Pennsylvania Pharmacist May/June 2014

May/June 2014 z Volume 95 z Issue 3

The official publication of the Pennsylvania Pharmacists Association

PRSRT STD U.S. POSTAGE PAID HARRISBURG PA PERMIT NO 533

PHARMACISTS: We Make A Difference!

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PPA Board of Directors PPA Officers: President: J. Scott Miskovsky, RPh President-Elect: Eric R. Esterbrook, RPh First Vice President: Donna Hazel, RPh Second Vice President: Eric Pusey, RPh, CDE Immediate Past President: Robert B. Frankil, RPh Regional Directors: Central: Ellen Nastase, BS Pharmacy, MS Pharmacy Northeast: Jonathan D. Ference, PharmD, BCPS Northwest: Elliott Cook, PharmD, BCPS Southeast: Nick Leon, PharmD, BCPS, BCACP Southwest: Lauren Simko, PharmD Academy Directors: Academy of Alternative Pharmacy Practice: Jamie McConaha, PharmD Academy of Pharmacy Technicians: Patrick Purcell, CPhT Academy of Chain Pharmacists: Stephanie Harriman McGrath, PharmD Academy of Community Pharmacists: Martin J. Kendra, RPh Academy of Health System Pharmacists: Richard Demers, RPh, MS, FASHP Academy of Long Term Care and Consultant Pharmacists: Brant Gahr, RPh Academy of Pharmacy Industry Association: Todd Eury Academy of Student Pharmacists: Kyle McCormick PPA Office Staff: CEO: Patricia A. Epple, CAE pepple@papharmacists.com Communications Coordinator: Erica Brandt ebrandt@papharmacists.com Membership Coordinator: Courtney Box cbox@papharmacists.com Program Coordinator: Sara Powers spowers@papharmacists.com Government Relations Manager: Donald L. Smith, III dsmith@papharmacists.com

Our Vision

Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as health-care providers.

Our Mission

The Pennsylvania Pharmacists Association, as the leading voice of pharmacy, promotes the profession through advocacy, education, and communication to enhance patient care and public health.

Pennsylvania MAGAZINE

Departments President’s Message..................................................................................... 5 Calendar of Events....................................................................................... 7

Ext. 3

Member News.............................................................................................. 8

Ext. 2

Campus Checkup........................................................................................ 10

Ext. 1 Ext. 4

Pharmacy Time Capsule............................................................................... 13

Ext. 6

New Members.............................................................................................. 14

Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com ppa@papharmacists.com www.facebook.com/PAPharmacy www.twitter.com/papharmacists

Features

Pennsylvania Pharmacist (ISSN 0031-4633) is the official publication of the Pennsylvania Pharmaceutical Association d/b/a Pennsylvania Pharmacists Association and is published every other month, six times per year. Annual subscription is $100 for non-members; for members it is included in the annual dues. Editorial information should be addressed to the PPA address listed above. Peer reviewed articles accepted according to the stated guidelines available from PPA.

Interprofessional Education: A Focus On Pennsylvania Pharmacists Engaged in Interprofessional Team-based Practices ................................ 23

Editorial Board: Tara L. Pummer, PharmD, Chairman Hershey S. Bell, M.D., M.S., FAAFP Stephanie Smith Cooney, PharmD Bernard Graham, PhD Brian S. Plager, RPh, MBA Associate Editor: Erica Brandt Editor/Manager: Pat Epple Published by: Graphtech Sarah DiCello, Publications Manager (717) 238-5751 sarah@thinkgraphtech.com For Advertising Information: Alexis Kierce, Account Manager (717) 238-5751 alexis@thinkgraphtech.com Designed by: Graphtech Pharmacist State Board of Pharmacy Members: Gayle A. Cotchen, PharmD, MBA – Institutional” Janet Hart, RPh – Community Chain Pauline Montgomery, RPh – Community Independent Theresa M. Talbott, RPh – Community Chain Mark J. Zilner, RPh – Community Independent 2014 Board of Pharmacy Meeting Dates: May 13, 2014

June 10, 2014 July 8, 2014

August 12, 2014 September 16, 2014

Financial Forum: Making Retirement Savings Last, Different Ways to Respond to the Challenge........................................................................ 15

Association News PPA Welcomes New Membership Coordinator............................................. 16 Pennsylvania Pharmacy Legislative Day “Pharmacists: We Make A Difference!”................................................................................ 18 PPA Election Information & Ballot.................................................................. 20 Pennsylvania Student Pharmacists Attend PPA’s Annual Government Relations Advocacy for Student Pharmacists (GRASP) Program.................................................................................... 40 PPA 2014 Annual Conference Save the Date —“Pharmacy’s Future is in the Stars”............................................................................................. 42

Industry News Small Doses ................................................................................................ 32

On the Cover: Top row, l–r: Duquesne Students, LECOM Students with Hershey Bell, Vice President of Academic Affairs and Dean, LECOM School of Pharmacy, Legislators discussing displays with Pharmacy Students; Middle picture: Legislative Day Attendees; Bottom picture: PPA President Scott Miskovsky, and Board of Directors Officers Donna Hazel and Robert Frankil during the Legislative Day Rally and Press Conference.

