to calm the mind. Many practices fall under the umbrella of mindfulness, the cultivation of present moment awareness and shift away from reactivity. Try meditation, yoga, tai chi, walking, or even bringing a bit more attention to your morning coffee or cup of tea.

With so many options for living more mindfully, focus on finding the habits and routines that work for you, and which fit easily into your day.

Deep breathing, a proven tactic for lowering stress hormone levels, is an accessible entry point. You may also benefit from the following resources:

Insight Timer, which offers a variety of free guided meditations

What’s Up?, which uses a cognitive behavioral therapy (CBT) approach to managing stress and negative thoughts

Healthy stress management isn’t just about using positive coping mechanisms in the moment. You may be able to stop stress before it happens — without getting too far into the future, of course.

Researchers have linked workplace stress, which many U.S. adults experience, to negative heart health. One Swedish study connected a poor experience of a manager to the risk of heart attack.

There are tangible ways to make the demands of a job or responsibilities at home feel more manageable (saying no when it’s necessary for starters). Stress management is personal, so consider what you need and don’t be afraid to ask for it.

At Alto, we make it as simple as possible to manage your risk for heart health issues and follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through in-app messaging or by phone at 1-800-874-5881.

For many Americans living with a chronic health condition, prescription medications are necessary to manage symptoms and prevent complications. But following a treatment plan can be easier said than done. There are many considerations involved, from managing medication interactions and side effects to staying on track with related testing and follow-up appointments. And of the 66% of U.S. adults who are prescribed medication, only half take their medication as prescribed.

National Pharmacists Month Spotlight: Wei-Lin Chang

At Alto, medication therapy management pharmacists like Wei-Lin Chang help patients navigate all the complexities of managing a chronic disease. As part of our coverage of American Pharmacist Month 2022, we spoke to Wei-Lin about her professional path, the challenges of retail pharmacy, and the importance of medication education.

I honestly didn’t know what I wanted to do when I first entered college. My parents encouraged me to pursue a career in healthcare, but I knew I was a bit too squeamish around needles to become a doctor or nurse.

I took a chemistry class that I really enjoyed and decided to do all the pharmacy prereqs. I then did an internship with the head of pharmacy at Cook County Hospital in Chicago. Through that experience, I saw firsthand that pharmacists were a critical liaison between patients and doctors, with so much valuable information about medication strength, directions, dosing, and administration.

After that, I pretty much knew that pharmacy was for me. I’ve been practicing since 2002.

Before Alto, I worked in traditional retail pharmacy. In that setting, you’re so busy as a pharmacist — it’s one customer after another after another.

I worked both daytime and night shifts, and it was during the night shift, when the store was much more quiet, that I could really counsel patients without feeling so pressed for time. During the day, I simply didn’t have the free minutes to always answer patient questions or give recommendations.

Another challenge I faced was the perception of our profession. At the beginning of my career, in the early 2000s, many people I encountered didn’t know a pharmacist did much beyond putting pills in bottles and handing them off to customers. Not only did this lead to frustration from my customers, who would wonder what we were doing and why it was taking so long, it led to missed opportunities to more actively participate in a patient’s health journey. 

More medication education for patients is an urgent need within American healthcare. People taking multiple medications have to be mindful of potential side effects and medication interactions.

The growing field of medication therapy management is an opportunity for pharmacists to play an even bigger role in patient health, and I’m very proud to work for a company that prioritizes this particular area of pharmacy.

As a medication therapy management (MTM) pharmacist, I contact patients who take multiple medications — often multiple heart medications — and review their entire regimen over the phone. I make sure that they understand the purpose of each medication they’re taking and are on track with related testing.

For example, it’s important to get your liver function checked every 6-12 months if you’re taking cholesterol-lowering medications that are processed by the liver, or to get your A1C levels checked every 3-6 months if you’re taking diabetes medication.

We also discuss side effects, interactions, when to take medication, and what food to take it with. Too often, there isn’t the space for these conversations between pharmacists and patients, but they are so essential to a patient’s overall health. 

I love our pharmacy specializations. It’s unique to have a team that focuses solely on patients and another team that focuses on fulfillment. Not all pharmacies have a medication therapy management program, and it’s possible at Alto in part because of our smart allocation of resources.

Being able to use all of my time to focus on my core job functions is such a contrast to retail pharmacy, where you’re constantly bombarded from all sides at once.

