E-prescribing now permitted for controlled substances!
Under DEA regulations that took effect June 1, e-prescribing of controlled substances is now permitted in the United States. All the dust has not yet settled, however; APhA joined with other pharmacy associations to suggest ways that the process could be improved. In addition, software developers may need at least a year to make the updates to computer systems that will allow prescribers to transmit scheduled medication orders, intermediaries to process the prescriptions, and pharmacies to receive them.
DEA has been moving for years toward allowing e-prescribing of controlled substances. The latest push began in June 2008 when the agency announced its intention to create an alternative to manual prescriptions. After the February 2009 economic stimulus act created incentives for increased use of health information technology by physicians, pressure increased for DEA to offer a structure for e-prescribing.
As pointed out in the article, pharmacists may not have to opportunity review a electronically submitted controlled substance prescription for 6-12 months, until this new process has sufficient time to be implemented. However, this is a long overdue – and welcome – policy change.
For additional information from the DEA, navigate your browser to the following site: http://www.deadiversion.usdoj.gov/ecomm/e_rx/index.html
Patient satisfaction with pharmacist telephone-based MTM
Abstract
Background
Patient satisfaction with medication therapy management (MTM), a required component of the Medicare Part D benefit, is an important outcome to consider when evaluating MTM programs.
Objective
To measure patient satisfaction with a pharmacist-provided telephone MTM program.
Methods
The study design was nonexperimental and cross sectional. A survey was mailed to Scott & White Health Plan Medicare Part D beneficiaries (n
=
Results
The response rate for the survey was 80% (47 of 59). Study participants were 70.8 (±7.9) years old, and most were white (84.1%) and female (54.3%). The alpha coefficient for the satisfaction scale was 0.88. Overall mean satisfaction score was 4.0 (±0.6), with items ranging from 3.6 to 4.3. The highest level of agreement (mean
Conclusions
Most of the beneficiaries were satisfied with their MTM care. The positive response to telephone MTM is important because Medicare Part D plans are using the telephone as a method of MTM delivery. Education regarding the pharmacist’s role in preventive care and pharmacist follow-up with non-pharmacist health care providers may lead to greater satisfaction levels.
Pillbox – pill identification system (NIH-NLM)
The National Institutes of Health (NIH)/National Library of Medicine (NLM) released a BETA version of a tool to help patients and healthcare providers identify medications via its physical properties (e.g., shape, color, imprint) and provide with FDA content consisting of links to medication information and labeling.
Although this tool is not really ready for full-time, clinical use – as evidenced by the disclaimer and the broken URLs – this has the potential to be a very helpful tool, free of subscription fees.
Lastly, I see projects like these as further evidence that the demand for informatics-trained clinicians will far exceed the supply in the marketplace.
Pharmacists Belong In The Medical Home (via Health Affairs)
Why Pharmacists Belong In The Medical Home
Marie Smith1,*, David W. Bates2, Thomas Bodenheimer3 and Paul D. Cleary4
1 Marie Smith (marie.smith@uconn.edu) is head of the Department of Pharmacy Practice, School of Pharmacy, at the University of Connecticut in Storrs.
2 David W. Bates is division chief of general medicine at Brigham and Women’s Hospital in Boston, Massachusetts.
3 Thomas Bodenheimer is an adjunct professor of family and community medicine at the University of California, San Francisco.
4 Paul D. Cleary is dean of the School of Public Health, Yale University, in New Haven, Connecticut.Pharmacists can affect the delivery of primary care by addressing the challenges of medication therapy management. Most office visits involve medications for chronic conditions and require assessment of medication effectiveness, the cost of therapies, and patients’ adherence with medication regimens. Pharmacists are often underused in conducting these activities. They perform comprehensive therapy reviews of prescribed and self-care medications, resolve medication-related problems, optimize complex regimens, design adherence programs, and recommend cost-effective therapies. Pharmacists should play key roles as team members in medical homes, and their potential to serve effectively in this role should be evaluated as part of medical home demonstration projects.
Great article; this is the type of professional advocacy we need.
ASHP Criticizes AMA Commentary on Pharmacist Scope of Practice
In a letter to American Medical Association (AMA) CEO Michael D. Maves, MD, MBA, ASHP CEO Henri R. Manasse, Jr., Ph.D., Sc.D., expressed his extreme disappointment with a recent members-only-access publication by the AMA entitled “AMA Scope of Practice Data Series: Pharmacists.” The AMA document, which includes a categorical analysis of pharmacists’ scope of practice in each state, contains numerous inaccuracies, false statements, and mischaracterizations about pharmacy practice and pharmacist education. ASHP calls on the AMA to retract the document, or, at minimum, correct the inaccuracies and mischaracterizations.Of particular concern, is the repeated characterization of pharmacists as having inadequate education and training, suggesting that their patient care roles should be limited.
Proud that ASHP is aggressively pursuing these type of issues!
