Transcript
Page 1: Developing A Community Pharmacy Practice Site

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Developing A Community Pharmacy Practice Site

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2 Working Definitions of ‘Developing a Practice Site’

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Starting from scratch and creating a practice environment that does not exist.

Taking a practice site that already exists and growing or shaping it into “your” ideal practice site.

From your perspective – what you want to do – we will address consumer demand in the next lectures.

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Possible Practice Sites & Activities

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Traditional sites: chain, independent or hospital setting staff to ownership positions

Non traditional opportunities: CVS Pharmacare (formerly ProCare), Kroger initiatives Head to Toe Wellness and Research APC Pharmacy Care Clinic Cherokee Pharmacy

Terry Forshee at the Pharmacy Clinic (and related businesses) http://www.cherokeepharmacy.com/

Barney’s Pharmacy; coumadin clinics; kinetics; long term care Nuclear pharmacy; Government; Insurance industry (ESI, Medco); Pharma, VA, etc.

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Possible Practice Sites & Activities

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Specialty compounding Oncology

Board certification, specialized practice sites Wellness

Workplace interventions such as Asheville project - http://theashevilleproject.net/

Fitness, lifestyle management Immunizations Long term care consulting

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DOES YOUR IDEAL “PRACTICE SITE” EXIST? IF NOT, THEN:

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Decide:

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Thinking about your ideal practice site, could you actually create it?

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What is your “mission?” What services will you offer? Are you clinically competent? Are you competent in terms of management,

accounting, marketing, advertising and promotions? Is this a new idea, or is there already competition?

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Thinking about your ideal practice site, could you actually create it?

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Location?What will you need in terms of:

Cash / Loans Staff Equipment Lawyers, builders, insurance agents…

How does the State BOP / Pharmacy Practice Act view your idea?

How will you get paid? Is there sufficient demand?

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APC Pharmacy Care Clinic

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Balancing Clinical and Business Interests

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Clinical

Business

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APC Pharmacy Care Clinic

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APC Pharmacy Care Clinic Disease management programs

Smoking cessation, asthma, lipids, coumadin, diabetes, HTN, general medication use.

Clinical Trials Pharmacotherapy Reviews Immunization programs

Payment / Reimbursement Billing incident to physician National HC Provider ID Number Contracts with insurers Direct payment from patients

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Current status of APC

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Independently operated Clinical trials & clinical services

Drs. Aull, McElhannon, Cook, Johnson, Herist have created similar-expanded service sites Monroe, Clinton SC, Raleigh NC, Athens

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Getting Started at the PCC

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Develop physician relationship Identify needs:

space equipment personnel (not just clinical)

Billing and reimbursementDevelop clinical protocols

Must have MD input and approvalLegal:

Develop the collaborative practice agreement Develop the annual operating plan Check in with State BOP

Take good care of patients

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Important Documents:

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The collaborative practice agreement Usually, required to be on file at State Board of Pharmacy

Annual operating plan or business plan Clinical protocols

Note: these documents will be very different for the many types of practice sites

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Collaborative Practice Agreement

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Spells out the legal issues between the providers (pharmacists and physicians) specifically, the boundaries of care are, and how care will be monitored.

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Annual Operating Plan

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Defines the financial arrangements:For APC, it was:

MD handles all billing (insurance and cash payments) First $2,000 goes to APC for their cost of operations For each $1 over $2,000 revenues are split 65% to PCC

and 35% to APC When payments will be made Financial controls to be used

Could be between you and a physician group, pharmacy, other retail establishment, etc.

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Clinical Protocols / Care Tools

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Detailed documentation of the specific procedures as to how care will be provided.

From a patient care perspective, these are the most important documents.

Clearly delineate the parameters of the providing care.

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Success Metrics

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How will you define success? Satisfaction

You Your patients The professionals you work with

Revenue / salary Student training site

Pharmacy students Pharmacy residents

Scholarship Dissemination of the practice concept; Clinical /

economic / outcomes studies

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What about developing more traditional practice sites?

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Are these kinds of practice environments possible?

Will you be able to find a practice site that you will truly like?

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Your ideal practice site could be right in your own back yard.

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THIS STRATEGY IS ALSO KNOWN AS SUCCESS.

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So remember (from first year): If you don’t want to be replaced by a robot, don’t act like one. Find or create the kind of practice site where you will be happy.


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