In a recent #KareoChat (first and third Thursdays at 9 a.m. Pacific), participants gathered with guest host Tony Guerra, PharmD (@Tony_PharmD), advisor at Des Moines Area Community College Pharmacy Technician program and Pharmacy Podcast Network Co-Host, to discuss how medical practices can make pharmacists part of the team.
We brought Tony in to lead the chat because he has always supported a physician-pharmacist relationship.
“The role of a pharmacist will depend greatly on patient population, needs of the healthcare team, financial considerations and state legal requirements. A pharmacist may perform pre-appointment medication reconciliation for complex patients or meet with individual patients to provide medication education, address barriers to adherence and answer questions. Together, physicians and pharmacists can create protocols to optimize drug therapy to achieve clinical outcomes”.
Tony Guerra, PharmD.
The discussion focused on both sides of the issue, from the physician point of view as well as the pharmacist.
Let’s dive into the discussion.
Topic 1: What Roles Can the Pharmacist or Pharmacy Technician Play in Your Practice?
Anytime a new team member is added, it is important to make sure the role fits well within the current practice. Here are some thoughts from the participants.
A1: In my former clinical role as a pediatric hospitalist in a community hospital, the pediatric pharmacists were instrumental in ensuring the safety of our young, vulnerable patients. Pharmacists play an invaluable role in advising physicians and patients. #kareochat https://t.co/XFxX8rxKzK— Your GPS Doc, LLC (@yourgpsdoc) April 19, 2018
T1 Each year, there are more than 1.5 million preventable medication-related adverse events in the United States. For practices, this means repayment penalties. Pharmacists can mitigate these issues #Kareochat pic.twitter.com/Ju5QJ7heMZ— ShereeseM, MS/MBA (@ShereesePubHlth) April 19, 2018
A1. My dad's kidney specialist recently added a pharmacy component to his office. You can fill the prescriptions all in one spot.#KareoChat— Angela Hemans (@AngelaHemans) April 19, 2018
Topic 2: How Can a Practice Benefit from Including a Pharmacist?
Another important topic to discuss is how a new role will benefit the current team structure, as well as patient care. Here are a few thoughts from the chatters.
“A practice’s resources and needs will determine if there is room to add a pharmacist to their healthcare team. An alternative way to include a pharmacist would be by sharing their services with another practice. The availability of an embedded pharmacist for multiple practices can keep costs down while achieving the benefit of the professional’s skills. Practices that cannot embed a pharmacist can try to collaborate with community pharmacists who many patients know and trust”.
Tony Guerra, PharmD
A2: With shift to value-based payments for practices & medication-related metrics, including #pharmacists can help practices meet quality metrics. #KareoChat https://t.co/9fsyEQ6Dh6 https://t.co/tcpELSvkYh— UNC CMOPP (@unc_cmopp) April 19, 2018
A2 From patient point of view, having pharmacist available to educate on meds & check interactions would make me more comfortable #kareochat— Melissa VanHouten (@melissarvh) April 19, 2018
Topic 3: Where and How Can You Find a Match With a Pharmacist or Pharmacy Technician?
Finding a pharmacist or pharmacy technician whose values align well with the practice vision is imperative. Here are a few responses from the participants.
“Finding a pharmacist or pharmacy technician that shares a practice’s vision is important. Practices can download a toolkit available as part of the module to help identify a pharmacist that best meets their needs. The module helps in the decision process by sharing skills and qualities practices should look for when embedding a pharmacist.” -
Tony Guerra, PharmD
Pharmacists should be networked with local practice care managers to close the loop on CCM work IMO #kareochat— Dr. Tom Giannulli (@drtom_kareo) April 19, 2018
Topic 4: What Expectations Should Be Determined for the Healthcare Team and Patients?
Adding pharmacists to practices was a well accepted idea by the attendees of the chat. Making sure roles are clearly defined seemed to be at the top of many chatters thoughts on the topic.
“Once a pharmacist has been chosen for a practice, it is important to designate a physician champion to explain the role pharmacists and pharmacy technicians will play in enhancing patient care. If a clinical pharmacist has been chosen, it is also important to explain to the team exactly what this means by clearly defining roles and creating decision trees to lessen confusion and conflict, according to the module. Being prepared for the inclusion of a pharmacist, clinical pharmacist or community pharmacist is important in maintaining a team-based approach.”
Tony Guerra, PharmD
T4 If a pharmacist is to be added to the mix, there has to be policy development and implementation for this, to include the job description. Roles need to be clearly defined, as well as compliance accountability #kareochat pic.twitter.com/O8H29qZKia— ShereeseM, MS/MBA (@ShereesePubHlth) April 19, 2018
And from a patient perspective, Melissa (@melissarvh) brings up a great point.
A4 I think it would be important 4 patient 2 know who is coordinating care re meds. Make clear where to take questions & concerns #kareochat— Melissa VanHouten (@melissarvh) April 19, 2018
Topic 5: What Resources Does the Pharmacist Need and What Is the Impact on the Physician’s Workflow?
Once the benefits of a pharmacist are determined and the roles clearly defined, it's time to talk logistics.
“It isn’t necessary to completely overhaul a practice when embedding a pharmacist. A practice will need to provide the pharmacist with a private space with a desk, phone and an exam room. Any room with privacy can potentially work for a pharmacist joining the practice. It is also important to provide access to a computer as well as common equipment to further aid the pharmacist in patient care.” -
Tony Guerra, PharmD
T5 Competency! Competent support staff, competent innovation, and competent partners. They also must be engaged. Their buy-in is crucial; their disengagement is costly. #kareochat— ShereeseM, MS/MBA (@ShereesePubHlth) April 19, 2018
Bonus Topic: How Would You Measure the Impact of Embedding a Pharmacist?
Measuring results is an important step in analyzing the impact of adding a pharmacist to an existing medical practice.
“There are various ways practices can measure the impact of a pharmacist or pharmacy technician. Suggestions include clinical outcomes, impact on process metrics, monitoring or documenting medication changes, improvement in medication adherence, and decreases in medical and pharmacy costs.” -
Tony Guerra, PharmD
Bonus - I don't know technicalities of measuring concrete monetary benefits but think patient satisfaction must be part of this. #kareochat— Melissa VanHouten (@melissarvh) April 19, 2018
Measuring outcomes is critical as part of care management program - need to collect and share data to do this well #kareochat— Dr. Tom Giannulli (@drtom_kareo) April 19, 2018
This chat had lots of momentum going and the participants were sad to see the last few minutes of the chat count down.
Many great ideas and thoughts on adding pharmacists to medical practices were discussed during this #KareoChat. So many great perspectives on the topic were seen today from pharmacists to doctors and patients points of view. These diverse discussions help propel vital healthcare concepts forward.