© 2003 pharmacy manpower project, inc pharmacy manpower 2020: meeting needs of patients...
Post on 15-Jan-2016
219 Views
Preview:
TRANSCRIPT
© 2003 Pharmacy Manpower Project, Inc
Pharmacy Manpower 2020: Meeting Needs of Patients
Implications for Educators, Practitioners and
Regulators
Slide Library2003
© 2003 Pharmacy Manpower Project, Inc
Today’s Objective• Provide insight into the pharmacist
shortage and projected growth in prescription use by US population
• Describe factors leading to expanded patient care roles as drug therapy managers by pharmacists
• Present findings of Conference convened to forecast professionally determined need for pharmacists in 2020
• Discuss implications of the projected, significant shortfall of pharmacists in 2020 to pharmacy education, practice and regulation
© 2003 Pharmacy Manpower Project, Inc
Section One
Is There a Pharmacist Shortage?, How Are They
Currently Deployed?
© 2003 Pharmacy Manpower Project, Inc
Are We Experiencing a Pharmacist Shortage?
• Employer perspective:– Staffing problems– Job vacancies in community and
institutional practice, industry, academia and government
– Escalating salaries• Customer/patient perspective:
– Inconvenience– Decreased access– Published ADI analysis: 92% US population
lived in areas where pharmacist demand exceeded supply 1999-2001
© 2003 Pharmacy Manpower Project, Inc
US Population and ADIJuly 2001
0
10
20
30
40
50
60
70
80
90
100
Pe
rce
nta
ge
States withdemand levels
>4.5
States withdemand levels
between 3.5 and4.5
States in whichsupply and
demand are inbalance
States in whichdemand forpharmacists
exceeds supply
US Population
© 2003 Pharmacy Manpower Project, Inc
Are We Experiencing a Pharmacist Shortage?
• Pharmacist perspective:– Increased workload/stress– Longer working hours
• Education Perspective:– Formation of new pharmacy schools– 12 since 1987
• Government Perspective:– HRSA Report– Federal legislation on loan forgiveness– Bush initiatives to expand 340B eligible
clinics and add pharmacy services to address growing number of uninsured
© 2003 Pharmacy Manpower Project, Inc
So we have a shortage of pharmacists…
A shortage of pharmacists to do
what??
© 2003 Pharmacy Manpower Project, Inc
Assure Safe & Accurate Medication Distribution
Community Pharmacy, 2001:
3,000,000,000 prescriptions 132,000 community
pharmacists 22,727 Rx/pharmacist/year
One prescription every 5 ½ minutes
© 2003 Pharmacy Manpower Project, Inc
Hospital Pharmacy, 2001:
1,898,000,000 drug orders 50,000 hospital
pharmacists 37,960
orders/pharmacist/year
One drug order every 3 minutes
© 2003 Pharmacy Manpower Project, Inc
What About Tomorrow?
© 2003 Pharmacy Manpower Project, Inc
Section Two
Common Vision for Pharmacists:
Helping People Make the Best Use of Their Medicines
© 2003 Pharmacy Manpower Project, Inc
Common vision of pharmacy practice:
helping patients make the best use of their
medicines.
Pharmacists Roles in Patient Care
• Pharmacists as drug therapy managers• Assessing, counseling and monitoring drug
therapy• Dealing with medication misadventures: $177
billion drug morbidity/mortality Ernst F, Grizzle A JAPhA 2001;
192-200. • Overseeing medication management systems• Delivering pharmaceutical care: could save over
$105 billion annually if universally available Johnson JA, Bootman JL AJHP 1997 54: 554-558.
© 2003 Pharmacy Manpower Project, Inc
These new roles are not just assuring safe and accurate
medication distribution….what about
tomorrow?
