Improving Patient and Health System Outcomes through Advanced Pharmacy Practice

By: Shannon Tellier

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In December 2011, a report written to the United States (U.S.) Surgeon General, Dr. Regina Benjamin, discussed the importance of pharmacists in the healthcare system.  The objective of the report was to obtain support for expanding the roles of pharmacists in patient care, primary care, and public health services.  This evidence-based report was an update to one written in 2009 to the previous U.S. Surgeon General.

Four main points that were included in this report discussed both, the current and future, roles of pharmacists in the healthcare system.  The first point gave current examples of pharmacists integrated into the healthcare system. Over the past 40 years, pharmacists in the federal healthcare system have actively participated in disease management, disease prevention, and other clinical services. More recently, pharmacists have become increasingly involved in patient care services including Collaborative Drug Therapy Management (CDTM) and Medication Therapy Management (MTM).  The federal healthcare system documents support for the movement of pharmacy toward a patient-centered practice, which exemplifies the expanding role of pharmacists.

The second point explains that pharmacists who provide patient care services should receive recognition as healthcare providers in national healthcare policy. According to The American Academy of Family Physicians, primary care is “health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis, and treatment of acute and chronic illnesses in a variety of healthcare settings.” After a diagnosis by prescriber, pharmacists become valuable members of the primary care team in managing the disease state with an optimal medication regimen.  Pharmacists formally educated in disease management and therapeutics can have a huge impact on the healthcare of the patient. By identifying pharmacists as healthcare providers under the Social Security Act, pharmacists will be involved in certain areas to improve patient care outcomes.

The third point addresses the difficulty that pharmacists face to receive compensation for patient care services. This barrier currently prevents pharmacists from integration into the primary healthcare team.  The current reimbursement model only pays pharmacists for dispensing medications, not patient care services. Although the Centers for Medicare and Medicaid Services (CMS) allows pharmacists to receive some compensation for MTM through Medicare Part D, there are numerous restrictions that limit the number of eligible patients who receive this service. A new compensation mechanism that includes all patients would be valuable in allowing pharmacists to receive compensation for services other than dispensing of drugs.

The last point provides evidence and documentation of healthcare outcomes involving pharmacists in patient care services. Numerous database reviews have published positive results in disease outcomes, patient safety, and cost-containment when pharmacists are directly involved in patient care. These documented examples provide evidence that support the expanded role of pharmacists in the healthcare system.

If the objectives of this report integrate into the U.S. healthcare system, we will be able to full utilize pharmacists’ knowledge about disease state management and patient care services. Maximizing the full potential of pharmacists will have a positive outcome on patient’s disease states, patient safety, and healthcare costs. Scott Giberson, the Chief Professional Officer for Public Health Service Pharmacists and also an author of this report stated, “I firmly believe that one of the most evidence-based and cost-effective decisions we can make as a nation is to maximize the expertise and scope of pharmacists, and minimize expansion barriers to successful healthcare delivery models. It is the right thing to do for our patients.” On December 14, 2011, the U.S. Surgeon General wrote a letter to Scott Giberson publically supporting the report and the awareness of pharmacists as a crucial part of the healthcare team.

For more information, please visit: http://www.usphs.gov/corpslinks/pharmacy/comms/sgreport2011.asp