E1. STUDENTS IN-NO-VA-TION 10:45-11:45AM

Transcription

1 E1. STUDENTS IN-NO-VA-TION 10:45-11:45AM Speaker: Randy P. McDonough, PharmD, MS, CGP, BCPS, FAPhA, is Co-owner of Towncrest and Towncrest Compounding Pharmacies in Iowa City and Solon Towncrest Pharmacy in Solon, IA. He is responsible for developing, implementing, and overseeing clinical services, managing staff, and marketing the business. He has helped to foster collaborative working relationships with several solo and group practice physicians in areas such as immunizations, anticoagulation, and medication therapy management services. He also helped to develop and implement health screening and case management programs for private pay patients and self-insured employers. He was instrumental in implementing Medication Therapy Management (MTM) services for the Iowa Medicaid Pharmaceutical Case Management Program. He provides MTM services for Iowa Medicaid, Medicare Part D, and private pay patients. Randy received his BS, MS, and Pharm.D. degrees from the University of Iowa College of Pharmacy, where he is adjunct professor (clinical). He is frequently asked to speak on topics related to practice development and implementation. He has published articles and book chapters about pharmaceutical care and co-authored a book on this same topic. He is a member of the American Society of Health-System Pharmacists, American Pharmacists Association, American College of Clinical Pharmacy, American Society of Consultant Pharmacists, and the Iowa Pharmacy Association. His area of interest is developing and implementing clinical services in the community pharmacy setting. He has helped to foster collaborative agreements with several solo and group practice physicians in areas such as immunizations, anticoagulation, and medication therapy management services. He also helped to develop and implement health screening and case management programs for private pay patients and self-insured employers. He was instrumental in implementing Medication Therapy Management (MTM) services for the Iowa Medicaid Pharmaceutical Case Management Program. He provides MTM services for Iowa Medicaid, Medicare Part D, and private pay patients. He is board certifi ed in geriatrics and pharmacotherapy. FEBRUARY 7-9, 2014 THE MEADOWS EVENTS & CONFERENCE CENTER ALTOONA, IOWA

2 IN-NO-VA-TION RANDY P. MCDONOUGH, PHARM.D., M.S., CGP, BCPS, FAPHA CO-OWNER, DIRECTOR OF CLINICAL SERVICES TOWNCREST, SOLON TOWNCREST, & TOWNCREST COMPOUNDING PHARMACIES Faculty Disclosure Randy P. McDonough reports he does not have actual or potential conflicts of interest associated with this presentation. Randy P. McDonough has indicated that off-label use of medication will not be discussed during this presentation 1

3 Learning Objectives Upon completion of this activity, student pharmacists should be able to: 1. Recognize practice areas where innovation can close the gap between current and future practice and patient needs. 2. Identify innovative solutions to solve practicerelated issues. 3. Develop strategies to implement innovative services. Pre-Assessment Questions 1. Each of the following statements are true except? a) Health care reform is emphasizing increased quality in health care services while reducing overall costs. b) Pharmacists are recognized providers by CMS and other major payers c) Technology is replacing traditional pharmacists dispensing roles d) Telepharmacy provides a new avenue for pharmacists to provide services from a remote site 2. Tech-check-tech programs have not been shown to be as effective as pharmacist-check-tech programs. True or False 2

4 Pre-Assessment Questions 3. Each of the following is a key factor for innovation in pharmacy except a) Implementation of technology b) Enhancing technician roles c) Board certification of pharmacists d) Becoming an integrated health care team member 4. Which of the following statements is true? a) All pharmacists are prepared to implement clinical services in their practice b) There will be less opportunities for pharmacist in health care reform c) SWOT analyses are helpful to identify a clinical service that may benefit patients d) All the statements above are true The Need for Innovation in Pharmacy Health care reform More patients having health insurance and consuming health care services including pharmacy services Emphasis on reduced costs and increased quality Development of new health care models including Accountable Care Organizations, Patient Centered Medical Homes, care transition programs, and team-based care 3