As a pharmacist, what does “care” mean to you?

Care to me means going above and beyond for your patients and making sure all loose ends are tied. As an example, I recently initiated a transfer for one of the heart medications a patient takes. At Alto, we always complete every single step of the prescription transfer process on the patient’s behalf. He was so appreciative, and when I got off the phone, I could tell from his voice that he was smiling ear to ear. That’s the experience I want all of my patients to have.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison and specialty patient care pharmacist Gabrielle Kaplan.

Despite the misconception of HIV as an illness that primarily affects young people, nearly half of all those with HIV in the U.S. are age 50 and older. This is both a testament to the effectiveness of treatment, as many of these individuals were diagnosed at an earlier age, and a reminder that people of all ages can receive an HIV diagnosis.

HIV and Aging: What to Know

As the HIV population ages, management of the condition continues to evolve, with different health challenges to navigate. Below, we highlight several important health considerations to be mindful of.

Antiretroviral therapy (ART) has been the frontline treatment for HIV since 1995. It is a combination of medications that keep HIV from replicating, stopping the progression of the virus and preventing transmission.

When all medications are taken every day as prescribed, ART can help those with HIV maintain an undetectable viral load. As a result, more than half of all individuals living with HIV in the U.S. are not at risk of transmitting the virus to others.

Regular attendance at doctor’s appointments is an important part of proactively managing HIV. Your provider needs to monitor your body’s response to your individual ART protocol, testing bone, kidney, metabolic, cardiovascular, cognitive, and liver function. (Thanks to the variety of medication options, it is easy to make adjustments as needed if you experience side effects or don’t achieve the desired results.)

For older adults with HIV, ongoing monitoring and testing is especially important, as there is a greater possibility of side effects such as impaired cognitive function and bone health issues.

It is also important to closely monitor how ART interacts with other medications. As you age, you are more likely to be prescribed multiple medications to manage several conditions.

People of all ages should be regularly tested for HIV, since a diagnosis is possible at any age. Older individuals are less likely to be tested — and more likely to receive a late diagnosis — due to the following factors:

The misconception of HIV as exclusively a young person’s illness

The overlap between HIV symptoms and typical signs of aging

Remember that getting tested is the only way to know your HIV status. Continue to stay proactive about regular testing every year. Search for an HIV testing site near you.

Older adults with HIV are more likely to also have health conditions associated with aging, including:

Here’s a quick look at how HIV intersects with several of these health issues.

The ongoing immune system activity and inflammation caused by HIV can contribute to plaque accumulation in blood vessels, a leading factor in the development of cardiovascular disease. Statins, a type of cholesterol-lowering medication, have been shown to lower the risk of heart disease in individuals with HIV.

To protect your heart health while living with HIV, stay on track with preventative care. Your provider should regularly check your cholesterol, blood pressure, and blood sugar. Additionally, maintain a heart-healthy lifestyle, with healthy habits like exercising regularly, eating a balanced diet, and refraining from smoking.

HIV has been linked to a greater risk of cancers including liver cancer, lung cancer, cervical cancer, and Hodgkin’s lymphoma. Ask your doctor about the recommended frequency of screenings for these types of cancer as well as others that are not related to HIV and AIDS.

The gradual loss of bone mass is a normal part of aging. For those with osteoporosis, a condition that weakens bones, the changes are more pronounced. HIV can increase a person's risk of developing osteoporosis. (While osteoporosis disproportionately affects women, both men and women with HIV face an increased risk.)

A simple bone mineral density test, sometimes referred to as a DEXA scan, can identify bone health issues. This screening is recommended for all women over the age of 65 and all men over the age of 70. If you have HIV, you may need earlier and/or more frequent screening. Consult with your doctor about recommended frequency.

Aging brings a risk of cognitive decline for anyone, regardless of health history. HIV has been linked to a faster decline in cognitive function. Though older individuals with HIV were once thought to have an elevated risk of dementia, the evolution of ART has helped lessen this possibility. However, a milder form of cognitive impairment called HIV-associated neurocognitive disorder (HAND) remains a health concern for older those with HIV.

Regular health exams should include screening for signs of cognitive issues including changes related to thinking or memory.

