Archive for the ‘Medication Therapy Management’ Category

« Older Entries

Merry Christmas, Happy Hanukkah, and Season’s Greetings

Friday, December 23rd, 2011

This is a busy time for pharmacy, especially for those in community practice who will barely have time to catch a breath as patients rush to get their year-end meds. Yet we all typically find a few minutes to breathe and reflect.

As we look back on the past year and anticipate the next, I “zoom in” to recalling the many conversations, e-mails, and letters this past year from individuals in all walks of pharmacy who have expressed the full range of emotions about our profession. As we “zoom out” to look at the macro view, we see huge challenges in the economy and old business model for pharmacy, while also witnessing major positive changes in the attitudes of policymakers and those in our colleague professions. And we see pharmacy systems and business changes that bode well for pharmacists and the patients we serve, if we can step up when the opportunities arise. Payers will increasingly turn to pharmacists to help them meet quality goals, and pharmacy employers are really gearing up with new technology, services, training, store configurations, and systems to make the conversion from buy low, sell high to the provision of enhanced patient care.

Yes, we’ve got a long way to go, and that’s where the frustration arises, at all levels. But in this season of thanks, hope, and new beginnings, I look forward to learning from you as we continue our path of advocacy and innovation. We will continue to highlight exemplary practices in our publications and meetings, and we’ll be driving for changes that empower you to provide the kind of care Americans deserve. We must succeed! Our patients are waiting.

On behalf of the staff and volunteer leadership at APhA, I hope you and your families enjoy a healthy, happy and prosperous New Year!

Posted in APhA News, Medication Therapy Management, Pharmacy Practice | No Comments »

Pharmacy is at the table

Friday, December 16th, 2011

Today I participated in an invitational roundtable discussion on clinical leadership in health care reform at the Brookings Institution, a leading think tank in Washington, DC. The other invitees were primarily physicians from 12 leading physician organizations, as well as nurse practitioners and nurses.

I shared with the group that, while the number of pharmacists in the US is only about one-quarter that of physicians and about one-tenth that of nurses, most Americans are in a pharmacy several times a month and have ready access to us. While we are in an uncomfortable place between building service offerings (medication therapy management) and finding payment for those services, we have a medication use crisis and there are very few incentives to fix that crisis, despite pharmacists being readily accessible and well trained. Also, we typically make a significant number of referrals to our medical colleagues in the course of our practice.

I further shared that I’ve been encouraging pharmacists to “walk across the street” and talk with physician colleagues about their approach to accountable care organizations and medical homes or medical neighborhoods. We should consider organizing joint listening sessions to learn more, and then to discuss in an interdisciplinary way the best approaches to integrated care delivery. It will only change if it changes at the practice level. I also shared that we have a growing workforce, well trained to integrate with physicians in medication management, but that we need help and cooperation among our physician colleagues to build the business models.

We MUST agree on principles for collaborative practice if we are going to avoid the typical turf wars that occur in state houses around the country when one discipline or another wants to change a practice act. And we must create incentives for all. I shared that incentives are not just about driving selfish action, but are primarily about a system describing through incentives the behaviors and outcomes desired.

I shared, too, how the lack of provider status was not only hurting our profession, but also the medical profession and health care in general. If we pursue it, we will face a major war absent up-front agreement in principle, but all have much to gain, as many of the services we provide will likely be done through physician practices and will lead to gains in improved patient care.

We had a chance to discuss each of these points, and I felt there was agreement that all of these topics were worth continued dialogue. I did not hear any disagreement. While there’s no cause for celebration just yet, I think it’s fair to say that pharmacy is at the table.

Thought you’d like to know.

Posted in Health Care Reform, Medication Therapy Management, Pharmacy Practice | 2 Comments »

At Thanksgiving, rough seas and a nearing shore

Wednesday, November 23rd, 2011

There were several emotive responses to one of my recent blog posts. I read each comment several times to not only get the words, but to put myself in the place of the writers. The general point made was that front line pharmacists face difficult challenges in their long shifts. They have to balance the demands of management, the requests of patients and caregivers, the endless stream of phone calls, and the constant denials and information requests of third-party payers, all while supervising the work of pharmacy technicians and student pharmacists. When I suggested that a large pharmacist employer was pursuing new initiatives, several folks took issue.

At this time of thanksgiving, I’m grateful for these comments and have great respect for the perspectives of my colleagues. It wasn’t that long ago that I was there. At different times in my career, I have been an employee, a manager, and an owner. As an employee, I too sometimes felt I didn’t have the help and support I needed. Even in management and ownership, life as a pharmacist can be challenging, and at times overwhelming.

Despite our challenges, I hope we can all see that we have the talent, insight, and innovative spirit to create a better world. My sole purpose in sharing my observations was to stimulate others to think about their own opportunities. Change is never easy, and we all know how hard it is, for example, to add immunization services on top of everything else we do as pharmacists during our 12-hour shifts. MTM programs take time to develop and even more time once implemented. But we know—somewhere deep inside—that while we continue to dispense safely and accurately, our pharmacy services must grow. “Buy low, sell high” is broken. Margins will never get better on either brands or generics. Chains, independents, and specialty pharmacy owners need to find other ways to pay for the services we know patients need. While we fervently pursue recognition and value (read “compensation”) for our services, we must embrace technology and certified paraprofessionals to give pharmacists the time needed to develop new services and new skills for the pharmacy workplace of the future, if we are to have a relevant role there.