5 The Need for Innovation in Pharmacy Evolution of pharmacy from a product-focus to patient-care focus Reimbursement models are changing Less focus on product distribution More focus on patient care and appropriate medication management Medications can be a cost-effective strategy to reduce overall health care costs, but only if the medication is used appropriately by the patient Pharmacists need to become interventionists Identifying and resolving drug therapy problems Working collaboratively with other health care team members The Need for Innovation in Pharmacy Survival of the profession Pharmacist need to demonstrate their value to health care by ensuring that patients are achieving optimal health outcomes with appropriate medication management strategies. Important to become a recognized provider for reimbursement for clinical services by CMS and major insurers. Dispensing a product can be automated and already technology is replacing traditional pharmacists dispensing roles Telepharmacy provides a new avenue for pharmacists to provide services from a remote site Evolving roles of technicians including the Tech-check-Tech program 4

6 Recognizing Practice Gaps Current practice issues Pharmacists time pressures Lack of recognition for clinical knowledge and expertise Patients Other health care providers Payers Insufficient reimbursement for all aspects of practice Dispensing Clinical services Patient counseling and education Drug information services Recognizing Practice Gaps Current practice issues Inadequate space for clinical services Pharmacists not prepared to provide clinical services Insufficient documentation of patient care activities Uncertainty of the future of pharmacy and the role of pharmacists 5

7 Innovative Solutions Utilizing technology Automated dispensing systems Innovative Solutions Enhancing the role of technicians Order entry, prescription processing, inventory management, practice management, compounding, marketing, etc. Triaging patients data collection, preliminary assessment of patient need/want, referral to pharmacist for clinical questions. Billing for services Tech-check-Tech (TCT) programs Conclusion The published evidence demonstrates that pharmacy technicians can perform as accurately as pharmacists, perhaps more accurately, in the final verification of unit dose orders in institutional settings. Current TCT programs have fairly consistent elements, including the limitation of TCT to institutional settings, advanced education and training requirements for pharmacy technicians, and ongoing quality assurance. "Tech-Check-Tech A Review of the Evidence on Its Safety and Benefits. Alex J. Adams, Steven J. Martin, Samuel F. Stolpe. Am J Health Syst Pharm. 2011;68(19):

8 Innovative Solutions Improve recognition of pharmacists Drug therapy experts Medication therapy management providers Innovative Solutions Improve recognition of Pharmacists Patient advocate Patient drug therapy counselor and educator Medication reconciliation manager Integrated health care team member Drug information provider Understanding drug plans, formularies, and drug costs 7

9 Innovative Solutions Advocate for Pharmacists reimbursement Become an engaged member of your profession Become active in local, state, and national pharmacy organizations Know your state and national legislators and get involved in legislative efforts to recognize pharmacists as providers Demonstrate value by providing innovative clinical services Re-engineer practice to support clinical services Become an interventionist Develop collaborative working relationships with physicians and other health care providers Document patient care activities Charge for services Implementing Innovative Services Identification of the service Determined by our SWOT analysis Unmet need in the community Financially feasible Fits within the scope and operations of the practice 8

10 Implementing Innovative Services Service Development Policies and procedures Creating the systems and processes Pharmacist training Service implementation Marketing and Promotions Physician referrals Documentation Implementing Innovative Services Development of the service What is the service? How is it delivered? Who delivers it? Where is it delivered? What are the processes involved? What forms are needed? How do we price it? How does it fit into the operations of the practice? 9

11 Implementing Innovative Services Developing systems and processes for each service Introducing the patient to the service Collecting patient history Performing the service Providing patient education (as needed) Providing patient with receipt for services rendered Communication with physician (as appropriate) Documenting the patient encounter Implementing Innovative Services Space issues Creating patient care areas Privacy issues 10