© 2003 Pharmacy Manpower Project, Inc
2020 Rx and Order Projections
Outpatient prescriptions: 7,500,000,000 (+5%/yr)
Hospital drug orders: 3,000,000,000 (+2.5%/yr)
© 2003 Pharmacy Manpower Project, Inc
Pharmacist Supply
2001: 200,000 active pharmacists
2020 projection: 260,000 active pharmacists
• Based on new graduates, adjusted for those
leaving; assumes 20% enrollment growth existing schools and 3 new ones in addition to those slated to open
© 2003 Pharmacy Manpower Project, Inc
If Nothing Changes…..
Community Pharmacy, 2020:
7,500,000,000 prescriptions 172,000 community pharmacists 43,604 Rx/pharmacist/year
One prescription every 2 ¾ minutes
© 2003 Pharmacy Manpower Project, Inc
If Nothing Changes…..
Hospital Pharmacy, 2020:
3,000,000,000 orders 65,000 hospital pharmacists 46,154 Rx/pharmacist/year
One order every 2 minutes
© 2003 Pharmacy Manpower Project, Inc
These figures reflect a
supply/demand model that only focuses on order
fulfillment. Something must
change.
© 2003 Pharmacy Manpower Project, Inc
How Does Need Fit Into Workforce Projections?
• Wants• Demands• Supply• Professionally-determined needs
© 2003 Pharmacy Manpower Project, Inc
What We Are Unsure About...
• Role of drugs in future health care• Role of genomics and biotech as an
adjunct, replacement, or addition to current drug therapy
• Organization and financing of drugs and pharmacy services
• Extent of adoption of new pharmacist roles
What Hasn’t Sunk in Yet...• The baby boomers are not yet 60!--But they will be
soon!• A boomer will turn 65 every 10 seconds beginning in
2011• Everyday in the US, 6000 people reach the age of 65• The over-65 population will DOUBLE by 2030—they
use 3 times the number of medicines• Other special need populations, such as pedicatric
patients or chronic disease sufferers, may influence demand
© 2003 Pharmacy Manpower Project, Inc
Their drug use has not yet been factored into the workforce
equation…
© 2003 Pharmacy Manpower Project, Inc
One could already argue we need 150,000 more
pharmacists now to help patients with their
medication and tackle the $177 billion in annual drug
related morbidity and mortality.
Barbara Wells2002-2003 AACP President
© 2003 Pharmacy Manpower Project, Inc
Section Three
Manpower Conference: Why, What, How
© 2003 Pharmacy Manpower Project, Inc
Led to: Conference on Professionally Determined
Need for Pharmacy Services
Convened by the Pharmacy Manpower Project, Inc.
Held in Baltimore, MD October 29-31, 2001
Carried out by the University of Maryland School of Pharmacy
© 2003 Pharmacy Manpower Project, Inc
Conference Goals
• Identify the future need for pharmacy services from a health professional viewpoint
• Describe “best practice” characteristics for providing these services
• Suggest the number of pharmacists to meet projected needs in 2020
© 2003 Pharmacy Manpower Project, Inc
Participants and Process
• Two dozen experts:– All segments of pharmacy– Medicine– Economics– Workforce specialists
• Three days of deliberations – all discussions; no speakers
© 2003 Pharmacy Manpower Project, Inc
Forecasting Need: Criteria for Best Practices
IOM’s Quality Chasm Report aims are that practices must be:– Safe– Effective– Patient-centered– Timely– Efficient– Equitable
© 2003 Pharmacy Manpower Project, Inc
External Trends Examined
• Population– 325 million by 2020– Older– More diverse
• People– Healthier– More Internet savvy
• Therapy– More targeted
(biotech)– More expensive
• Health care organization– Managed care– Community pharmacy– Institutional pharmacy
• Reimbursement methods– Drug product related– Other
• Technology
© 2003 Pharmacy Manpower Project, Inc
Technology Changes Influencing Pharmacy
• Electronic data processing and information transfer:– Electronic order entry– Expert systems to evaluate drug orders– Improved electronic communication systems
• Improvements in automated order fulfillment systems for both outpatient and institutional use
© 2003 Pharmacy Manpower Project, Inc
Summary
• A 3-day conference of 25 selected participants evaluated the need for pharmacists in 2020
• Best practice criteria were developed and applied to order fulfillment, drug therapy management (patient care), and other functions
• Estimates of professionally determined need were made and compared with the estimated supply of pharmacists
• A shortage of pharmacists with significant magnitude was forecast: 157,000 conservatively
• Next steps were suggested
© 2003 Pharmacy Manpower Project, Inc
Strengths of Approach