Loneliness and social isolation — factors in the development of physical health issues like dementia as well as mental health disorders — are more common among older adults. Older individuals with HIV should be even more proactive about monitoring mental health, as living with HIV at any age is linked to depression.

Make sure your doctor screens you regularly for depression and other mental health issues. If you have symptoms, ask about potential treatment options or a referral to a psychiatrist or psychologist. You may also want to explore additional resources such as virtual or in-person support groups for older adults with HIV.

Navigate HIV treatment with Alto by your side

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy. We will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best option for your needs at the best price. To learn more, reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

Each October, American Pharmacist Month is an opportunity to not only celebrate the dedication of pharmacists and pharmacy technicians, but also to shine a light on all that they do.

National Pharmacists Month Spotlight: Gabrielle Kaplan

The average American visits a pharmacy 35 times a year, and the availability of pharmacists has the potential to address many gaps within healthcare, like access to the underutilized HIV prevention medication PrEP.

Many people who could benefit from the medication are unable to get a prescription from their primary care provider, whether it’s because they live too far from the doctor’s office or aren’t comfortable speaking about their sexual health. There's growing recognition that expanding the role of pharmacists in HIV prevention can help increase PrEP usage.

At Alto, we’re committed to maximizing the possibilities of pharmacy care. Not only do we divide our pharmacy roles into fulfillment and patient advocacy — we have numerous specializations under the umbrella of patient advocacy that allow our pharmacists to be part of the solution to precisely these healthcare challenges.

As part of our coverage of American Pharmacist Month, we spoke with Gabrielle Kaplan, a specialty patient care pharmacist who makes HIV prevention medication and treatment for complex chronic conditions more manageable for patients.

I’m a patient care pharmacist in our specialty department. We oversee medications that aren’t as common and which often have more side effects — or more serious side effects — including HIV medications, PrEP for HIV prevention, and injectable medications used to treat chronic conditions like psoriasis, rheumatoid arthritis, and high cholesterol.

The side effects associated with these medications can keep people from continuing with them. Since there’s a team of us whose sole focus is serving the patients who take these medications, they don’t just stop treatment. And they don’t have to worry about reaching out to us — we proactively check in. If anything is bothering them, we’ll take the initiative to call their provider and discuss their concerns.

What motivated you to focus on specialty pharmacy, specifically HIV treatment and prevention?

I was very interested in learning more about HIV treatment back in pharmacy school since a family member had passed away from it. The medications available today have drastically transformed what a diagnosis even means. I was excited by the possibilities, and it was always on my radar as a potential interest for the future. Working at Alto is the first time that I’ve been able to completely immerse myself in this specialization.

It’s a rapidly evolving area of both medicine and pharmacy, and there continues to be so much opportunity for pharmacists to take on a bigger role. In my state of Colorado, pharmacists can prescribe the HIV prevention medications PrEP and PEP. At Alto, we’re always discussing these updates and trying to expand the scope of what we offer patients and how we support their treatment.

By far the biggest pain point I experienced in retail pharmacy was staffing and having the number of pharmacists needed to execute all the day’s tasks while still providing great patient care.

Everyone working in a pharmacy is doing their very best, but there’s only so much we can do in an allotted time. It’s a disservice to patients and to those who work in the field — trying to balance the demands with your own mental well-being becomes nearly impossible.How do Alto’s pharmacy specializations make a difference for you and your patients?

Having a specific focus on patient care allows us to actually deliver quality patient care. At retail pharmacies where one pharmacist is doing it all, you’re trying to fill a prescription while on the phone and with someone yelling at you from across the room.

With fulfillment and patient advocacy separated at Alto, we are each able to focus on what’s in front of us at any given moment. For me, that means I can give patients my full and undivided attention and spend as much time with them as possible.

We have such a great team and plenty of support, so there’s no need to worry about other people’s tasks. We can each do the jobs that we’ve been specifically trained and are uniquely equipped to do.

What else is unique about Alto’s model?

The digital model makes it so that geography is less of an obstacle to care, and that each patient in our service areas has access to all of our resources. This is particularly relevant to my division of specialty pharmacy.

Many traditional retail pharmacies don’t have a specialty pharmacy in every physical location. Sometimes the specialty pharmacy is one centralized location from which everything is mailed. That means you won’t necessarily have a pharmacist in your local store who’s familiar with your medications and able to counsel you.

