“If it’s rights for the patient, then its right for pharmacy”. I first heard this statement, or something very similar to this from an esteemed colleague, Bob Osterhaus. Over the years, I have cited this statement in many venues convincing pharmacists to always put the patient first and do the “right thing” to ensure that they are achieving therapeutic outcomes through safe and effective medications. This phrase was paramount to my business partner (Mike Deninger) and I as we re-engineered our practice to provide continuous medication monitoring (CMM) for all of our patients. To put it simply, CMM was a process that we developed and implemented so that we became accountable to our patients. Filling a prescription becomes more than just a dispensing process, but rather a meaningful encounter with the patient whereby pharmacists are reviewing the patients medications, identifying and resolving drug therapy problems, communicating with patients and prescribers, and documenting their activities in real time. We firmly believed that this was the RIGHT thing to do for patients.
Since implementing CMM, our pharmacists have improved their efficiencies in their patient care processes so much so that we are documenting approximately 3000 interventions every month. But how did we get there? This did require an investment of time, money, and resources. Early one Mike and I realized that CMM can only be done if there is an effective and efficient documentation system. Initially we developed a documentation system that allowed pharmacist to do final verification along with patient SOAP notes and we called it our “Quick Clinical” system. Eventually, it became a comprehensive documentation tool that allows our pharmacist to provide final verification, create on-the-run interventions, identify potential drug therapy problems, and write SOAP notes. This clinical documentation system is now called PharmClin and we have filed for a patent to the United States Patent and Trademark Office (USPTO). This system has allowed our pharmacists to better manage our patients drug therapy. It was the RIGHT thing to do for our patients.
We also hired more pharmacists to ensure that we could provide other clinical services in addition to CMM. These services include immunizations, medication therapy management (MTM), consulting services for hospice and long term care, medication adherence program (MAP), durable medical equipment (DME) consults, medication synchronization, and health screening/promotion. We invested in technology (e.g. Parata Pass and Parata Max), participated in the new practice model (tech-check-tech program) initiated in our state, and fully engaged in medication synchronization with the sole purpose to make sure pharmacists were freed up to provide patient clinical services. Although a sizable investment, it is the RIGHT thing to do for our patients.
Mike and I fully understand that we have a sizable financial investment in our pharmacies, but we firmly believe that we have put our pharmacy on the right path for a bright future. It is not without concerns, fear, or doubts. But then I am reminded of the statement by Bob Osterhaus “If it’s right for the patient, it’s right for pharmacy”. Then I know that we have done the RIGHT thing because our patients are benefitting.
It is time for all of us to critically evaluate our practices to determine if we are doing the “RIGHT” things for our patients. It begins by creating efficiencies in the practice so that pharmacists are freed up to provide clinical services. Dispensing should be technician driven. Medication synchronization services should be the standard of community pharmacy practice as it improves dispensing efficiencies, inventory management, and the provision of clinical services. Pharmacists need to become “interventionist” by identifying drug therapy problems, providing clinical recommendations to patients and/or prescribers, and documenting their clinical activities. Pharmacists need to make sure they are practicing to the level of their degree. If they are uncomfortable and incapable of doing this, then they need remedial education/clinical training. Obviously this is not easy, nor can it be done without some type of investment (time, money, or resources). But, ultimately, it is not about what is best for us, but rather what is RIGHT for the patient!