Posted on July 15, 2019 in: Professional Practice
The field of ambulatory care pharmacy represents a diverse area of practice that ranges widely in populations served and disease states managed. Ambulatory care embodies one of the fastest growing specialty areas within the profession of pharmacy. The most recent report from the Board of Pharmacy Specialties indicated that board certification in ambulatory care was the third most common certification, behind pharmacotherapy and geriatrics.2 Driven largely by the realization that physicians, nurse practitioners and physician assistants can't "do it alone" pharmacists have become a natural fit to supplement the increasingly complex care of patients in the outpatient setting while also helping to achieve the "quadruple aim" (see Figure 1).3
Figure 1. The Quadruple Aim to Optimize Health System Performance
In order to better grasp the state of ambulatory care practice in Michigan, a survey was sent out in early 2019 to ambulatory care pharmacists and health system pharmacy managers across the state. Twenty-one responses were collected from the survey. The majority of those surveyed practice in a primary care setting (67 percent) with the most common services provided including disease state management (76 percent), medication access/prior authorization/patient assistance (71 percent), and medication therapy management (67 percent). Most of the respondents bill for their services (62 percent), have prescriptive authority under a collaborative practice agreement (93 percent), and track performance metrics (81 percent), such as interventions, number of patient contacts per day, and productivity. Just over half of respondents are tracking clinical outcomes (52 percent), such as hemoglobin A1c or blood pressure and only 47 percent are using a pharmacy extender (student, resident or technician) in their practice.