Pharmacy News

Entries for May 2016

In Need of a Primary Care Provider? Ask Your Pharmacist!

by Julie Schmidt, Pharm.D., Public Affairs Committee

Pharmacists are the most accessible healthcare professionals. That is a powerful statement. As most of us have heard this statement multiple times throughout our pharmacy careers, do we always take advantage of it? We talk to multiple patients each day in a variety of scenarios, including counseling patients, making phone calls, completing medication reconciliations, and in each of these cases, we can help every patient and educate them about the pharmacists’ skills and capabilities. While we continue to pursue provider status, we should also be concerned about our current role in patient care. The Affordable Care Act has expanded the number of patients with health insurance, and with a subsequent shortage of primary care providers, patients seeking primary care can become overwhelmed.

The MSHP Public Affairs Committee charges include participation in the development of the “That’s My Pharmacist” campaign. The Michigan Society for Health-System Pharmacists (MSHP) Public Affairs Committee and Michigan Pharmacists Association (MPA) made this public affairs campaign available, and it was originally created to promote the idea of patients getting to know their pharmacist. This year the Public Affairs Committee decided to include in the initiative how pharmacists can help patients in transitions of care and primary focus roles.

In the upcoming months, two additional flyers will be added to the “That’s My Pharmacist” campaign. These flyers will focus on encouraging patients to ask their pharmacist about finding a primary care provider. These flyers should ideally be used throughout pharmacies to promote awareness for patients who may not realize that pharmacists are a resource for identifying a primary care provider. For example, one flyer will highlight transitions of care, primarily those when patients are discharged from the hospital and sent home. In order to decrease hospitalizations, patients should visit a primary care provider after being discharged from an inpatient setting where they will receive the most appropriate monitoring and management for their conditions. Pharmacists are often not seen as a resource for this type of transition.

The second flyer will be for use in outpatient pharmacies. Many patients who are filling prescriptions written by an emergency room or urgent care physician may find themselves looking for a single primary care provider but do not know where to begin. These patients can benefit from the assistance of their pharmacist. The flyer will illustrate the importance of a pharmacist as an integral member of the healthcare team and will explain our role in identifying primary care options for patients. Pharmacists can help in this area by contacting their insurance plan, using a hospital referral service, and asking friends, family or coworkers for referrals. By informing patients of these different resources, patients may seek additional advice from us about other resources, and we can help to further a team-based healthcare approach, potentially avoiding emergency room or urgent care visits that may not be necessary.

In addition to the materials being created this year, the Public Affairs Committee would like to encourage you to take advantage of the current materials on the website which can be found here. While pharmacists continue to pursue provider status, it is important to promote our profession to patients and help them to fully understand our capabilities – including assistance in finding the primary care provider they need. After all, the more patients that realize we are the most accessible healthcare professional, the stronger our relationships will be. Then, they will be able to say, “That’s My Pharmacist!”

Posted in: Member News
Crash Course in Provider Status Resources

Shawna Kraft, Pharm.D., BCOP, Clinical Pharmacist Specialist – Oncology, University of Michigan Comprehensive Cancer Center, MSHP Board of Directors

I believe in the idea that, if you know where to look for the answer, then you already have the answer. Knowing our resources is extremely important and necessary to successfully educate yourself and others on provider status. Sure, we are hearing about it, and some of you may even be saying, “enough already”, but do you really know about provider status, how it will impact you and how you can implement innovative services within your own practice? For most of us the answer is, “probably not.” In our February issue, Dana Staat touched on the essential education of ourselves, our patients and our provider partners (physicians, NPs, PAs, etc). If we do not fully educate ourselves, then it is very difficult and intimidating attempting to educate our non-pharmacy colleagues, legislators and patients.

The Basics

What is this law I keep hearing about?

Pharmacy and Medically Underserved Areas Enhancement Act

But I don’t live in an underserved area, so this does not impact me.

Not true, as Jesse Hogue stated in January, even areas you may think are not underserved, actually qualify in the law. Additionally, as the FAQs from ASHP clarify, other healthcare professionals (e.g., nurse practitioners) were first recognized as providers in service in underserved communities. Additionally, this proposal would directly affect practitioners in ambulatory/community settings, and this recognition would expand to pharmacists in all settings by establishing a precedent. We need a starting point in order to prove how adept we are as official providers.

