NCPA Executive Update

NCPA Executive Update delivers insights on legislative, regulatory, policy, and industry developments from NCPA CEO B. Douglas Hoey, Pharmacist, MBA, to NCPA members and pharmacy leaders every Friday.

Pharmacist eCare plans put your pharmacy ahead of the curve | NCPA Executive Update | November 2, 2018

by NCPA | Nov 02, 2018

Dear Colleague,

Doug Hoey

I was reading my youngest son, a kindergartner, a book from the library the other night when he came across the pocket that used to hold the library card. We had previously talked about how books used to have library cards that had to be pulled out, stamped, and held by the library when a book was checked out. He was fascinated by the empty card pocket, now taped shut, that used to hold the keys to access all kinds of information.

In the pharmacy space, there's new technology that is just as revolutionary.

That vanished library card reminded me about pharmacy technology (it's funny how everything I see and do somehow leads back to something pharmacy related). In the late 1970s, my dad bought his first prescription processing system. He might have been the first store in town to computerize. I remember being at the store with one of my brothers late on a Saturday moving boxes to make room for the large (and heavy) computer system. I remember being fascinated that things we typed on a keyboard would pop up on a screen. Before the computer system, we would have to pull the hard copy of every prescription before refilling it. Pricing, inventory management, medication profiles were manual tasks too.

Technology has made both of those examples quaint at best and archaic at worst. As pharmacists, we would be extremely limited in what we could do for our patients if we didn't have technology. No refill reminders. Only manual drug interaction checks (although lifting Facts and Comparison regularly was a good biceps workout). No automatic pricing updates. And the list goes on and on.

Community pharmacy is evolving. It has to. It's moving from a heavily commoditized model with less reimbursement for generic prescriptions and specialty medications being steered into PBM-owned mail order houses to a model where the patient care services pharmacies provide are recognized for helping lower overall health care costs.

That evolution is going to be enabled by recording and transmitting Pharmacist eCare plans.

The first step to being paid for the care we deliver is documenting that care. This includes things like active med lists, drug therapy problems, lab results, vitals, health concerns, patient goals, pharmacist care recommendations, actions we've taken, and referrals we've made. Some of that we have documented; some of it we typically don't.

Our pharmacies are busier now ... more patients, more staff, more phone calls. Having good documentation of patient interactions and how we are caring for each patient is first and foremost an important step in organizing our practice to better serve patients and decrease the chaos that comes from not knowing or remembering where we (or another staff member) left off.

When we have transformed our practice and workflow to document what we do, myriad opportunities arise. We can now share that data to support our own community pharmacy-run clinically integrated networks like CPESN®, which is in a position to aggregate it across the network to demonstrate value to payers.

NCPA, CPESN, and many other pharmacy organizations are far along in establishing a new standard electronic means of sending, receiving, writing, and reading pharmacist care plans (hence the "Pharmacist eCare Plan") – a standard that is structured in the same way as care plans used by other health professionals.

Standardized Pharmacist eCare Plans "speak" with other health care provider systems. The eCare plans share information between health care providers so pharmacists can document the care plans and patient services they are providing, and other health care providers can reciprocate. Means to produce these standard eCare Plans are accessible to community pharmacists in one of three ways:

  • Embedded in pharmacy management system. QS/1, PioneerRx, BestRx, and PrimeRx are systems that currently offer the ability to record and transmit eCare plans. Other systems will soon also be able to do the same.

  • One system "bolted on," or integrated, with a pharmacy management system. Computer-Rx, McKesson, Rx30 offer this approach today.

  • A standalone system not integrated with pharmacy management systems.

You can see more information on the various system vendors involved here.

Library cards have been phased out. A typewriter to fill a prescription? Only in the direst emergencies. Technology has propelled us far beyond those days. Likewise, Pharmacist eCare plans are new now, but adopting them into your workflow will become standard.

Be ahead of that curve.

Doug Hoey

P.S. I'll bet you know that this Tuesday is Election Day, and I'll bet you're planning to go vote. But did you know that the NCPA PAC is supporting a bunch of candidates who have been champions for community pharmacy, and who deserve your consideration when you go to the polls? Here's the complete list. Take a look, and support those who've supported your business.