Expanding Pharmacy Services to the Hemophilia Treatment Center.

Background: Hemophilia treatment centers (HTC) are multidisciplinary clinics that serve as medical homes for patients with hemophilia and other bleeding or clotting disorders. Traditionally, hemophilia treatment center teams have included hematologists, social workers, nurse coordinators, physical therapists, and in some instances, other healthcare professionals. Objective: This report describes the role of clinical pharmacy services added at 2 HTCs. Method: Retrospective review of services provided by pharmacists integrated into the care team conducted at 2 HTCs. Conclusions: Pharmacists have the knowledge and training to positively contribute to the care of hemophilia treatment center patients. Specifically, with expertise in therapeutic drug monitoring, pharmacokinetics and patient counseling, pharmacists have the ability to manage the cost of care by promoting adherence, minimizing emergency department visits, and assisting providers in formulating optimal treatment plans to improve care for this patient population.

Effect of a Pharmacist-Driven Monitoring Program and Electronic Health Record on Bleeding Log Completeness and Documentation.

BACKGROUND: Pharmacists have the ability to enhance comprehensive care for bleeding disorders patients by bridging the gap between hemophilia treatment centers (HTC) and specialty pharmacies, specifically by monitoring bleeding logs. In September 2015, a pharmacist-driven monitoring program was implemented through the specialty pharmacy associated with a medical center to improve bleeding log completeness and electronic documentation for HTC patients. OBJECTIVE: To measure the effect of a pharmacist-driven bleeding disorder monitoring program on bleeding log completeness, successful bleeding log documentation in the electronic health record (EHR), and pharmacist-driven clinical interventions using an EHR tool. METHODS: A single-group pre-post intervention study was conducted of a pharmacist-driven monitoring program. Pre-implementation (January 1, 2014-December 31, 2014), all patients who received and returned a bleeding log following an appointment at the HTC were included; post-implementation (September 1, 2015-December 30, 2015) included patients seen at the HTC who chose to participate in the program for at least 3 months. Before implementation, patient-completed bleeding logs were scanned into the EHR by clinic staff. After implementation, bleeding logs were completed by a pharmacist and documented using a case management tool in the integrated EHR. Bleeding log records successfully documented in the EHR were collected. Completeness was calculated based on 10 clinical data elements for each bleeding log record. Pharmacist-driven interventions resulting from the program in the post-implementation period were recorded. RESULTS: In the pre-implementation period, 19 of 117 bleeding log records (16.2%) were documented in the EHR; all 15 (100%) records were documented post-implementation (P < 0.001). Among all clinical data elements across all records, 706 of 1,170 data elements were recorded pre-implementation (60.3%), and 120 of 150 (80.0%) were recorded post-implementation (P < 0.001). Pre-implementation, no logs were 100% complete; post-implementation, only 6.7% of logs were fully complete (P = 0.114). For the 15 bleeding log records documented in the EHR during the post-implementation period, 14 documented pharmacist-driven clinical interventions occurred. The majority of interventions fell under coordination of care (8 [57.1%]). CONCLUSIONS: Improvement in bleeding log completeness and documentation in the EHR was associated with the use of an EHR tool and pharmacist-driven monitoring program. DISCLOSURES: Not outside funding supported this study. The authors have nothing to disclose.

Specialty Pharmacy Services: Preparing for a New Era in Health-System Pharmacy.

To deal with the changing health care landscape and the expanding growth of specialty pharmaceuticals, it is imperative that health systems evaluate their current structure of providing hospitalbased specialty pharmacy services. Specialty pharmacy services have rapidly expanded over the last decade, and this has affected a wide variety of disease states and in many cases has dramatically enhanced clinical outcomes. However, these medications come at a substantial cost, and a clear plan must be established at each institution to sustain financial viability. By focusing on developing a plan for specialty pharmaceuticals, the pharmacy director can help ensure the institution has prepared a strategy that is conservative, financially viable, and patient-centered.

Assuming a Pharmacy Organization Leadership Position: A Guide for Pharmacy Leaders.

Important and influential pharmacy organization leadership positions, such as president, board member, or committee chair, are volunteer positions and require a commitment of personal and professional time. These positions provide excellent opportunities for leadership development, personal promotion, and advancement of the profession. In deciding to assume a leadership position, interested individuals must consider the impact on their personal and professional commitments and relationships, career planning, employer support, current and future department projects, employee support, and personal readiness. This article reviews these factors and also provides an assessment tool that leaders can use to determine their readiness to assume leadership positions. By using an assessment tool, pharmacy leaders can better understand their ability to assume an important and influential leadership position while achieving job and personal goals.