In your next daydream sequence, spend some time reflecting on your practice site. If I were to have provider status in my daily work, what more could I do for my patients? In our March issue, Frank Zaran discussed various examples and best practices for potential programs, thereby putting ideas into practice. Work to read other articles on the topic, and pay attention at conferences from the local, state and national levels for ideas. Network with other pharmacists (we all love doing this anyway) so that when you do decide to implement an idea, you have colleagues you can talk with. Next, ask yourself what obstacles at your site need to be overcome in order to put your idea into practice. Engage your managers and colleagues, early and often. Think about how you can utilize “free” or reduced cost resources such as students to leverage/overcome these obstacles.

Start now?
Why not? This is the future of pharmacy; having appropriate structure in our practices will provide a smoother transition when provider status becomes a reality. If you have policies or processes that are due for updating, take advantage of the timing to restructure (if needed) in order to align with provider status goals. For example, when documenting patient care activities performed, scrutinize what you are documenting. Is it really all necessary? What components or data are essential for accrediting bodies and demonstrating value? Look at the requirements set forth by your specialized accreditation body/bodies and model your documentation after those needs. Leverage your technology for your documentation so when data is needed to prove your value, it is easily attainable in a report or dashboard. Even if you are not able to currently bill for your services, review what is currently required to obtain billing, so again, you can structure your approach to fit within a payment model. Even if your eventual payment model isn’t exactly the same, you are more likely to be ahead with your documentation had you not started at all. ASHP has wonderful, detailed resources in the ambulatory care resource center to guide you.

Ok, ok, this is important, I get it. So how do I know if my representative was a cosponsor/supporter of this bill, and what can I do to help?

Cosponsors for Michigan:
Rep. Miller, Candice S., District 10, 7/10/2015
Rep. Bishop, Mike, District 8, 7/22/2015
Rep. Walberg, Tim, District 7, 9/17/2015
Rep. Kildee, Daniel T., District 5, 10/1/2015
Rep. Dingell, Debbie, District 12, 10/27/2015
Sen. Stabenow, Debbie, 4/22/2015
Sen. Peters, Gary C., 7/28/2015

To check to see what district you are in, visit the Secretary of State’s district locator map. Sign up to keep updated with MSHP/MPA advocacy and contact your legislator.

I am certainly not an expert in provider status and the laws and regulations associated, but I would like to use this opportunity to encourage you to explore the issues, and if you have additional knowledge or helpful resources, speak up and out, even by posting online comments at the end of this article. I think we have much to learn from one another via collaboration and can use each other as best practice examples to model our practices and create new ideas.

Posted in: Professional Practice
A Preview of the ASHP House of Delegates 2016

by Ryan J. Bickel, Pharm.D., MHA, FASHP; MSHP Organizational Affairs Committee

We are all familiar with previews that are played prior to the start of a movie to promote upcoming films. They usually consist of short, exciting scenes from a movie designed to entice the audience into seeing the film when it is released. In this article, I intend to provide you with a series of “scenes” that will be discussed next month at the American Society of Health-System Pharmacists (ASHP) House of Delegates. Following Jesse Hogue’s May MSHP Committee Day presentation, I have highlighted one policy from each ASHP council and the resolution.

Safety of Epidural Steroid Injections
This new policy proposed by the Council on Therapeutics encourages healthcare providers to inform patients of the risks of epidural steroid injections and to request their informed consent. It also advocates for pharmacists to be involved in epidural steroid protocol development. Some delegates have voiced concern over the lack of studies supporting this practice. Others have suggested amending the policy to require resuscitation equipment be available and encourage use of commercially available products.

Pharmacy Technician Training and Certification
The Council on Workforce Development recommended modifying ASHP Policy 1519. The revised version advocates for all pharmacy technicians maintaining Pharmacy Technician Certification Board (PTCB) certification. The policy also states that by 2020, pharmacy technician training programs need to be accredited by ASHP and the Accreditation Council of Pharmacy Education to obtain PTCB certification. The Michigan delegates have suggested that the policy should be amended to allow for equivalent ongoing education as an alternative to maintaining PTCB certification, consistent with Michigan law. Other delegates have expressed concern over the potential conflict of interest in requiring participation at an ASHP-accredited training program.

Surface Contamination Vials of Hazardous Drugs
The Council on Pharmacy Management suggested revising ASHP Policy 0618. The major change is the addition of the following statement:

“To advocate that the Food and Drug Administration require standardized labeling and package design for hazardous drugs that would alert handlers to the potential presence of surface contamination.”