The medication used to treat or prevent HIV is complex, and it can be difficult to stay on track with treatment. The fact that any Alto customer taking these medications can talk to a pharmacist with deep expertise in that area of pharmacy makes a world of difference.

It means always putting patients first — thinking about the care you would want a family member or friend to receive and delivering just that.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison.

Pharmacists are one of the most accessible healthcare professionals, seeing people 5 to 8 times more frequently per year than primary care providers. Their role has become more expansive than ever, and many people don’t realize just how integral they are to a patient’s health and well-being.

National Pharmacists Month Spotlight: Travis Allison

At Alto, fulfillment pharmacists focus on dispensing medication — ensuring that the entire process is carefully monitored every step of the way — while patient advocacy pharmacists tackle anything related to a patient’s wellness, from provider communication and insurance coordination to guidance on managing chronic health conditions.

These specializations have opened up entirely new possibilities for the patient-pharmacist relationship at Alto. And this October, as we celebrate American Pharmacist Month, we’re spotlighting a few of the extraordinary Alto pharmacists who focus on patient advocacy.

To kick things off, we’re pleased to introduce Travis Allison, a patient care pharmacist based in Dallas, Texas.

I took the long and winding road here. I didn’t always know this was what I wanted to do. In college, I started off as an English major but had a change of heart after a semester or two. I went on to study agriculture, and those experiences made me believe that I could pursue a path grounded in science.

My childhood memories of visiting the pharmacist were always in the back of my mind. As a kid, I hated going to the doctor. When those dreaded appointments were over and done with, I knew I’d get to see a guy in a white coat who would give me something to feel better. I always saw pharmacists as a comfort in the often scary world of healthcare.

At any chain pharmacy — which is where I spent my career before Alto — pharmacists are inundated with so many tasks. It isn’t that these tasks are unrelated to pharmacy, but they interfere with our ability to deliver patient care.

On a typical day, I would give 100 Covid shots and fill 200 prescriptions by myself while also coordinating billing and calling doctors’ offices. We also had to think about corporate metrics. I was frequently asked to get more people signed up for text message alerts and hit specific quotas.

Patient care is always the priority, for any pharmacist, but the reality of my job made it extremely difficult, and often impossible, to give patients the time they deserved.

The first thing I noticed when I started at Alto were the specializations. We have many different team members to handle all the responsibilities that fall on a single person’s shoulders at a traditional retail pharmacy.

I’m a patient care pharmacist, which is distinct from fulfillment pharmacists who process prescriptions.

I review prescriptions for accuracy and initiate medication transfers, and I interact with both patients and doctors. I’m here to answer any questions a patient has about their medication.

In a way, I feel like I’m on the frontlines the same way that I was when I worked in a pharmacy chain. It’s all of what I liked about retail pharmacy without the distractions of retail. We’re able to practice our most important functions as pharmacists without the noise.

We’re utilizing technology in a way no other pharmacy does, which allows us to communicate with patients and providers in so many different ways — without having to rush through interactions.

And the wheels of change turn much more quickly at a tech-oriented company than they do at a massive corporation. At my previous job, you could have conversations all day about what improvements were needed, but nothing ever happened. Alto was founded by software engineers, and we’re able to easily make changes in real time.

As a digital pharmacy, we serve so many patients that only we can serve. I talk to many who are homebound without a caretaker. Because of Alto’s model, I’m able to communicate with them, and we’re often their only point of contact within the healthcare system. I don’t know of another way these patients could get pharmacy care.

The digital model also allows us to get a broader view of healthcare, and to make an impact on a larger scale. Alto was one of few places where New Yorkers could get the Covid medication Paxlovid when it was first introduced.

It was incredible to be sitting here in Texas, getting prescriptions out in New York City just as a new variant came out that was really devastating to the city. At no other pharmacy would I have been able to help out my neighbors in New York.

Those moments where you can tell in a patient’s voice that you seriously helped them. To me, that’s an indication of how well I’m doing my job, much more so than the number of prescriptions processed or dollars generated.

A child’s diabetes care needs don’t stop during the school day, and starting a new school year or returning to the classroom after a diagnosis can be overwhelming for students and parents alike. Advanced planning and coordination with school staff can ease the transition and ensure that your child has everything they need to stay safe and healthy while at school. Below, we highlight the most important steps to take.