Pennsylvania Pharmacist I May/June 2014 I 3

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Departments

J. Scott Miskovsky, RPh PPA President 2013–2014

Message from the President W here has the time gone? This will be my final President’s Message. I guess it is true that when you enjoy your work, time will pass quickly. When I began my term, I was fortunate to take over an organization that was strong and vibrant, thanks to the work of previous Boards and our dedicated PPA staff. My goal was to continue to build upon their good work with membership improvement, political action and promoting our PPCN (PA Pharmaceutical Care Network). We strive to serve all pharmacists and to protect and serve the profession every day. I would like to think that I have accomplished my goal.

As evidenced by recent reports of increasing membership, we are a growing organization. We have been gaining student members at a steady pace which is great; however, we still seek more active voting members to augment our ranks. I want to mention that we need everyone’s help here. There is no magic wand. You have to be a friend and a mentor and bring members in; it’s as simple as that!

With new members will come the energy and commitment to guide us to future success.

During my time as President we

have achieved political success as well. The passage of SB 201 now Act 207 was just the first, we hope, in a long string of legislative successes. As you know we are currently promoting bills that affect pharmacy practice. This year’s focus is on PBM Transparency, Fair Audits, and Immunizations.

These bills were the focus of Legislative Day, which occurred at the Capitol in Harrisburg on April 2nd. Your vocal and financial support is needed!

Most exciting is the progress of our PPCN. We are continuing in our effort to be national leaders in promoting patient care. We have committed substantial resources to this project as we feel strongly that patient care is an integral part of the future of pharmacy. Don’t be left out when the opportunity comes along, take control of your future. The world of pharmacy has changed dramatically in the last 10 years. I can only imagine what will happen in the future.

We must be ready to adapt to change quickly. We have to able to “turn on a dime”.

If you are reading this you must be interested in pharmacy and your future. Don’t be slow to act, now is the time. You will

be rewarded many fold for your efforts. BE A MENTOR. BE A LEADER. BE THE SOLUTION! Many thanks to Pat and her staff. Without their daily hard work and dedication, PPA’s success would be diminished greatly. We have had some staff changes during my term, but this did not interrupt their duties one bit. No one missed a step or skipped a beat.

Congratulations on a fantastic job.

Finally thank you to all of the members for your advice and support. Friendship is a key ingredient for any Officer and I certainly benefited greatly. I do appreciate it. It truly has been an honor and a privilege to serve as your President and I promise to be with you in the future as we face countless new challenges and opportunities together!

Thank you, J.Scott Miskovsky

Pennsylvania Pharmacist I May/June 2014 I 5

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DIAMOND LEVEL

GOLD LEVEL

SILVER LEVEL

Calendar of Events

May

5–8

8

17–20

31–June 4

July

26-30

August

24

NCPDP Annual Conference — Phoenix, AZ PPA Board of Directors NABP Annual Meeting — Phoenix, AZ ASHP Summer Meeting — Las Vegas, NV

AACP Annual Meeting — Grapevine, TX

NASPA Annual Meeting — Boston, MA

September

BRONZE LEVEL

14–16

ACCP Annual Meeting — Atlanta, GA

18–21

PPA Annual Conference — Mars, PA

October

8–10

AMCP Educational Conference — Boston, MA

18-22

NCPA Annual Conference — Austin, TX

For additional events and PPA committee meetings, be sure to see our Calendar of Events on the PPA website!

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Departments

Member News NACDS RXImpact Day Pharmacists Raymond McCall, Andy Markievich and Gary Petruzzelli from Ahold USA, pharmacy students Amanda Jaber, University of Pittsburgh, and Sarah Elias, Wilkes University, and Don Smith, PPA’s Government Relations Manager, met with Congressmen Lou Barletta, Jim Gerlach and Scott Perry during the NACDS RxImpact Day in Washington, D.C. z

Duquesne Faculty Receive Academic Affairs Award Dr. Janet Astle, Director of Experiential Education for the Mylan School of Pharmacy and Dr. Bruce Livengood, Associate Professor of Clinical, Social and Administrative Sciences in the Mylan School of Pharmacy, received an Academic Affairs Award at Duquesne’s annual assessment brunch on January 23.