Overall, there is general support for this revision.

Automated Preparation and Dispensing Technology for Sterile Preparation
This new policy created by the Council on Pharmacy Practice advocates health-systems to implement automation and information technology for preparing and dispensing sterile preparations. Some of the examples provided in the background include IV compounding technology for nutritional support preparations, barcode verification and workflow management software. The policy also advocates for further research, development and publication of best-practices surrounding automated preparation and dispensing technology for sterile products. Some Michigan pharmacists have expressed concern about the lack of validated dispensing technologies for sterile products. They suggest additional research and development should occur before advocating for broad implementation.

Direct-to-Consumer (DTC) Advertising for Prescription Drugs and Implantable Devices
The Council on Public Policy recommends revising ASHP Policy 1119 to closer match the American Medical Association’s stance, which calls for a ban on DTC advertising of prescription drugs and implantable devices due to its impact on drug prices. Most pharmacists at Committee Day indicated that they were supportive of taking a strong stance against DTC.

ASHP Position on Assisted Suicide
One resolution was submitted this year to the Committee on Resolutions. It seeks to modify ASHP Policy 9915, ASHP Position on Assisted Suicide. The current version takes a neutral stance on pharmacist participation in assisted suicide. The resolution seeks to oppose pharmacist participation. This resolution created a great deal of discussion, as there are many strong feelings regarding this topic and multiple questions exist about what constitutes assisted suicide. At the House of Delegates, the delegates will be given the opportunity to accept the resolution, reject the resolution or to refer it to an ASHP council for further study. An electronic survey can be found here in order for Michigan ASHP members to have an opportunity to indicate how you would like the Michigan delegates to vote.

This concludes this year’s preview of the ASHP House of Delegates agenda. For a complete listing of all the policy recommendations, which will be addressed next month, please visit:

The delegates that will be representing Michigan in the 2016 House of Delegates are:

  • Ryan Bickel
  • Gary Blake
  • Jesse Hogue (Alternate)
  • Michael Ruffing
  • Kari Vavra (Alternate)
  • Paul Walker

Our duty is to represent the ASHP members in Michigan. I encourage any current MSHP and ASHP members to complete the following online feedback form if you would like to express your feelings about the policy recommendations or the proposed resolution. ASHP members can also follow the delegate discussion and contribute by joining the House of Delegates community on ASHP Connect. Unlike the movie previews, there is still time to edit this production if you have input.

Posted in: Member News
Don’t Forget to Order PSI Controlled Substance Inventory List to Comply with Annual Requirement

Michigan law requires an annual inventory of controlled substances to be completed no more than 30 days prior to May 1 and no later than 60 days after May 1. Your copy must be submitted to the state between April 1 and June 30.

Complete this important task by using the Controlled Substance Inventory List available from Pharmacy Services Inc. (PSI). Contact PSI at (517) 484-1467, e-mail or click here to print the order form and fax back to (517) 484-1605.

Posted in: Professional Practice
Magellan/First Health Services Corporation Clinical Detailing Opportunities!

MPA would welcome the opportunity for MPA member pharmacists to participate in our clinical detaling program, which includes occasional live presentation trainings or home/Internet study. MPA’s clinical detailing project with Magellan/First Health Services Corporation has recently completed a project dealing with short acting Opioids for chronic pain. The clinical detailing projects ask pharmacists to provide Medicaid prescribers with the most up-to-date information on specific disease states. For this most recent project, one hundred physicians were profiled by Magellan throughout the state with over 25 pharmacists trained to present these physicians with the educational materials relating to this specific disease state. Previous disease states profiled by this project include GERD, NSAIDs, diabetes, depression, asthma, lipids and vascular disease, the Michigan MAPS program and inappropriate drug use in the elderly. 

Pharmacist detailers who participate in the program have completed visits with over 3,500 physicians in the 15+ years of the program’s existence. From the training, pharmacists will then schedule 15-20 minute face-to-face interventions with physicians/prescribers with each project. The pharmacists already contracted find the experience to be both personally rewarding and an excellent avenue to utilize their skills as an integral member of the healthcare profession as well as receiving fair reimbursement for their efforts. For more information about how to sign-up and become part of MPA’s mission to “encourage and support its members as the professionals responsible for the delivery of patient-focused care,” contact Pam Farley, Director of Clinical Services Administration, at her home office (517) 589-8392, or

Posted in: Member News
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