12 Implementing Innovative Services Marketing the services Creating a budget line for marketing and promotions Determining the promotional mix In-store signage and promotions Direct mail To employers To physicians Newspaper Radio Cable TV Implementing Innovative Services Time issues Expansion of services may require us to hire new employees Financials Is the service worthwhile from a financial viewpoint? Cost benefit analyses performed on several services 11

13 Towncrest Pharmacy CASE EXAMPLES Towncrest Pharmacy Background information Pharmacists Bernie Cremers, Mike Deninger, Randy McDonough, Danielle Kennedy, Denise Prybil, Angela Lyons, Jill Weetman, Melanie Furman Resident Wendy Lantaff Technicians Mary Powers, Bonnie Forbes, Dana Conrad, Amanda Rhines, Amy Runge, Joseph Weirather Student technicians Bri, Jenny, Katy, Jessica, Monica, Robert, Traci, Aaron Inventory Management and Book keeping Bill Haigh 12

14 Towncrest Pharmacy Location 2306 Muscatine Avenue Behind us is HyVee Pharmacy Across the street is CVS To the West-side of us is Walgreens Towncrest Pharmacy Clients Majority are 50+ Well educated, middle class Specialized areas Hospice care Supported Community Living organizations Community mental health 13

15 Towncrest Pharmacy Reputation Known for patient care Loyal patient following Good relationship with physicians Five Functional Areas Dispensing area for our ambulatory, independent patients Nursing home area (ICF, SNF, assisted living, group homes and supported community living agencies) Clinical services Compounding Durable Medical Equipment 14

16 Towncrest Pharmacy Clinic Services Med Check Program Medication Adherence Program Influenza and Pneumococcal Vaccinations Zostavax Vaccination Tdap Vaccination Pharmaceutical Case Management (PCM) Medication Therapy Management (MTM) Nursing Home Consulting CPAP service/education Ostomy Consultations Drug Information Service PCAB accredited Compounding Employer based health screenings Wellness Center Cholesterol screening Blood glucose screening BP screening Height and Weight BMI Specialized Focused Mental Health Wellness Geriatrics End of life/palliative care 15

17 16

18 17

19 18

20 19

21 Towncrest Pharmacy Comprehensive list of services Some services are recognized by insurers Vaccination services PCM by Iowa Medicaid MTM by some Part D plans For other services, patients pay out of pocket and we will provide them with the documentation so that they can try to receive reimbursement from their insurance company Employer paid services Vaccinations, screening services, case management 20

22 Towncrest Pharmacy We have 5 levels of value added services that we can provide Prospective DUR Quick Clinical Program Screening with risk factor assessment and patient education Clinical services Vaccinations, MedCheck, DME consults, compliance packaging, nursing home consulting, etc Disease state management Medication therapy management Conclusion Pharmacy innovation is important for the future viability of the profession. The traditional dispensing roles of pharmacists is being replaced by technology and enhance responsibilities of technicians Innovation requires thought, planning, and attention to details Being innovative will help to secure new and unique job opportunities and clinical practice responsibilities. 21

23 Post-Assessment Questions 1. Each of the following statements are true except? a) Health care reform is emphasizing increased quality in health care services while reducing overall costs. b) Pharmacists are recognized providers by CMS and other major payers c) Technology is replacing traditional pharmacists dispensing roles d) Telepharmacy provides a new avenue for pharmacists to provide services from a remote site 2. Tech-check-tech programs have not been shown to be as effective as pharmacist-check-tech programs. True or False Post-Assessment Questions 3. Each of the following is a key factor for innovation in pharmacy except a) Implementation of technology b) Enhancing technician roles c) Board certification of pharmacists d) Becoming an integrated health care team member 4. Which of the following statements is true? a) All pharmacists are prepared to implement clinical services in their practice b) There will be less opportunities for pharmacist in health care reform c) SWOT analyses are helpful to identify a clinical service that may benefit patients d) All the statements above are true 22

24 Questions 23