The reward was given in recognition of their work on PharmEd Plus: A Competency-Based Curricular Assessment Web-Based Program. z

School of Pharmacy Faculty Receive Teaching Awards

RxImpact attendees from Pennsylvania with Congressman Lou Barletta

The Duquesne University Creative Teaching Award is a University-wide competition to judge exemplary strategies in teaching and learning. The following Duquesne faculty were recognized at the Annual Creative Teaching Award ceremony on Thursday, April 10, 2014: Dr. Lauren O’Donnell, Dr. Michael Perry, Dr. Christine O’Neil and Dr. Janet Astle. z

APhA Annual Meeting Recap

Attendees with Congressman Jim Gerlach

Attendees visiting Congressman Scott Perry

8 I Pennsylvania Pharmacist I May/June 2014

Congratulations to Melissa Somma McGivney, PharmD, FCCP and Adam C. Welch, PharmD, MBA, BCACP for being selected as fellows by APhA-APPM. McGivney is the Assistant Dean of Community Partnerships and Associate Professor at the University of Pittsburgh School of Pharmacy. She has focused her professional career on developing best practices for pharmacists to provide care to patients in their own communities and as a part of interprofessional teams.

Welch is an Associate Professor and Acting Assistant Dean for Academic Affairs and Assessment at Wilkes University School of Pharmacy. He has trained faculty at five different schools of pharmacy to teach the immunization training program in their curricula. In addition to this, he is a Past President of PPA. PPA and the seven Schools of Pharmacy in the Commonwealth once again hosted a Pennsylvania

Departments Pharmacy Reception during the American Pharmacists Association 2014 Annual Meeting. This year is the seventh year for the event which is open to school alumni, current students and faculty as well as PPA members and other Pennsylvania pharmacists. More than 300 attended the reception on Saturday evening of the conference. Thank you to all who joined us at the reception! z Shown at Right: Melissa Somma McGivney, PharmD, FCCP and Adam C. Welch, PharmD, MBA, BCACP being recognized as fellows by APhA-APPM during the 2014 APhA Annual Meeting with Tom Menighan, APhA EVP/CEO. Pictured below: Attendees at the Pennsylvania Pharmacy Reception.

Pennsylvania Pharmacist I May/June 2014 I 9

Departments

Campus Checkup APhA Recap Pennsylvania’s seven Schools of Pharmacy were represented at the APhA-ASP House of Delegates during the APhA 2014 Annual Conference.

The schools of pharmacy were present during the 2 sessions where they voted on resolutions that will serve as the backbone to the student academy in the coming years. The national executive committee for 2014–15 was also elected during the ASP House of Delegates.

House of Delegates at 2014 APhA Annual Meeting Congratulations to the three students from Pennsylvania who were finalists dangers that exist within the household. As a part of among ten individuals in the National Patient the outreach for young children, seven students from Counseling Competition! These students were: the University of Pittsburgh School of Pharmacy, with Adrienne Jantzi, University of Pittsburgh School of Rite Aid Pharmacist Stephanie McGrath and PGYPharmacy, Meghan Mitchell, Temple University School 1 Community Pharmacy Resident Kristine Ossman, of Pharmacy and Jamie Salvador, Jefferson School of visited Jeffery Primary School in Shaler Township, Pharmacy. z PA to speak with approximately 100 kindergartners and first graders about the dangers of poison. While Poison Prevention: Kindergartners and most of the children knew about common things that were poisonous such as “poison ivy” and “black First Graders at Jeffery Primary School widows”, they were very surprised to find out that items such as household cleaning products and March 16–22 was Poison Prevention Week, and medicine if taken incorrectly could be poisonous as educating young children about the dangers of poison well. One of the key points of emphasis was helping is an important component of preventing the potential

From left to right: Alyssa Polinak (P2), Elena Schaller (P2), Shayna Stout (P4), Megan Dunlop (P1), Madison Adams (P1), Ho-Sik Kim (P4), Sajid Ahmed (P4)

10 I Pennsylvania Pharmacist I May/June 2014

Students at Jeffery Primary School

Departments the children differentiate the medications that are unsafe (ie. If the medications are not those belonging to the children) and medications that are safe because a parent is giving it to them. The education program involved introducing Mr. Yuk as a sign of what is poisonous, and explaining to them that certain items in the household should be avoided unless instructed otherwise by a parent or caregiver. Many various household items were brought into the school and presented to the kindergartners and first graders. The children volunteered to pick an item from the bag and

tell the other children whether this was considered safe or poison. The children were very intrigued at just how many common household items could be considered poison, and the experience was rewarding for the pharmacy students because of how interactive and eager the children were to learn, and how much they already knew at such a young age! By targeting children earlier and educating them with information about poison prevention, many accidental poisonings in the household can be avoided. z

LECOM Activities LECOM participated in the Script Your Future Generation RX — Community Health Fair at the Red Barn Flea Market, February 15th, 2014. In addition to this, LECOM, in collaboration with the Erie County Executive, arranged for an official presentation of a Proclamation of the Script Your Future Medication Adherence Challenge to LECOM. This marked the beginning of a month full of events hosted by both the College of Medicine and the School of Pharmacy. Local media was present, and statements were be giving by various members of faculty, students and the County Executive.

