Implementing Providers into Neighborhood Pharmacy Workflow Presents Challenges

Areas for enchancment embody the enterprise mannequin, well being care workforce buy-in, affected person engagement, and expertise.

The Medicare Prescription, Drug, Enchancment, and Modernixzation Act of 2003 established necessities below Half D to supply remedy remedy administration (MTM) providers to eligible Medicare beneficiaries.1

This set the stage for an growth of pharmacists’ roles in affected person care. In 2018, roughly 65% of plans reported utilizing neighborhood pharmacists by way of vendor contracts.2,3 Nonetheless, challenges exist with implementing MTM providers into the neighborhood pharmacy workflow.

Overcoming Obstacles

The outcomes of 1 cross-sectional examine from a random pattern of Medicare beneficiary enrollment information evaluating 2014 Half D MTM recordsdata confirmed that neighborhood pharmacists supplied extra remedy remedy downside (MTP) suggestions (P<.001) however resolved fewer MTPs than these supplied by non-community pharmacists (eg, MTM vendor in-house pharmacists, Medicare Half D plan pharmacists)2. Proof reveals that the next are challenges to implementing MTM providers in the neighborhood apply setting: enterprise mannequin obstacles, incorporating packages throughout the well being care workforce, integration into the pharmacy workflow, lack of affected person engagement, and expertise adaptation struggles (Determine2-5).

Challenges to incorporating MTM providers into the pharmacy workflow embody issue coaching personnel, insufficient devoted bodily area to carry out consults, and lack of time.2,3 Busy chain pharmacies can have issue incorporating MTM providers due to the various pharmacist obligations that embody administering immunizations and meting out drugs. Proof reveals that entry to expertise is essential for MTM providers, particularly to assessment digital medical information.3,4 Usually, MTM distributors use web-based software program for documentation and billing, so incorporating educated pharmacy technicians into this job is essential. The outcomes of one other examine recognized obstacles and implementation methods for integrating a web-based remedy administration software in neighborhood pharmacies.4 Moreover, the examine outcomes confirmed that medical coaching, laptop literacy, and management coaching facilitated implementation of a web-based program into the apply setting.4 Nonetheless, employees opposition to vary and supplier reluctance to share information have been thought of obstacles to implementing the expertise.4

Lack of affected person curiosity in MTM providers can be an impediment.3 Moreover, many sufferers are unaware that pharmacists’ medical coaching goes past meting out drugs.3 Pharmacists can develop a standardized method to delivering MTM providers and clarify their roles to sufferers. Pharmacists and physicians may efficiently work collectively by way of collaborative drug remedy administration to enhance communication and affected person care providers.3 The outcomes of a 3rd examine confirmed there was a rise in MTM completion charges after an academic intervention was applied at neighborhood pharmacies (P<.001).5

Greater than 600 pharmacist practitioners and program administrators who supplied survey responses thought that complete remedy administration (CMM) providers enable well being care organizations to attain clinician satisfaction, price financial savings, improved outcomes, and affected person satisfaction, in line with the outcomes of a report from Health2 Sources.6

The CMM method focuses on medical, affected person, and private targets to enhance well being outcomes.6 Goodrich Pharmacy, an impartial pharmacy in Anoka, Minnesota, and HealthPartners have efficiently carried out CMM.6 HealthPartners began paying for CMM providers in 2006.6 At press time, Goodrich Pharmacy employed 18 pharmacists at 7 websites and so they used CMM with roughly 900 sufferers.6

About The Writer

Jennifer Gershman, PharmD, CPh, PACS, is a drug data pharmacist and Pharmacy Instances® contributor who lives in South Florida.

References

1. Medicare Prescription Drug, Enchancment, and Modernization Act of 2003, HR 1, 108th Cong (2003). Accessed April 7, 2022. https://www.congress.gov/invoice/108th-congress/ house-bill/1

2. Adeoye OA, Farley JF, Coe AB, et al. Medicine remedy administration supply by neighborhood pharmacists: insights from a nationwide pattern of Medicare Half D beneficiaries. J Am Coll Clin Pharm. 2019;2(4):373-382. doi:10.1002/jac5.1160

3. Ferreri SP, Hughes TD, Snyder ME. Medicine remedy administration: present challenges. Integr Pharm Res Pract. 2020;9:71-81. doi:10.2147/IPRP.S179628

4. Turner Okay, Renfro C, Ferreri S, Roberts Okay, Pfeiffenberger T, Shea CM. Supporting neighborhood pharmacies with implementation of a web-based remedy administration software. Appl Clin Inform. 2018;9(2):391-402. doi:10.1055/s-0038-1651488

5. Hohmeier KC, Wheeler JS, Brookhart A, et al. Focusing on adaptability to enhance remedy remedy administration (MTM) implementation in neighborhood pharmacy. Implement Sci. 2019;14(1):99. doi:10.1186/s13012-019-0946-7

6. GTMRx Institute. The Get the Drugs iight Report: a Nationwide Snapshot of Professional Practices–Complete Medicine Administration in Ambulatory/Neighborhood Pharmacy. Might 2016. Accessed April 8, 2022. https://gtmr.org/the-gtmr-report/

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