In the face of hospital closures, pharmacies can play a crucial role
Monday, November 17, 2014
The profession of pharmacy is in the midst of a job crisis. And, despite what many may think, the situation is more than an oversupply problem.
Pharmacies are closing. Jobs are disappearing.
Just this week the Boston Globe reported that another hospital — Quincy Medical Center, a 196-bed acute care facility — will be closing its doors by the end of the year. Earlier this year, North Adams Regional Hospital in Massachusetts shut down its operations as well. These two hospitals join the ranks of many others, 13 in 2013, that could not maintain sufficient profitability to stay open.
Hospital-based pharmacists interested in the advancement of the profession need to think about the role we play in helping hospitals improve their bottom line. Great service to patients — service that improves their health and quality of life — depends upon a functioning and profitable institution within which to offer such services.
The pharmacy department can help. Beyond functioning as the center of drug distribution and drug safety, pharmacies can actually play a critical role in helping hospitals succeed financially.
There are several specific ways in which the pharmacy operation in a given hospital can help to significantly improve its profitability.
1. Reducing hospital readmissions
Hospital readmissions sometimes indicate the patient was not adequately prepared or truly ready to be released. As such, Medicare has begun to penalize hospitals for readmitted patients for certain disease states.
One frequent reason for hospital readmission is medication-adherence failure. Pharmacists are in a unique position to understand issues that may impact patients' ability to comply with their prescribed treatments.
Could the drug require prior authorization? Is the patient properly educated on side effects and how to manage them? Are cost considerations addressed? Are the proper techniques for medication administration fully understood? Is transportation to the pharmacy an issue?
These and many other issues can be addressed by pharmacies prior to discharge and may help reduce unnecessary readmission to the hospital.
2. Inventory and buying arrangements
Pharmacy inventory is expensive. However, a well-managed inventory can greatly improve the hospital cash flow.
Some studies suggest that many pharmacies are managing to turn their inventory a mere 10 times per year. The implementation of better tracking systems and automation can improve that to 14 or even 16 turns, thereby greatly reducing inventory waste. Such automated systems can also ensure pharmacies take full advantage of the benefits of their buying contracts as well.
"The result is a more efficient system that can produce significant savings for the hospital while providing pharmacy with more time to focus on patient care activities," Chris Alverson wrote about inventory management in a Managed Healthcare Executive article.
3. Meaningful use incentives
There isn't the space in this article to fully explain and explore the complexities of meaningful use criteria for hospitals. Suffice it to say that a strong reimbursement incentive exists for hospitals to implement and utilize the newest technologies to promote such things as medication ordering and patient health records.
Pharmacy, especially the area of informatics, can offer significant help to hospitals in achieving these goals.
"Pharmacy and pharmacists need to get involved in meaningful use. You should be chairing the meaningful use committees, because you have the practical experience. You know the processes that make information sharing work," John Poikonen, the clinical informatics director from UMass Memorial Medical Center in Worcester, Massachusetts, wrote in Drug Topics.
4. Outpatient pharmacy services
Finally, more hospitals are beginning to appreciate the value they can add to their operations and bottom line by the careful integration of an outpatient pharmacy in their institution. Such a move should not be undertaken without careful consideration — ideally in consultation with those know how to do it right. Done correctly, however, this move can provide a substantial revenue and cost-saving opportunity to the hospital.
In the face of hospital closures and mergers, pharmacists and pharmacy departments need to be vigilant in asserting the value they can bring to maximizing the revenue potential of the facility. In the end, it is all about patient care. But a healthy bottom line is a critical requirement for hospitals engaged in the pursuit of making healthy patients.
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