• Knowledgeable participants• Balance of viewpoints• Rapid engagement with issues• Global perspective• Highly focused• Substantial pre-meeting preparation• Analysis based on “best practice” case
examples
© 2003 Pharmacy Manpower Project, Inc
Weaknesses of Approach
• Short 3-day meeting• Small, selected group of participants• Broad-brush discussions• Quantitative estimates are rough• Many assumptions about external
environment, health care organization and financing, uptake of technology in communications and dispensing, and regulatory issues
© 2003 Pharmacy Manpower Project, Inc
Section Four
Conference Outcomes, Projections and Assumptions
© 2003 Pharmacy Manpower Project, Inc
Current and Projected Need for Pharmacists
2001 Estimated Deployment
2020 Forecast Need
Order fulfillment(Dispensing)
136,400 100,000
Patient Care 48,000 295,000
Other 12,300 22,000
Total Need 196,700 417,000
Total Supply 260,000
Projected Shortfall
157,000
© 2003 Pharmacy Manpower Project, Inc
Order Fulfillment Functions Will Require 100,000 FTE
Pharmacists
• Defined narrowly to include only order fulfillment functions (“bottling”)
• Best practices focus solely on assuring that a prescription is completed and delivered precisely as ordered
• Assumes that drug orders entering the dispensing system have been assessed, clarified and verified
• Pharmacist need will be to design, implement and oversee order fulfillment systems
• Pharmacists will not have to inspect every order personally• Assumes that post-dispensing pharmacy services such as
counseling and monitoring will be accomplished as patient care functions
© 2003 Pharmacy Manpower Project, Inc
Best Practices for Order Fulfillment
• Concentration of fulfillment of maximum number of orders in sophisticated central fill facilities– Current examples include mail order pharmacy
(Merck Medco) and the Veterans Health Administration
• Increase the efficiency of community pharmacy based order fulfillment:– Increase use of qualified pharmacy technicians– Increase use of automation– Reduce administrative burden of third party
programs
• These are in addition to Quality Chasm criteria.
© 2003 Pharmacy Manpower Project, Inc
Community Pharmacy Order Fulfillment
• Conference estimates that 101,400 FTE pharmacists currently dispense about 30,000 prescriptions per pharmacist per year
• Arthur Anderson report identified major inefficiencies in use of pharmacists in order fulfillment NACDS Education Foundation: Pharmacy Activity Cost and
Productivity Study, November 1999, www.nacds.org/publications/research&studies
© 2003 Pharmacy Manpower Project, Inc
Many Initiatives Will Affect The Shortage...
• Automated dispensing/central fill/pre-packs/unit of use
• Bar-coding and electronic control of products
• e-prescribing, electronic record-keeping and drug use control• Improved use of qualified technicians
and other supportive personnel
© 2003 Pharmacy Manpower Project, Inc
Outpatient Order Fulfillment Forecast
• 80% of time now spent by pharmacists in the order fulfillment function can be assumed by automation and/or technical personnel
• Therefore, best practices could increase order fulfillment output/pharmacist five times
• Conference projects outpatient prescriptions to grow at rate of 5% per year
© 2003 Pharmacy Manpower Project, Inc
Pharmacists’ Time:Actual and Preferred
9%16%
19%
56%
Medication dispensing
Consultation
Business management
Drug-use managementresponsibilities
9%19%
34%
38%
Medication dispensing
Consultation
Business management
Drug-use managementresponsibilities
Source: Schommer JC et al. Community Pharmacists’ Work Activities in the United States During 2000
Percent of Time Pharmacists Devote to Specific Tasks—Actual
Percent of Time Pharmacists Devote to Specific Tasks—Preferred
© 2003 Pharmacy Manpower Project, Inc
Hospital Order Fulfillment Forecast
• 35,000 FTE pharmacists currently fill about 1.9 million drug orders per year in hospitals
• Inpatient drug orders to grow at 5% per year, assuming that patient population stays about the same size with increased acuity
• Best practices could double order fulfillment output/pharmacist
© 2003 Pharmacy Manpower Project, Inc
Long Term Care Order Fulfillment
• Conference estimated at 196 million prescriptions in 2001
• Orders for assisted living, home care and hospice not estimated separately
• Conference forecasts assume these orders included in outpatient and inpatient totals
© 2003 Pharmacy Manpower Project, Inc
Order Fulfillment Needs Forecast: Summary
• Assuming all conference projections hold, about 100,000 pharmacists will be needed in 2020 for the order fulfillment function.