As I wrote in Chain Drug Review earlier this year, we in pharmacy are in an uncomfortable place. Times are challenging, and we’re not yet where we need to be. We have the opportunity to be the disruptive positive force in health care. We have the skills and ability to address the medication-use crisis in this country. I hope we can continue to talk about our profession’s internal challenges while simultaneously pursuing change in the system to allow us to practice the way we’ve been trained. We have a bright future as a profession. The question is not whether change is real or inevitable—it’s how are we going to manage that change.

I recognize these challenges and those faced by those who commented about my blog. I hope we can all focus our passions on positive change. We need all pharmacists as members of APhA, and I wish everyone could attend one of our meetings to see people being the change they want for our profession.

It’s not easy, and APhA will be there to help with this transition. The tide is rising and people are noticing. If we can keep our boats intact as we navigate these rough waters, we will all find ourselves in a much more comfortable place than many imagined.

Happy Thanksgiving, everyone!

Posted in Medication Therapy Management, Pharmacy Practice, Policy & Advocacy | 11 Comments »

Visiting the University of Florida MTM call center

Tuesday, November 8th, 2011

As I’ve visited and talked with pharmacists all over America, I’ve learned that there are many delivery models for medication therapy management (MTM). I visited one novel operation on October 26 in Gainesville, FL, where the University of Florida College Of Pharmacy operates a freestanding business and simultaneously trains students to deliver comprehensive medication reviews under contract with a major benefits manager. (Pharmacy Today profiled the program in February 2011.)

Dean Bill Riffee and David Angaran, Director, Medication Therapy Management Call Center, hosted me. I met with the MTM team, including Heather Hardin, Teresa Roane, Anna Hall, and Michele Lawson. I also heard from Karen Whalen, Vinita Patel, and Kim Barimo (a student and veteran of the program).

Students from the University of Florida rotate through the call center on 10-week rotations, with the first 2 weeks spent in training and the remaining 8 weeks spent telephonically conducting approximately 80 comprehensive 45-minute medication reviews with patients referred to them by their health plan client. Students are monitored and supervised by pharmacists and faculty, and numerous techniques are employed to ensure effective oversight and excellent service. The supervising pharmacist can be summoned by the student through various “channels” that allow everything from a back-channel “chat” to the pharmacist taking over the call if issues arise beyond the student’s capabilities.

These intense interviews teach many aspects of patient care, while establishing a relationship between the student and the patient. At the same time, early results suggest great outcomes in working with the most complex patients in the plan’s program. I look forward to hearing more as results get published.

Posted in Medication Therapy Management, Tom's Travels | No Comments »

The debt deal made simple

Thursday, August 11th, 2011

The New York Times website has a flow chart and other charts that simplify and bring some semblance of understanding to the various plans that were considered and what the upcoming stages are in the budget discussions. What happens over the next few months is extremely important to pharmacy because of our efforts around medication therapy management and potential cuts to Medicare and Medicaid that are embedded in the fine print. Please continue to monitor our APhA Legislative and Regulatory Updates on pharmacist.com and stay in touch with your Members of Congress.

Posted in Medication Therapy Management, Policy & Advocacy, What Tom is Reading | No Comments »

NCL adherence campaign: Script Your Future

Wednesday, May 18th, 2011

Raising awareness about medication adherence, the National Consumers League (NCL) launched a public education campaign, Script Your Future, last Wednesday. VADM Regina Benjamin, MD, MBA, the U.S. Surgeon General, helped to kick off the campaign event, saying that three out of four Americans fail to take prescribed medicines as directed—meaning 75% are at risk of not healing as quickly or suffering increased symptoms and serious health complications from illness. Also on the program was APhA member Cherokee Layson-Wolf, PharmD, CGP, who spoke about the role that pharmacists can play in promoting medication adherence through programs such as medication therapy management and with good communication with patients.

Script Your Future is a multiyear campaign that will include free text message reminders, sample questions, medication lists and charts to keep track of medicines, and fact sheets on chronic conditions such as diabetes, asthma, and high blood pressure. The campaign is supported by a coalition of nearly 100 public and private partners and sponsors including health professional groups, chronic disease groups, health insurance plans, pharmaceutical companies, business organizations, consumer groups, and government agencies. APhA is a campaign partner and will be exploring ways to use this platform to expand knowledge of the good work that pharmacists do every day.

Visit ScriptYourFuture.org for more information about the campaign.

Posted in APhA News, Medication Therapy Management | No Comments »

Documenting pharmacists’ clinical services in EHRs

Tuesday, May 17th, 2011

I wanted to make you aware that the Pharmacy e-Health Information Technology Collaborative recently submitted a set of clinical terminology codes for pharmacists’ services to the National Library of Medicine. These codes will be important in the electronic health record (EHR) system infrastructure in allowing pharmacists to document and exchange clinical information. A news article on pharmacist.com provides further information on this important initiative. Any questions should be directed to Jim Owen, our Senior Director of Professional Practice, at jowen@aphanet.org.