SNPhA, along with APhA, went to Mercyhurst Prep to educate the students about medication and vaccination adherence. The students’ knowledge was tested by engaging them in True and False games about vaccinations and medication adherence. z

Mercyhurst Prep Wellness Fair

Script Your Future Generation RX - Community Health Fair at the Red Barn Flea Market

Medication Adherence Proclamation by Erie County Executive

Pennsylvania Pharmacist I May/June 2014 I 11

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Departments

Pharmacy Time Capsules 2014 (Second Quarter) 1989

The Medicare Catastrophic Act of 1988 was resoundingly repealed after disclosures that insurance coverage could be bought on the open market for a fraction of the surtax imposed by the government.

Epogen (Amgen) the first recombinant human erythropoetin product approved by the FDA for marketing.

1964 Surgeon General Luther Terry made an announcement that cigarette smoking causes lung cancer and probably heart disease.

1939 Joseph Lynch, a 1927 Fordham College of Pharmacy alumni, became a police office was killed disarming a bomb set by Nazi saboteurs at the World’s Fair in Flushing Meadows.

WW II starts, Germany invades Poland.

1914 West Virginia University establishes its College of Pharmacy.

Franz Ferdinand, Archduke of Austria and his wife are assassinated in Sarajevo by a Serbian nationalist, the justification of World War I. y: Dennis B. Worthen, PhD, Cincinnati, OH B One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America’s history. Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org BuySell_ads14_Layout 1 1/25/14 4:01 PM Page 6

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Departments

New Members P

PA welcomes the following New Members who joined the association – January 28, 2014 – April 4, 2014.

Please make these new members feel welcome and part of Pennsylvania pharmacy!

Active Pharmacist Philip Empey University of Pittsburgh School of Pharmacy Jeffrey T. Lipman Medicine Shoppe Harrisburg JoAnn C. Lipman Pharmerica Harrisburg Philip J. Maceno III Walgreens Pharmacy Collingswood

Technician Samer Doss Williamsport Pamela Hale York Kisiah Shavonee Hall Millennium Pharmacy Service Oreland Kashmir Kaur Upper Darby Elizabeth King Elizabeth

Olufunmilola Odukoya University of Pittsburgh School of Pharmacy

Windie LaRizzio Hazleton

Rikin K. Patel Whitehall

Thomas Lindeman Whitehall Pharmacy Whitehall

Brandon James Patterson Philadelphia College of Pharmacy Philadelphia Kin Tran Thomas Jefferson Hospital Lancaster Heather Tyas Philadelphia Michael Zemaitis University of Pittsburgh School of Pharmacy Bethel Park

Kathleen Boileau Ward Broomall Dena Willis York

Resident Ashley Higbea University of Pittsburgh Medical Center Pittsburgh

Pharmacy Technician Student Melanie Reddy Yardley Duquesne University

Tanna Mezacapa Erie Bonnie Panabaker Clearville Tenille Petty Meena Sakar Philadelphia Ashley Shay Philadelphia Frank Smith Hanover Township Frank J. Stetter Altoona

14 I Pennsylvania Pharmacist I May/June 2014

Hannah Cawoski Mariah Hill Jacob Moore Michaela Palermo Emily Schimizzi LECOM School of Pharmacy Cassandra Camp Kyle Spaniol Whitney Stiffler Philadelphia College of Pharmacy at USP Sun Woo Ahn Frantz Benjamin Jung Yoon Chae Francesca Chieffallo Allison Conte Robert DeSantis Alyson Destefano Nabil Dharsi Heather Edwards

William Fine Daniel Flannery Adam Gockley Joseph Guan Paul Hanna Alexandra Hauser Mitchell Hughes Monica Huon Zhimeng Jin Laney Jones Ann Joy Hany Karara Joseph Keglovits Jessica Kim Rachel Kim Soo Yun Kim Marianna Koerner Derek Krajek Sarah Kraus Julia Kravitz Michelle Kwon Yvonne Labram Annette Lista Tiffany Liu Andriy Lykhatskyy LIgi Mathew Robert McNeill Keegan Miller Lisa Mitchell Deana Musaka Sophia Ng Jinsun Paek Richard Parente Judy Park Jigna Patel Christina Persaud Katrin Samy Jennifer Santamala Masato Sugeno Robin Thomas Jennifer Vidal Leonard Vinciguerra Julia Weiner Danny Yang Catherine Yi Ashley Zielen

Thomas Jefferson Jefferson School of Pharmacy Michelle Link University of Pittsburgh School of Pharmacy Zachariah Hicks Megan McConnell Danielle Schneider David Tylavsky William Tylavsky West Virginia University School of Pharmacy Jeanine Hardy Wilkes University Nesbitt College of Pharmacy Julie Miller Krista Zawistowski We sincerely thank everyone who has helped recruit a member and for helping make PPA stronger! z

Features Financial Forum:

Making Retirement Savings Last Different ways to respond to the challenge This series, Financial Forum, is presented by PRISM Wealth Advisors, LLC and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

A

s you retire, there are variables you can’t control; investment performance and fate are certainly toward the top of the list. Your approach to withdrawing and preserving your retirement savings, however, may give you more control over your financial life.

