Healthcare in the United States is facing serious problems when it comes to patient access, quality of care, and cost of care. Healthcare delivery continues to evolve toward a value-based system where quality and cost outcomes determine success or failure.
As this evolution unfolds, the challenges of producing higher quality outcomes at lower costs are significant. But where there are big challenges, there are also big opportunities. For too long, healthcare has relied on incremental change methodologies to drive improved results. Systems or tools are changed, but the basic way organizations think does not change. The new tools or systems allow for improved outcomes, but only to a point.
To truly achieve the kinds of breakthrough results needed for U.S. healthcare, transformational change is required, which means changing the way organizations think. To quote the old maxim “If you always think what you’ve always thought, you will always do what you’ve always done, and you will always get what you’ve always got.”
A major opportunity for innovative thinking includes how pharmacy is positioned in the healthcare system. Pharmacy is a fragmented service with distinct demarcations between key practice areas, such as retail, hospital, and managed care. For too many organizations, pharmacy is viewed as an ancillary service and they tend to manage it more like a commodity than a unique clinical and business enterprise. Unfortunately, pharmacy as a profession has not done enough to change this view. We have approached our position from our individual silos and have not created a powerful enough story to change thinking—and we have a very powerful story to tell.
Consider the following:
- The primary treatment modality for the majority of patients in the ambulatory setting is medication. In hospitals, virtually every patient receives at least one medication. From the perspective of quality, effectively optimizing medication management is a major opportunity to enhance outcomes. No profession is better trained or positioned to do this than pharmacy.
- An aging population coupled with more insured patients via the Affordable Care Act has accelerated access and demand issues. At the same time, we are looking at future shortages of physicians. Using pharmacists practicing at the top of their license as the medication therapy experts on the healthcare team frees up physicians to see more patients and helps keep patients out of high cost limited sources of care like hospitals.
- Medications are the fastest growing element of U.S. healthcare. They currently consume approximately 17% of healthcare dollars. By the end of 2019, prescription drug spending in the United States could top half a trillion dollars. The most effective way to address medication use is to ensure that the optimal therapeutic regimen is chosen and that patients adhere to it. Pharmacists are the best-trained individuals in healthcare to support and drive optimal medication use.
- Medication errors are the number one source of medical error and account for approximately $21 billion annually in the United States. Using pharmacists to support patient education and accurate utilization of medications presents a significant opportunity to reduce medication errors with the associated reduction in cost and increase in quality.
Healthcare leaders need to change the way they think about pharmacy and better understand how pharmacy can materially contribute to solving the challenges of access, quality, and cost. Pharmacy needs to act as a unified entity, speak with one voice that represents all facets of pharmacy practice, and tell our story more effectively.
The opportunities are significant, but it will take stronger influence and advocacy to change thinking and help us realize our full potential to contribute to the advancement of healthcare.
James A Jorgenson, RPh, MS is CEO and board chairman of Visante, Inc. and Visante Ltd. St. Paul, MN, and a member of the Editorial Advisory Board of Drug Topics.