Posted in Medication Therapy Management | No Comments »

APhA in action with WebMD

Thursday, April 28th, 2011

To spot an APhA member in action as the medication expert on the health care team, all you have to do is take a look at WebMD, the highly popular website for health information.

APhA has once again teamed up with WebMD for “Ask the Pharmacist,” part of WebMD’s “Ask the Specialist” series. This series consists of 10 pretaped video webcasts with a 30-minute live chat component, and the topics are preselected based on questions from WebMD’s vast online community.

Who’s the pharmacist for this series? None other than APhA member Macary Weck Marciniak, PharmD, BCPS, FAPhA, Clinical Associate Professor and Assistant Director of the Community Pharmacy Residency Program in the Eshelman School of Pharmacy at the University of North Carolina–Chapel Hill.

The first time we did this with WebMD, APhA Senior Director of Corporate Alliances Kristen Binaso was our expert.

The series is running from April 19 to November 8 on the following schedule:

April 19: “Can I Take This With That?”
April 26: “Women’s Health Issues”
May 10: “Moms and Newborn Babies”
June 14: “Pregnancy Dos and Don’ts”
July 12: “Common Drug Questions”
September 6: “Pain Relief Drugs”
September 20: “Headache Medications”
October 4: “Kids and Cold Medicine”
October 18: “Diabetes Care”
November 8: “Caring for Elderly Parents”

View the latest episode at WebMD.com.

Posted in APhA News, Medication Therapy Management | No Comments »

Let’s play through.

Monday, February 28th, 2011

You can waste a lot of good golfing weather waiting for it to rain. Instead, carry a rain suit and umbrella.

What does this sports analogy have to do with pharmacy?

Today, we are pursuing projects to build recognition of and support for pharmacists’ services within Medicare, Medicaid, and evolving team-based integrated care and transitions of care models driven by implementation of the Affordable Care Act (ACA). As you have likely seen, however, there is a lot of media attention around congressional and court activity to potentially defund or repeal ACA.

Yes, we know that ACA’s Patient-Centered Outcomes Research Institute was funded by the American Recovery and Reinvestment Act (the 2009 stimulus package). We know that the CMS Center for Medicare and Medicaid Innovation, which already has funds, may be in jeopardy of being defunded (it might rain). But doing nothing because it might rain is not an option.

Be assured that we are assessing the full picture. We do not have all our advocacy efforts focused on Medicare and the role that pharmacists can play in implementing ACA’s provisions and the continued improvements to Medicare Part D medication therapy management (MTM). Rather, we are also doing everything possible to stimulate the growth of MTM within Medicaid programs, private and commercial insurers, managed care, entrepreneurs, community practice, and other entities looking to improve patients’ medication use, address drug-related problems, and reduce overall health care costs. As evidence, check out the new MTM Digest soon to be published and released at the 2011 APhA Annual Meeting & Exposition in Seattle.

Yes, we know it could rain. But let’s play through.

Posted in Annual Meeting, Health Care Reform, Medication Therapy Management, Policy & Advocacy | No Comments »

Reading the Plain Dealer, pitching MTM to your newspaper

Tuesday, December 14th, 2010

Recently a great article about medication therapy management (MTM) services was published in Cleveland’s Plain Dealer. The article was an in-depth look into some of the newer services being offered by pharmacists, and highlighted how pharmacists are helping the Ohio community.

Many of the pharmacists quoted in this article have close personal ties to APhA. Dan Krinsky and Curtis Black are both working closely with members of APhA’s staff to expand patient access to MTM services throughout Ohio. And Dan is the editor of the Handbook of Nonprescription Drugs, published by APhA.

Articles like this leave room for an open dialogue about medication check-ups with your patients. The public does read these articles, which APhA and state associations like the Ohio Pharmacists Association (in this case) work hard to get placed. It’s up to pharmacists to capitalize on these opportunities and use them to open up that dialogue with your patients. One suggestion would be to post these types of articles in areas where people can read them while they wait, then ask them if they have any questions about your services.

Now, what about pitching to your newspaper the new pharmacy services available in your area? This approach works best if you are promoting a service, not a business—so approaching as a local MTM collaborative would work well. Find a few other local pharmacists who might be interested in talking about MTM services and pitch a newspaper together.

The key to any successful article is engagement on the part of the sources, the reporter, and the reader. A source must be engaging to a reporter for the reporter to make a story engaging to her editor and the public. This commitment must continue even after an article is completed, as a pharmacist still has the opportunity to engage the public about the article after it has been published and read.

Remember, if you love what you do, a good “elevator speech” can make all the difference. Consider three points the maximum and be prepared to make them frequently. When pharmacists get involved as coaches, costs go down and quality goes up.

Posted in APhA News, Medication Therapy Management | No Comments »

« Older Entries