Drawing retirement income without draining your savings is a challenge, and the response to it varies per individual. Today’s retirees will likely need to be more flexible and look at different withdrawal methods and tax and lifestyle factors.

Should you go by the 4% rule? For decades, retirees were cautioned to withdraw no more than 4% of their retirement balances annually (adjusted north for inflation as the years went by).

This “rule” still has merit (although sometimes the percentage must be increased out of necessity).

T. Rowe Price has estimated that someone retiring with a typical 60%/40% stock/bond ratio in their portfolio has just a 13% chance of depleting retirement assets across 30 years if he or she abides by the 4% rule. A 7% initial withdrawal rate invites an 81% chance of outliving your retirement assets in 30 years.1 That sounds like a pretty

good argument for the 4% rule in itself. However, while the 4% rule regulates your withdrawals, it doesn’t regulate portfolio performance. If the markets don’t do well, your portfolio may earn less than 4%, and if your investments repeatedly can’t make back the equivalent of what you withdraw, you will risk depleting your nest egg over time.

Or perhaps the portfolio percentage method? Some retirees elect to withdraw X% of their portfolio in a year, adjusting the percentage based on how well or poorly their investments perform. As this can produce greatly varying annual income even with responsive adjustments, some retirees take a second step and set upper and lower limits on the dollar amount they withdraw annually. This approach is more flexible than the 4% rule, and in theory you will never outlive your money.

Or maybe the spending floor approach? That’s another approach that has its fans. You estimate the amount of money you will need to spend in a year and then arrange your portfolio to generate it. This implies a laddered income strategy, with the portfolio heavily weighted towards bonds and away from stocks. This is a more

conservative approach than the two methods above: with a low equity allocation in your portfolio, only a minority of those assets are exposed to stock market volatility, and yet they can still capture some upside with a foot in the market.

Attention has to be paid to tax efficiency. Many people have amassed sizable retirement savings, yet give little thought as to the order of their withdrawals.

Generally speaking, there is wisdom in taking money out of taxable accounts first, then taxdeferred accounts and lastly taxexempt accounts. This withdrawal order gives the assets in the taxdeferred and tax-exempt accounts some additional time to grow.

A smartly conceived withdrawal sequence may help your retirement savings to last several years longer than they would in its absence.2 Keeping healthy might help you save more in two ways.

Increasingly, people want to work until age 70, or longer.

Many assume they can, but their assumption may be flawed. The 2012 Retirement Confidence Survey from the Employee Benefit Research Institute found that 50% of current retirees had left the workforce earlier than they Continued on page 16

Pennsylvania Pharmacist I May/June 2014 I 15

Features Financial Forum

continued from page 15

planned, with personal or spousal health concerns a major factor.3 When you eat right, exercise consistently and see a doctor regularly, you may be bolstering your earning potential as well as your constitution. Health problems can hurt your income stream and reduce your chances to get a job, and medical treatments can eat up time that you could use in other ways. Good health can mean fewer ER visits, fewer treatments and fewer hospital stays, all saving you money that might otherwise come out of your retirement fund.

Fidelity figures that a couple

retiring now at age 65 will spend $240,000 (in 2012 dollars) on retirement health expenses across their remaining years. That $240,000 doesn’t even include dental, over-the-counter drug and long term care costs (and as a reminder, many eye, ear and dental care costs are not even covered under Medicare or by Medigap policies). Every year you work may mean another year of health insurance coverage as well as income.4 Citations 1 individual.troweprice.com/staticFiles/ Retail/Shared/PDFs/retPlanGuide.pdf [5/10] 2 online.wsj.com/article/SB100014240527 48703529004576160693310435366.html [3/7/11]

Association News

PPA Welcomes New Membership Coordinator!

P PA has a new Membership Coordinator, Courtney Box. Courtney, a graduate of Elizabethtown College with a Bachelor of Arts in Corporate Communications and a minor in Marketing/Management, started with PPA at the end of February.

She will be assuming the duties of coordinating our membership recruitment and retention efforts, working with the students and coordinating their programs, and developing our member services and benefits. Prior to her work at PPA, Courtney’s work experience includes marketing, business development, customer service and event planning. In her spare time, Courtney enjoys working out, going to concerts, exploring the craft beer world, spending time outdoors, reading, and spending time with her boyfriend, family and friends. Please welcome Courtney to PPA! z

16 I Pennsylvania Pharmacist I May/June 2014

3 www.dailyfinance.com/2012/09/03/ postponing-retirement-70-not-thenew-65/ [9/3/12] 4 www.marketwatch.com/story/ good-health-means-more-retirementmoney-2012-12-06 [12/6/12] Pat Reding and Bo Schnurr may be reached at 800-288-6669 or pbh@berthelrep.com. Registered

Representative of and securities and investment advisory services offered through Berthel Fisher & Company Financial Services, Inc. Member FINRA/SIPC. PRISM Wealth Advisors LLC is independent of Berthel Fisher & Company Financial Services Inc. This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. Please note - investing involves risk, and past performance is no guarantee of future results.