• This assumes that utilization rises 5% annually, mail order and hospital productivity double, and community practice productivity improves by a factor of five
© 2003 Pharmacy Manpower Project, Inc
Order Fulfillment Projection Assumes:
• Increased use of information technology and automation, with safety assurances
• Changes in regulatory environment
• Successful adaptation to HIPAA• Changes in pharmacist attitudes
and culture
© 2003 Pharmacy Manpower Project, Inc
Patient Care Functions Will Require Nearly 300,000 FTE
PharmacistsExpanded need will be due to:
– Population demographics & special need populations
– More drugs, increased potency, higher cost
– Emergence of personalized drug therapy through gene therapy and biotechnology
– Requirements of specialized drug therapy management for high-risk treatments
– Increased need for communication among patients and providers
© 2003 Pharmacy Manpower Project, Inc
Patient Care: Drug Therapy Management
• A core function of pharmacy: drug therapy management, and other aspects of pharmaceutical care
• Patient care needs were assessed in all settings
• Mechanisms for paying pharmacists for these services is prerequisite and assumed
© 2003 Pharmacy Manpower Project, Inc
Ambulatory Drug Therapy Management Forecast
• Two best practices models were discussed: a highly-organized HMO (Kaiser Permanente-Denver) and community pharmacy
• Estimates of pharmacists needed based on two methods resulting in range of 165,000 to 358,000 pharmacists; used the more conservative number
• Agreed not all patients require same level of primary care
© 2003 Pharmacy Manpower Project, Inc
Ambulatory Drug Therapy Management Forecast
• 2/3rds of population get at least 1 Rx/year while 40% receive 4 or more Rx/year
• Latter group requires complex primary care at best practice estimate of 1 FTE pharmacist per 1000 patients; while remaining population receives services at a ratio of 1 FTE pharmacist per 5,500 patients
© 2003 Pharmacy Manpower Project, Inc
Hospital-Based Drug Therapy Management
• About 5,000 hospitals in the U.S.• About one pharmacist per hospital
performs population-based patient care: safety, policy, etc.
