Health Systems

The Truth Behind Three Health Systems Myths, Part 1

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Ambulatory pharmacy for the greater good.

Controlling costs while maintaining quality care can feel like walking a tightrope sans the safety net. The good news? Health system pharmacists are in a unique position to help the organization overcome challenges related to both cost and care through ambulatory pharmacy models. But first, they'll have to overcome a common myth surrounding how to socialize the benefits of building out the health system's ambulatory care model.

Myth #1: Health system leadership already knows ambulatory pharmacies are a good idea.
Truth: As a cost center that can account for up to 20 percent of a health system's budget, the C-suite has undoubtedly looked to the pharmacy to optimize expenditures and savings.1 But do they know of the pharmacy's potential to improve quality of care, especially as it relates to the management of chronic disease and in helping to reduce readmissions through more rigorous medication reconciliation and better care coordination? While leadership may understand the importance of having these protocols in place, they may not be aware of the impact a pharmacy-led program can have. Hospital leadership may not know that:

  • The error in the collection of medication histories between pharmacy and non-pharmacy staff can vary by more than 30 percent.2
  • Pharmacists are able to create more comprehensive medical histories, which according to the largest medication reconciliation study to date, accounts for 85 percent of medication errors.3
  • Putting pharmacy technicians in charge of creating medication lists can reduce prescribing errors by 89 percent.4
  • Medication adherence, knowledge and appropriateness have been shown to improve when a pharmacist is in charge of educating the patient.5
  • Because support from the C-suite is an essential component of any successful ambulatory pharmacy, pharmacists need to close the gap between what leadership may know in theory and what has been demonstrated.

With most systems still in fee-for-service arrangements, it's important to communicate the value of an ambulatory pharmacy as a profit center in addition to the clinical and care coordination enhancements it provides. Not only is ambulatory pharmacy a means to increase employee prescription capture and reduce benefit costs, but hospitals can also save between eight and 12 percent on the drug purchasing side when they set up in-house pharmacies.6

Directors of pharmacy looking to translate progress into C-suite speak should invest in leading-edge tools and analytics, which we'll discuss in Part 2 of this series.

1Edwards, Randy. "In Struggle to Cut Expenses, Hospitals Eye the Pharmacy." Hospital Health Networks RSS. N.p., 1 Nov. 2011. Web. 08 Feb. 2016. Available online at http://www.hhnmag.com/articles/4403-in-struggle-to-cut-expenses-hospitals-eye-the-pharmacy.
2Hart, Coleen, Christine Price, Glenn Graziose, and Jonathan Grey. "A Program Using Pharmacy Technicians to Collect Medication Histories in the Emergency Department." Pharmacy and Therapeutics. MediMedia USA, Inc., n.d. Web. 02 Feb. 2016.
3Gleason KM, McDaniel MR, Feinglass J, et al. Results of the Medications At Transitions and Clinical Handoffs (MATCH) study: an analysis of medication reconciliation errors and risk factors at hospital admission. J Gen Intern Med. 2010;25:441-7.
4Doyle, Edward. "Medication Reconciliation Done Right." Today's Hospitalist. N.p., n.d. Web. 10 Feb. 2016.
5Exploring Pharmacists' Role in a Changing Healthcare Environment (2015): 1-30. Avalere Health LLC. Web. Available online at http://assets.fiercemarkets.net/public/Pharmacist%20Report.pdf.
6Shaw, Gina. "Is It Time To Build an Outpatient Pharmacy." Pharmacy Practice News June 2015: 32+. Web. 25 June 2015.
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