The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional.

This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment

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Association News

Pennsylvania Pharmacy Legislative Day “Pharmacists: We Make A Difference!”

O n April 2, more than 325 pharmacists and pharmacy students from all across Pennsylvania converged in Harrisburg to advocate for their profession. The focus of the day was the promotion of “Making a Difference”, which centered around advocating for pharmacy benefit manager (PBM) regulation and transparency, fair pharmacy audits, ways pharmacists can curb prescription drug diversion and expanding immunization opportunities.

PPA’s Legislative Day began with a continental breakfast in the East Wing of the Capitol, along with screenings, displays and information provided by Pennsylvania’s seven Schools of Pharmacy. Legislators, staff and the public learned ways to better manage their health by conversing with the students and participating in screenings.

The schools of pharmacy provided information on the following topics:

Duquesne University Mylan School of Pharmacy

• Duquesne University Mylan School of Pharmacy: Cardiovascular Risk Assessment and DermaView Displays and Blood Glucose Screenings • Lake Erie College of Osteopathic Medicine (LECOM) School of Pharmacy: Immunizations Display and Blood Pressure Screenings • Temple University School of Pharmacy: Hypertension Display and Blood Pressure Screenings • Jefferson School of Pharmacy: Simple 7 Ways to Prevent Heart Disease Display and Blood Pressure Screenings

18 I Pennsylvania Pharmacist I May/June 2014

Lake Erie College of Osteopathic Medicine (LECOM) School of Pharmacy

Association News • University of Pittsburgh School of Pharmacy: Immunization Awareness Display and Hypertension Assessment Screenings • USciences/Philadelphia College of Pharmacy: Medication Adherence Display and “Are You Taking Meds Appropriately?” Screenings • Wilkes University Nesbitt College of Pharmacy: Smoking Cessation and Education Displays Attendees then filled the grand staircase in the Main Rotunda at 10:00 a.m. for the “Pharmacists: We Make A Difference!” rally and press conference. PPA CEO Pat Epple started the rally by addressing the media and the public. Cameras flashed and attendees listened as the rally focused on Medication Therapy Management through PPA’s Pharmaceutical Care Network, covered by PPA First Vice President Donna Hazel, RPh; ways pharmacists can curb prescription drug diversion, covered by President Elect Eric Esterbrook, RPh; the need for PBM regulation and transparency, covered by Immediate Past President Rob Frankil, RPh; fair and uniform standards for pharmacy audits discussed by Second Vice President Eric Pusey, RPh; and expanding opportunities for pharmacists to provide immunizations in Pennsylvania by lowering the age and permitting trained student interns to immunize, covered by President Scott Miskovsky, RPh. Attendees met individually and in groups with legislators and staff to discuss PPA’s priority issues throughout the day.

Additionally, several special meetings were set up for small groups of attendees in the PPA office.

These informal meetings included presentations and/or discussions with: Representative Seth Grove (R-York) – Sponsor of HB 776; Representative Tim Hennessey (R-Chester) – Chair, Aging and Older

Temple University School of Pharmacy

Jefferson School of Pharmacy

Continued on page 38 University of Pittsburgh School of Pharmacy

Pennsylvania Pharmacist I May/June 2014 I 19

Association News

Article Head Goes Here Important Message PPA Elections for 2014–2015 PPA Online Voting is now open!

Your vote is important and we encourage members to cast your vote for the individuals you wish to represent you and the pharmacy profession. Your vote is confidential and the system is tied to only allow a person to vote only one time!

To cast your vote – here is what you need to do: 1 – Go to this website: www.associationvoting.com/ papharmacists/ 2 – Login by entering your last name and member ID that were emailed to you – or contact the office if you have misplaced these.

3 – Review the candidate options for the categories in which you are entitled to vote (see right), check your selected candidates, and cast your ballot!

4 – Please note that ballots MUST be cast before midnight on May 10.

Voting is open beginning now and will continue until Midnight

20 I Pennsylvania Pharmacist I May/June 2014

on May 10, 2014. At which time, shortly thereafter the Nominating Committee will certify the results.

Your ballot will be matched to your ID and Last name, so you will only be able to vote for the offices for which you are entitled.

However, if you believe there is an error in the options you have – do not cast your vote, exit, and please contact us. If you have any problems in doing this or have any questions, please contact the PPA office at (717) 234-6151 and speak with either Courtney Box or Pat Epple. Or email one of these individuals at cbox@papharmacists. com or pepple@papharmacists. com. Any member who prefers to receive a paper ballot, may do so by contacting the office, prior to May 10 and we will send you one.