• Best practice estimate doubles this number
© 2003 Pharmacy Manpower Project, Inc
Hospital-Based Drug Therapy Management
• 10,000 FTE pharmacists currently provide this service
• ASHP surveys find that only about 10% of best practice services are now routinely provided
• Conference estimates that 100,000 FTE pharmacists needed for this function
© 2003 Pharmacy Manpower Project, Inc
Drug Therapy Management in LTC and
Related Settings• 3,000 FTE pharmacists currently
provide this service• Although over-65 population will
be much larger in 2020, it will also be healthier
• Best practice estimate is 18,750 FTE pharmacists in 2020
Drug Therapy Management Needs Forecast: Summary• Conference forecasts a need for almost
300,000 pharmacists to meet drug therapy management needs of patients in 2020.– Ambulatory patient care: 165,000– Hospital-based patient safety, policy:
10,000– Hospital-based patient care: 100,000– Long term patient care settings: 18,750
© 2003 Pharmacy Manpower Project, Inc
Non-Patient Care Needs Forecast
• Estimated at 22,000 in 2020
• Relatively small but critical area
• Specialty and leadership positions in– Profession– Industry– Academia– Government
© 2003 Pharmacy Manpower Project, Inc
Variables and Assumptions: Order
Fulfillment• Outpatient Order
Fulfillment– 2001 prescription
number: confident– Growth rate (5%):
conservative– Mail order growth
(10%): conservative, given low base
– Dispensing productivity increases: liberal
• Hospital, LTC Order Fulfillment– 2001 drug order
numbers: unknown (extrapolated from orders/patient/day)
– Hospital growth rate: liberal (5%)
– LTC orders: conservative
© 2003 Pharmacy Manpower Project, Inc
Variables and Assumptions: Drug
Therapy Management• Ambulatory:
– Highly-managed setting (HMO)(one pharmacists/1000 patients): confident/liberal
– Community setting (1/1000): unknown/liberal
• Institutional:– Hospital patient
safety/policy: confident
– Hospital patient care: survey-based/confident
– LTC patient care: conservative
© 2003 Pharmacy Manpower Project, Inc
Variables and Assumptions:Other Needs; Pharmacist
Supply
• Other Needs:– Category by
category assessment: conservative
• Pharmacist Supply– Enrollment growth
in existing schools (10% total): conservative
– New schools (class size 100; 3 new 2010-2020): moderate
© 2003 Pharmacy Manpower Project, Inc
Assumptions Underlying Conference Projections
• Improved and compatible IT systems will be implemented throughout health care
• Patient data and reference information will be available to practitioners at the point of service in real time
• Health care teams will really work• Quality and safety systems will be in place• Financial incentives will be appropriate
© 2003 Pharmacy Manpower Project, Inc
Manpower 2020: Conclusions
• A large shortage of pharmacists is forecasted in 2020
• The supply of pharmacists needs to increase substantially
• Productivity of pharmacists needs to increase even more than projected
• Or services will remain unmet or be provided by others
© 2003 Pharmacy Manpower Project, Inc
Additional Conclusions• Conference forecasts demonstrate
that professionally determined needs for order fulfillment services and for drug therapy management services are inextricably intertwined
• Unless an even more dramatic solution is adopted to meet the forecasted demand for dispensing, the expansion of direct patient drug therapy management by pharmacists will fall far short of need
© 2003 Pharmacy Manpower Project, Inc
Section Five:
Actions Needed by Profession
Actions Required By The Profession• Embrace responsibility for drug therapy management
• Commit to obtaining and maintaining the knowledge, skills and abilities required by patient care
• Achieve provider status for pharmacists under Medicare
• Obtain a supporting payment mechanism• Expand the size of the profession in order to meet
unmet societal needs• Fully utilize technology & technicians for order
fulfillment
© 2003 Pharmacy Manpower Project, Inc
Even If You Disagree with the Details…
• Each person will filter the forecasted numbers through their unique perspective and experience
• Where you find you might reduce the needed number of pharmacists in one area, you will find you raise it in others
© 2003 Pharmacy Manpower Project, Inc
…You Will Agree at a High-Level
• Your revised forecasts compared against pharmacist supply estimates will show a significant shortfall of practitioners
• Findings should be used and challenged within the profession’s practices, educational and regulatory arenas and other stakeholder groups to assist in their long-term planning efforts
© 2003 Pharmacy Manpower Project, Inc
What Does 2020 Look Like…
• If we don’t move ahead?• Open discussion• Top 10 Issues Summary
© 2003 Pharmacy Manpower Project, Inc
Section Six
Implications for Various Stakeholder Groups: Educators, Practitioners,
Regulators, All
© 2003 Pharmacy Manpower Project, Inc
Implications for Educators: How to Expand the
Profession?• Good news: today’s graduates are
being educated at level consistent with profession’s long-term patient care vision
• Many new opportunities for pharmacists, especially with doctoral level training
© 2003 Pharmacy Manpower Project, Inc
Implications for EducatorsProducing more graduates:
– Enrollments rising; impact of PharmD transition closing
– 12 new schools since 1987– Decade trend numbers show sizable
increase– Role of foreign graduates?