Managing Your Child’s Diabetes at School

To ensure effective management of your child’s diabetes during the school day, school staff should be informed of your child’s treatment plan as well as what to do in the event of a hypoglycemia or hyperglycemia emergency. There are two important plans to finalize and share with the school.

A diabetes medical management plan (DMMP) is the foundation of your child’s care regimen at school. It translates your endocrinologist’s recommendations into actionable items for your child’s school nurse, teacher, and other school staff members who are responsible for students.

A DMMP should cover every aspect of your child’s diabetes management, including the following. The American Diabetes Association has a detailed DMMP template that you can use as a starting point.

Insulin therapy needs, including the delivery device and timing of dosages and whether to contact you to adjust a dose

Important considerations for physical activities

Diabetes care needs — and the amount of support a child needs with them — evolve with time. Include information about your child’s self-care skills in your plan, clarifying specifically what support will be required from staff. Each school year, revisit your child’s DMMP with your endocrinologist and make updates if needed.

As you finalize your child’s treatment plan and your DMMP, consult with your endocrinologist about your insulin delivery device options. Many children find it convenient to use an insulin pump while at school, given the ease of use and automated timing of injections.

Insulin pens, which combine insulin and a syringe into a single device, also allow for faster and easier administration than syringes. (Some types of insulin pens are covered under pharmacy benefits — Alto may be able to help your child get started with these devices.)

You may also want to explore a continuous glucose monitoring (CGM) device for your child’s blood glucose monitoring needs. In contrast to traditional blood glucose meters (BGMs), which provide a single blood glucose reading by pricking a finger, CGMs automatically collect glucose readings regularly throughout the day. They can identify patterns that aren’t as easily captured by a traditional BGM and eliminate the need to step away for blood sugar readings. (Some CGMs give you the option of adding “followers,” so that you can alert your child’s provider and the school nurse to a potential emergency.)

504 Plan or Individualized Education Program (IEP)

After your DMMP has been finalized, the next step is to draft a 504 plan or individualized education program (IEP). This plan takes all of the information about your child’s care needs from the DMMP and documents the school’s specific responsibilities.

If the school nurse will typically oversee your child’s care, a 504 plan should address who will step in if the nurse is unavailable. Account for after-school activities and events and field trips as well.

Share any relevant information with your child. For example, make sure they know who to go to for help with blood sugar testing or if they experience symptoms of low blood sugar.

This plan should be revisited each year and shared with anyone who will be responsible for your child during the school day or at school events. View the ADA’s template for a 504 plan.

Many staff members are integral to a child’s diabetes management during the school day: the school nurse, your child’s teacher, and administration, as well as the sponsors of extracurricular activities and nutrition service staff. Their knowledge of diabetes and level of comfort overseeing care may vary. In addition to distributing the DMMP and 504, consider asking your healthcare professional to lead a special training for key staff members.

Have one-on-one conversations as needed to get any information about school policies that impact your child’s diabetes. Here are some topics to cover with specific staff members.

Make sure that you, your child, and your child’s teacher are on the same page about each other’s needs. Ask about classroom rules and guidelines, such as what a student needs to do in order to leave the room — is it necessary to ask permission each time? Let the teacher know more about your child’s specific signs of hypoglycemia, as these vary by individual.

Many children with diabetes find it helpful to bring lunch to school, for carbohydrate counting purposes. If your child will eat meals in the cafeteria, request information about the menu and dietary guidelines from a member of the nutrition services team.

Participating in physical activities is both beneficial to your child’s diabetes management and important for their social life. Share any relevant information with the physical education instructor or another staff member to ensure that your child can safely participate.

Make sure your child’s school has all diabetes essentials on hand, including the following:

Blood glucose meter and extra batteries (include these as a backup even if your child uses a CGM)

Blog

How to Treat and Prevent Migraines

National Pharmacists Month Spotlight: Roni Hein

Understanding the Stress-Heart Health Connection

National Pharmacists Month Spotlight: Wei-Lin Chang

HIV and Aging: What to Know

National Pharmacists Month Spotlight: Gabrielle Kaplan

National Pharmacists Month Spotlight: Travis Allison

Managing Your Child’s Diabetes at School

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

Common Treatments for Allergic Rashes

What to Know About PrEP Follow-Up Appointments and Testing

How to Manage an Overactive or Underactive Thyroid

Switch to a better pharmacy.