The following elections are scheduled for this year and the Nominating Committee announces the candidates for each: Please note many of these positions have more than one candidate. Please carefully review their brief biographical information

available on-line at the voting site, to aid you in selecting the best candidate to represent you, the profession, and PPA! You can also submit a write-in vote.

PPA OFFICERS

All of the following are for oneyear terms. Only active pharmacist categories of membership vote for these positions.

President-Elect – Donna Hazel, RPh First Vice President – Eric Pusey, RPh, CDE Second Vice President – Choose one: Mark Lawson, PharmD, MBA or Nicholas Leon, PharmD, BCPS, BCACP PPA BOARD OF DIRECTORS

All are for two year terms.

Only members of the respective Academy/practice setting may vote for the Director.

Director – Academy of Community Pharmacists – Martin Kendra, RPh Director – Academy of Chain Pharmacists – Choose one: Brian Bobby, PharmD or Stephen Pfeiffer, PharmD, MBA, RPh

Association News Only pharmacist members of the respective region may vote for Director.

Director – Northeast Region – Thomas Franko, II, PharmD, BCACP Director – Southwest Region – Choose one: Brian Bobby, PharmD or Lauren Simko, PharmD, RPh Director – Central Region – Ellen Nastase, BS Pharmacy, MS Pharmacy PPA STUDENT ADVISORY BOARD SAB

ACPA Director – Brandon Antinopoulos, PharmD, Gary Tedesco, PharmD or Nicholas Wytiaz, PharmD BUCKSMONT PHARMACISTS

Only BMPA members may vote for these positions.

PROPOSITION VOTES

In addition to the election of officers – PPA is also conducting a straw poll on members’ positions on the following topics: (all members have access to these items)

BMPA Secretary – Carla Herling (Tomlinson), RPh

1. How much do you read/like the PA Pharmacist magazine/ Journal?

BMPA Director – (Bucks County) Robert Schreiber, RPh or Steve Pfeiffer PharmD, MBA, RPh

2. Should PPA move to an electronic only version of it’s magazine/Journal? z

BMPA Director – (Montgomery County) John C. Barrett, RPh, CHC

Only student members cast their vote for these.

PPA Director – Choose one: Mohamed Amer or Ben Andrick Chair – Choose one: Amanda Jaber or Michelle Link Vice Chair – Choose one: Amanda Jaber, Michelle Link, Beth Miller or Jennifer Nguyen Corresponding Secretary – Choose one: Madison Adams, Michael Bellano, Beth Miller or Jordan Moore Recording Secretary – Choose one: Jennifer Smith or Brenna Stackhouse ALLEGHENY COUNTY PHARMACISTS

Only ACPA members may vote for these positions.

Tony Hayslip, ABR/AREP 713-829-7570 Tony@RxBrokerage.com

Ernie Zost, RPH 727-415-3659 Ernie@RxBrokerage.com

ACPA Vice President – Teresa Breslin, PharmD ACPA Secretary – Lauren Simko, PharmD, RPh ACPA Treasurer – Donna Hazel, RPh

Pennsylvania Pharmacist I May/June 2014 I 21

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Features

Interprofessional Education: A Focus On Pennsylvania Pharmacists Engaged in Interprofessional Team-based Practices (Part 3 of a 3 Part Series on Interprofessional Education)

Edward F. Foote, PharmD ­— Professor and Chair, Department of Pharmacy Practice, Nesbitt College of Pharmacy and Nursing, Wilkes University Elena M. Umland, PharmD ­— Associate Dean for Academic Affairs and Professor, Department of Pharmacy Practice, Jefferson School of Pharmacy, Thomas Jefferson University Susan Meyer, PhD ­— Associate Dean for Education and Professor, Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy Hershey Bell, MD, MS, MedEd ­— Vice-President of Academic Affairs and Dean, Lake Erie College of Osteopathic Medicine, School of Pharmacy Janet Astle, BS Pharm, EdD ­— Director of Experiential Education and Director of Student and Government Relations, Mylan School of Pharmacy, Duquesne University Corresponding Author: Edward F. Foote, PharmD, FCCP, BCPS Professor and Chair, Department of Pharmacy Practice Nesbitt College of Pharmacy and Nursing Wilkes University Wilkes-Barre, PA, 18766 570-408-4290 (v) 570-408-7729 (f) edward.foote@wilkes.edu

Funding, Conflict of Interest and Presentation Statement The authors have no perceived or real conflict of interest. There was no funding for this project. Some of the information in this paper may have been presented, in part, in other venues.