Foreign Pharmacy Graduate Equivalency Examination™ (FPGEE®).
© 2003 Pharmacy Manpower Project, Inc
Entry-Level Pharmacy Graduates
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Year
Number of First Professional Degrees Conferred 1985-2002
PharmD
BS Pharmacy
© 2003 Pharmacy Manpower Project, Inc
Projected Entry-Level Graduates
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
2000 2001 2002 2003 2004 2005 2006
Year*
Enrollments by Expected Graduation Year
PharmD
BS Pharmacy
*Data for expected graduation for years 2003-06 from Profile of Pharmacy Students Fall 2002. For years 2000-02 from Profile of Pharmacy Students Fall 1999.
© 2003 Pharmacy Manpower Project, Inc
Implications for Educators
Expansion of programs that support current practitioner’s transition to new roles:– Accessible – Affordable– Flexible– Partnerships with practice organizations
© 2003 Pharmacy Manpower Project, Inc
Challenges for Educators
• Faculty needs: new models & partnerships with practice; more residency trained faculty needed
• Training sites: new models, residencies• Curriculum to address distributive/patient care roles• Technology application to both: e.g. distance education• Sharing resources across institutions: curricular resources,
faculty?• Financing for expansion in era of state budget issues• Research enterprise: where will growing funding be
secured?
© 2003 Pharmacy Manpower Project, Inc
Challenges for Educators/Practice
Determining how many practitioners will need to make the transition?– Decrease of 25,000 for order fulfillment
(dispensing) over 20 years vs. need for 295,000 in drug therapy management services
– Create tools to identify best practitioners to target?
© 2003 Pharmacy Manpower Project, Inc
Implications for Practice: How to Accelerate
Change?Continued, rapid
implementation of technology and qualified pharmacy technicians to improve order fulfillment efficiency, patient safety and patient services
© 2003 Pharmacy Manpower Project, Inc
Implications for Practice: How to Accelerate
Change?Increase residency trained
practitionersAs of May 2003 *
• 383 Accredited pharmacy practice programs
• 242 Accredited specialized residencies • 1,077 Residents/year
*Programs that have been accredited or have applied for accreditation
© 2003 Pharmacy Manpower Project, Inc
Stepping Stone Summit: Technology Recommendations
APhA/NCPA/NACDS in 2/2002:#1 – Bar code verification#2 – e-prescribing systems & interface#3 – In pharmacy dispensing automation
& central fill#4 – Broadband Internet connectivity#5 – Reduce regulatory barriers
© 2003 Pharmacy Manpower Project, Inc
From American Society of Automation in Pharmacy (ASAP)
2003 Hot Technologies: ASAP Survey 2-2003
• E-signatures, primarily HIPAA driven
• E-prescribing will grow• Continued system integration: IVR,
dispensing, POS• High-speed Internet connectivity
© 2003 Pharmacy Manpower Project, Inc
Adapted from July/August 2002 ComputerTalk
Chain Use of Technology: July 2002
90
50
45
40
40
20
45
40
65
90
85
0 10 20 30 40 50 60 70 80 90 100
Percentage
Chains using IVR
Stores in chain withIVR installed
Using IVR to route refills to doctors
Chains evaluatingrobotic solutions
Chains using scanners in the pharmacy
Stores in chain using scanners
Central fill on the agenda
Central processingon the agenda
Chains that applied for HIPAA extension
Will be applying forHIPAA extension
Want continuedsupport of 3.2
© 2003 Pharmacy Manpower Project, Inc
© 2003 Pharmacy Manpower Project, Inc
Hospital Use of Technology
• Computerized Prescriber Order Entry (CPOE)– 3.5% of hospitals use CPOE
• Use of Automated Storage and Distribution Devices (ASDDs)– 58% have some ASDDs
• Bar Code Point-of-Care Technology– 1.3% verify medication, patient id, and nurse at the
bedside
• Pharmacy Robots– 8% use robot filling devices
Source: 2002 ASHP National Survey of Pharmacy Practice in Hospitals
© 2003 Pharmacy Manpower Project, Inc
Adding Pharmacy Technicians to the Mix: 131,000++ (12-02)
And Ratios are Changing...
