Pharmacists and patient care: Bring the value

Pharmacists have an opportunity to change healthcare by increasing their professional value in today's healthcare system, according to Dr. Rajiv R. Shah, this year's keynote speaker at the 2016 American Pharmacists Association annual meeting in Baltimore.

The healthcare system is changing dramatically, in part because patients want to get involved, access their healthcare records, and become real partners in their care. But while today's healthcare-team model encompasses the patient, physician, nurse, and specialists, it is still very physician-centered.

That model needs to change, said Shah, a nephrologist from Minneapolis and the entrepreneur behind MyMeds (www.My-Meds.com), a medication adherence platform designed to enable patients, physicians, and pharmacists to work together for better patient outcomes.

One way for pharmacists to secure their place on healthcare teams is for them to be recognized as doctors. Unfortunately, said Shah, those inside and outside medicine are not aware of the educational requirements pharmacists must master.

"You are doctors, and you have to accept that responsibility. As doctors on the bench, you have such an opportunity to get engaged on this team," Shah said. "People need to know that you are doctors. You can't just fill pills when you are a doctor. It's not acceptable, because medication nonadherence is the biggest fixable problem in healthcare today, and pharmacists can solve the problem of medication nonadherence."

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Other proficiencies

As key members of the healthcare team, pharmacists have the opportunity to educate patients about their medications. They already have demonstrated their power as diabetic educators. But there are other opportunities to claim, including in cardiology, asthma treatment, and specialty pharmacy, Shah said.

"Pharmacists need to show their return on investment," he said. "Besides diabetes, there is a huge opportunity in cardiology. If a patient is readmitted to a hospital after a heart failure, heart attack, or pneumonia admission within 30 days, the healthcare system isn't paid the second time. And the No. 1 reason for readmissions is [medication] nonadherence."

One company that recognizes the value of the pharmacist is Dovetail Health (www.dovetailhealth.com), a medication management solutions company. Following a hospital discharge, its clinical pharmacists can make house calls to ensure that patients understand and take their medications correctly.

The improvement shown by patients involved in this program was not lost on United Healthcare, one of the largest insurance companies in the United States.

"United Healthcare bought [Dovetail Health] because they recognized that this is the future - pharmacists going into the homes to help," Shah said.

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Proof of ROI

Pharmacists can also have an impact on pediatric asthma emergency room visits and hospitalizations through education of patients and caregivers.

"The numbers are staggering: 400,000 hospital admissions and one million ER visits," Shah said. "Twenty percent of kids with asthma going to the ER are admitted every year, translating into $50 billion of wasted expense in hospitalizations and productivity loss - parents missing work."

The other area where pharmacists can make inroads is in specialty pharmacy, which is expected to make up 50% of the drug spend by 2018.

"Never before has adherence mattered as it does today," Shah said. "If I'm a payer like the government, an employer, or a health plan, and investing money in you [the patient], I’d better be sure that you are taking that medicine - and pharmacists have a role like never before to protect that investment and prove their ROI."

A marketing opportunity

Do pharmacists have a marketing problem? Yes, said Shah, but they also have an opportunity to reach out to physician groups that already recognize the value of pharmacists. These include the American Academy of Family Physicians, the American College of Physicians, the American Society of Anesthesiologists, and the American College of Cardiology.

"Once you get the endorsements of these groups, the American Medical Association has to follow," Shah said. "The AMA will have to endorse the pharmacist as a key member of the team, because doctors [from AAFP, ACP, ASA, and ACC] will be saying this is important, because changes are happening in healthcare."