Letter to AMA [PDF]: http://www.ashp.org/DocLibrary/News/NewsCapASHPlettertoAMAreScopeofPractice03…
New APhA CPE activity: “Health Information Technology: A new world for pharmacy”
Health information technology: A new world for pharmacy
AUTHORS: Lisa Webster, BPharm, MS, and Rachelle F. Spiro, BPharm, FASCP
Activity Preview
This article provides a primer on Health Information Technology (HIT) for pharmacists, including the current state of HIT, future expectations, and strategies to ensure success.
After participating in this activity, the pharmacist will be able:
- List at least five ways in which health information technology (HIT) is predicted to improve patient care.
- Provide at least five ways in which patient care might be at risk as a result of the adoption of HIT.
- Discuss six actions that pharmacists can take to help prevent patient harm related to the implementation and use of converging technologies.
- List four reasons for physician resistance to HIT implementation.
- Name six organizations involved in the development of HIT standards.
- State seven ways in which HIT is expected to benefit U.S. patients.
[note: free subscription required to access CPE activities]
A nice, straightforward Continuing Pharmacy Education (CPE) activity from The American Pharmacists Association directed towards educating practicing pharmacists about the importance of HIT.
Resident Abstracts for Western States Conference
In order to acknowledge the hard work of our resident pharmacists – and to promote an exciting new collaborative tool available to OSHP members - the 2009-2010 resident pharmacist abstracts for Western States Conference taking place May 25-28, 2010 are now posted for viewing on the OSHP wiki.
What is the Western States Conference?
The Western States Conference for Pharmacy Residents, Fellows and Preceptors is designed to provide pharmacy residents and fellows with an opportunity to make a formal presentation of their project or research in a relaxed professional setting; discuss clinical or administrative case experiences; have open forum discussions; meet leaders in health-system pharmacy and pharmaceutical industry; and broaden relationships with other residents and fellows. Today’s residents and fellows will become the leading practitioners of tomorrow.
Source: Western States Conference
What is a wiki?
A wiki is a website that allows the easy creation and editing of any number of interlinked web pages via a web browser using a simplified text editor. Wikis are typically powered by wiki software and are often used to create collaborative websites, to power community websites, for personal note taking, in corporate intranets, and in knowledge management systems.
Source: Wikipedia
Please peruse the abstracts for our outstanding resident pharmacists and let us know what you think about the new collaborative tool!
Key Healthcare Act Provisions That Take Effect Immediately (via Medscape)
Health Reform Contains Key Clinical Pharmacy Provisions (via ACCP)
Clinical Pharmacy Services
Specific to clinical pharmacy services, the law provides for:
MTM Grant Programs. The new law establishes a stand-alone grant program to ensure pharmacist-provided MTM services as defined by the pharmacy profession’s consensus definition on the Core Elements of an MTM program. The program ensures the testing of practice and care delivery models, such as patient-centered self-management programs, that improve patient outcomes through team-based collaborations between prescribers and pharmacists.
Integrated Care Models. The law also includes provisions to ensure that providers with expertise in pharmacotherapy, including pharmacists, are fully engaged in integrated, collaborative, team-based approaches to delivering care, including medical homes, accountable care organizations, community health teams, and home-based chronic care programs.
Transitional Care Activities. The law recognizes the gaps in care coordination and communication that often occur when patients are transferred from one care setting to another. Problems arising from inappropriate medication use are a primary reason for hospital readmissions. Pharmacists—by helping manage pharmacotherapy as part of a transitional care team—will be able to play major roles in preventing these events. Transitional care activities might include medication reconciliation, improved use of personal medication records, and discharge planning that may include MTM services.
Medicare Advantage Plan Incentives. The law provides bonus payments to Medicare Advantage plans that conduct care coordination and management activities. In particular, it acknowledges the need for MTM programs to address medication use issues such as poly-pharmacy through medication reconciliation, periodic reviews of drug regimens, and integration of medical and pharmacy care for chronically ill, high-cost beneficiaries.
Workforce. The law establishes a National Health Care Workforce Commission that will study health care workforce supply issues and make recommendations to Congress.
A nice summary from the American College of Clinical Pharmacy (ACCP) regarding the clinical pharmacist provisions in the Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872).
DEA interim final rule for e-prescribing controlled substances
The Drug Enforcement Agency (DEA) has released an interim final rule for electronic prescribing of controlled substances. The rule sets forth requirements for prescribers, application providers and pharmacies/pharmacists that will allow electronic prescribing of controlled substances.
Among other things, the rule calls for “identity proofing” and a two-factor authentication for physicians. Application providers are required to produce monthly logs for prescribers, and pharmacy systems are required to keep an audit trail of each prescription. The rule will be published in the Federal Register on March 31, and will take effect June 1.
Source: AMCP
Interim final rule [PDF]: http://www.federalregister.gov/OFRUpload/OFRData/2010-06687_PI.pdf
Joseph Lassiter
