The Pharmacist’s News Source
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in this issue CLINICAL
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Cleveland Clinic’s drug information FAQ database: a rich resource. ED pharmacists document $225,000 in annual savings. In heart failure, baseline albumin may signal poor renal function. Protocols aim at reducing risk from fibrate–statin combinations.
OPERATIONS & MGMT
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Compliance experts say time is now to plan for audits and surveys. Are you measuring up to CMS’ core measures? Here’s how to tell.
POLICY
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New rules for reimbursement change the payment landscape.
EDUCATIONAL REVIEW
Immune Globulins: Therapeutic, Phamaceutical, Cost, and Administration Considerations See insert after page 4.
Volume 40 • Number 1 • January 2013
40th ANNIVERSARY YEAR 1972–2012
In Fight for Safe Compounding, a Salvo From NABP P
Smart Strategies for Savings Presented at ASHP Meeting Las Vegas—As the financial pressures on heaalth systems continue to mount, facilities are responding with a wide range of cost-cutting strategies, many of which were presented during the American Society of Health-System Pharmacists 2012 Midyear Clinical Meeeting. Whether it was billing for drug waste, putting limits on the use of o high-cost pancreatic enzymes or having pharmacy leaders manage employee e drug benefits—the latter racking up nearly $2 million in an nnual savings—all of the efforts shared a laudable goal: to conserve precious health care dollars without com mpromising patient care.
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nspectors from the National Asso ociation of Boards of Pharmacy (NABP) and state pharmacy boards descended on six compoundingg pharmacies in four states during th he first two weeks of December as parrt of a broad, unified effort to bolsteer the safety of customized medicinees being shipped across state lines. The inspections were carried ou ut in California, New Jersey, Texas and Utah as public and political pressurre for increased federal and state regulaation of pharmacy compounders con ntinued to mount in the wake of th he fungal meningitis outbreak that, b by mid-December, had sickened morre than 650 individuals in 19 states and claimed nearly 40 lives. The dual inspection campaign is seet to continue well into 2013. It is parrt of the association’s contractual agreeement with the Iowa State Board o of Pharmacy to strengthen surveillancce of compounding pharmacies licensed
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The Overlook Medical Center in Summit, N.J., recouped more than $500,000 in 2011— m and d another $350,000 from January to August 2012—by ensuring that Medicare rreimbursed the hospital for discarded portions of biological aagents and other costly drugs. The payments were made possible by collaboration between the pharmacy and the hospital’ss Finance Department, which identified Centers for Medicarre & Medicaid Services (CMS) regulations allowing certain n levels of reimbursement for wasted medications from m single-use vials. (Multidose vials are not eligible for waste w reimbursement.)
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see NECC CRISIS, page 19 1
Heart Failure Programs Take Aim at Readmits Hollywood, Fla. and Las Vegas V — As part of the requirements of the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) started imposing potential reimbursement penalties on hospitals based on their 30-day heart failure (HF) readmission rates beginning in October 2012. Concerned about these potential penalties, hospitals have ramped up efforts to forestall readmissions
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F Flushing Out the Waste IIn Unused Medications
see HF READMISSIONS, page 8
see SAVINGS, page 17
ADE Tracking ki May G Get Boost From New Reporting Software
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n most health systems—even those with well-established electronic medical records—reporting adverse events is a spotty and not always standardized process. New software called KBCore may change that. In November, the program’s developer, CRG Medical, won the Reporting Patient Safety Events Challenge issued by the Office of the National Coordinator for Health Information Technology (ONC), in part due to the software’s flexibility: It enables users to generate error reports from any mobile
device or within the EMR simply by scanning a patient’s bar code. The program also is garnering positive reviews for the depth of relevant data that users can rapidly access. “Most reporting systems I’m familiar with don’t take advantage of the existing electronic data [they contain],” said Matt Grissinger, RPh, the director of error reporting programs at the Institute for Safe Medication Practices. “We already have the patient’s name, room number, the medications they’re on, their dosages and so
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see ADE TRACKING, page 3
The Book Page Clinical Skills for Pharmacists: A Patient-Focused Approach/Edition 3 Karen J. Tietze Visit mcmahonmedicalbooks.com