Pharmaceutical Care II

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Pharmaceutical Care II

• Patricia Marken, Pharm.D. , FCCP, BCPP
• Chair and Professor of Pharmacy Practice

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Collaborative Practice

• Agreement between pharmacist(s) and
  physician(s) whereby the delegation of
  authority to initiate or modify drug therapy
  under a defined protocol occurs.
• Can be broad or patient specific
• Can be approved locally or by a central
  authority
• What do you think we need to enter into a
  collaborative practice arrangement??

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Reimbursement

• Paid for product or services or both
• Use of language
• Patient, consumer, customer????
• What are your minimum legal responsibilities when
  dispensing a medication?

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Steps Towards Reimbursement

• Define service and recipients of service
• Set fee
• Salary, fringe, overhead, profit
• Competitive
• Source(s) of reimbursement
• Define outcomes to demonstrate value of service

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Manpower ProjectModels of Practice
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Manpower ProjectModels of Practice

• Order Fulfillment Services
• Maintain the safest possible medication system
• Reduce clinical rework by moving clinical
  decision making upstream
• Use administrative personnel to deal with program
  controls
• Use technical personnel and technology for
  filling
• Professionals only for supervision of process
• AJPE 2002 66421-429.

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Manpower ProjectModels of Practice

• Primary Care Pharmacy Services
• Patients obtaining Rx and OTCs in a community
  setting
• Manage simple and complex medication issues in
  ambulatory patients
• Patient assessment, advising on drug use process,
  counseling, monitoring for response

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Manpower ProjectModels of Practice

• Secondary and Tertiary Care Pharmacy Services
• Acute care and institutionalized patients
• Selecting, monitoring, adjusting therapy,
  transfer of care, long-term assessment of chronic
  therapy
• Need ability to make decisions within protocols,
  be responsible for drug-use policy and present on
  every unit.

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Manpower ProjectModels of Practice

• Examples of outcomes
• 100 of patients get a medication history (today
  5)
• Discharge medication education (20 today vs. 75
  needed)
• Prospective regimen design
• Outcome monitoring
• Decentralized pharmacists

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Manpower ProjectModels of Practice

• Nonpatient Care Pharmacy Services
• Faculty
• Federal government (policy, entitlement programs)
• Information technology
• Pharmaceutical Industry
• Drug Information
• Population-based care