Greater than 2:1 2:11:1No Established RatiosNo Data
Alaska
Hawaii
Puerto Rico
© 2003 Pharmacy Manpower Project, Inc
Implications for Community Practice
Continued creation of opportunities for new service development in the community:– Residency programs in community
practice: 65 programs with 32 that are accredited or have applied for accreditation
– Participation in demonstration projects, e.g. Patient Self-Management: Diabetes
– Partnerships with education and practice organizations
Seeking payment mechanisms and provider status
© 2003 Pharmacy Manpower Project, Inc
Challenges for Practice
• Generating sufficient capital to support practice transition
• Maintaining practitioner knowledge and skills: Does CE enterprise need to be different?
• Addressing attitudes and culture among practitioners to embrace new technologies and roles
© 2003 Pharmacy Manpower Project, Inc
Challenges For Practice/Regulators
• Changing regulatory environment to embrace rapid practice change
• Securing collaborative practice authority
• Securing ability to immunize
Immunizations Bill Passes in House
© 2003 Pharmacy Manpower Project, Inc
Implications for Regulators:
“Technologically Facilitated Care”
• How to regulate “technologically facilitated care”
• Remove impediments to change that can improve dispensing efficiency and patient care: – Qualified pharmacy technicians– Automation– information sharing: HIPAA concerns and
security
© 2003 Pharmacy Manpower Project, Inc
Implications for Regulators
• Focus on outcomes vs. structure, process
• How to ensure continuing competence among a changing workforce
© 2003 Pharmacy Manpower Project, Inc
Implications for All
• How to implement services that people don’t know they need– Physicians, public not overly concerned
about medical errors NEJM 2002: 347:19330194
– Public not aware of health professional shortage AmerisourceBergen Poll 7/2002
• Continued learning from those successfully implementing among patients
• Publicizing outcomes from practices widely
© 2003 Pharmacy Manpower Project, Inc
Implications for All
• People outside the profession care about drugs and believe they are:– Expensive– Toxic– Complex
© 2003 Pharmacy Manpower Project, Inc
Implications for AllThey are not a no-risk proposition and must be actively managed
© 2003 Pharmacy Manpower Project, Inc
What if This Was Your Mom?
What Will You Do When You Leave?
• Elderly consume 34% of all Rx’s
• Many have issues related to medication access and coverage
• Adverse drug reactions (ADRs) are among the top 5 threats to senior’s health
© 2003 Pharmacy Manpower Project, Inc
What If This Was Your Child?
• Little known about ADR’s in children
• Pediatric ADR Reporting System--Pediatric Pharmacy Advocacy Group
• 2 to 17% of children admitted to hospitals were admitted due to ADRs Mitchell et al AmJEpid: 1979: 196-204.
• 65-75% of FDA-approved meds not approved for use in children Yaffe et.al Ped. Pharmacology 1992: 3-
9.
What Will You Do When You Leave?
© 2003 Pharmacy Manpower Project, Inc
How Are You Spending Your Time?
• I’ll get to that project tomorrow?
• My colleagues are tackling that issue
• That issue is the responsibility of X, Y and Z?
• What can I do?
Or…
© 2003 Pharmacy Manpower Project, Inc
How Are You Spending Your Time?
Are you moving ahead to:– Implement new programs?– Implement technology?– Use qualified support
personnel?– Collaborate with
colleagues?– Stay current with new
developments?
Or taking other steps to help patients?
© 2003 Pharmacy Manpower Project, Inc
Where To Go From Here?
• Open Discussion: what are top 5 issues for Educators, Practitioners, Regulators?
top related