Keywords Interprofessional Education, Pharmacy Education, Schools of Pharmacy

Introduction This is the third and final manuscript in a three-part series on interprofessional education (IPE) in the Pennsylvania Pharmacist. These articles represent a part of an ongoing effort between the seven schools of pharmacy and The Pennsylvania Pharmacists Association to promote excellence in pharmacy education and practice. The first article was intended to provide an overview of IPE, including some of the drivers of IPE; identification of common resources; and suggestions for incorporation of interprofessional activities into the practice experiences.1 The second article, published in the previous issue, described some strategies and activities employed by Pennsylvania schools of pharmacy to incorporate IPE into their programs.2 This final installment highlights practitioners in our state who contribute to the profession as preceptors for student pharmacists and who hold interprofessionalism as a core value of their practice and learning environment.

Interviews were conducted in early 2014.

The schools of pharmacy in Pennsylvania have taken leadership roles in the national move toward implementing IPE in all stages of pharmacy education.

The authors of this series hope that these publications will make an impact by improving pharmacy education in our state so that we can ultimately improve patient care.

Brian Deihl, PharmD CareSite Pharmacy Geisinger, Lewistown Clinic, Lewistown, Pennsylvania

By Susan M. Meyer

SMEYER: Take me through your training path and how you came to be in your current position.

BDEIHL: I earned my PharmD degree at Wilkes Brian Deihl University in 2011. As a fourth-year pharmacy student, I had the opportunity to complete an advanced pharmacy practice experience with Geisinger Health Plan and was subsequently invited to apply for a pharmacist position.

SMEYER: Tell me about your current practice and how it is interprofessional.

BDEIHL: This CareSite Pharmacy is located within the Geisinger Medical Clinic. We are a full service community pharmacy offering prescription Continued on page 24

Pennsylvania Pharmacist I May/June 2014 I 23

Features Interprofessional Education

continued from page 23

medications, as well as over-the-counter and special order items. What makes us interprofessional is our physical location as well as how we practice.

Co-located with the Geisinger Medical Group, we have several family practice physicians as well as three internal medicine physicians and a nephrologist on the same floor as the pharmacy. Pharmacists have direct interactions with these practitioners. It is much better to have that face-to-face interaction with a provider. In fact, with some of our patients, we are able to occasionally interact with the patient at the same time they are with the physician.

SMEYER: Were you specifically educated for these types of interprofessional interactions?

BDEIHL: Yes, I had many pertinent experiences as a student. In my introductory pharmacy practice experience, I was able to shadow in a physician’s office and to interact with physicians and nurses. I had other interprofessional experiences in advanced pharmacy practice hospital rotations, including rounds in the ICU and making telephone calls to physicians and nurses when in distribution roles. I did not feel challenged or disadvantaged when faced with interprofessional interactions when I first started as a pharmacist. I was well prepared.

SMEYER: When you precept students, are you explicit in your teaching about the interactions with other health care providers or is interprofessionalism just inherent in the day-to-day activities?

BDEIHL: The interprofessional nature of the learning occurs naturally because it is part of how our day normally flows. Our fourth year students do chart reviews, check for drug interactions, and, if changes are needed, take lead on managing that change.

If students have questions about a patient, under supervision of course, they are expected to go ask the question of the provider.

SMEYER: How do they respond to the level of responsibility and engagement you ask them to assume?

BDEIHL: We hear from them that they have a positive experience here and feel like they are making a difference in the care of patients.

24 I Pennsylvania Pharmacist I May/June 2014

SMEYER: Four domains of interprofessional competencies were outlined by the Interprofessional Education Collaborative, or IPEC, in 2011, and included roles and responsibilities, values and ethics, interprofessional communication, and teams and teamwork. Does hearing these domain labels trigger any thoughts about how you may be focusing specifically on one or more of them?

BDEIHL: Teams and teamwork is huge for us, especially with filling med boxes because the process demands everyone coming together. It starts with the patients and families because they have to be aware of what day we will be delivering. Delivery is a particular challenge with our patients with Alzheimer’s disease. Everyone, the patient, family, physician, case manager, nurse, pharmacist, has to work together to make everything happen. From that comes interprofessional communication – we have to have that communication to be sure that all the “med boxes” go out correctly.

SMEYER: As you look toward the future, what do you envision for interprofessional collaborative practice more broadly?

BDEIHL: I do expect to see an increased presence of clinics like ours. This kind of practice provides a great place to work and is a robust training site for future practitioners. If I had known about a practice like this, I would have chosen it as my community practice site as a learner.

SMEYER: What suggestions do you have for other pharmacists who serve as preceptors so they can explicitly engage students as members of an interprofessional team?

BDEIHL: If they are in a traditional community pharmacy, have students make calls to physician offices about prescriptions. Make them talk to nurses.

There isn’t any way to really train for that other than to go out there and do it. As pharmacists, they will need to be comfortable initiating communications with other care providers, and practice as students will help to build their confidence. Not everybody has the luxury of being in the middle of the clinic with the opportunity for face-to-face communication but that doesn’t mean we shouldn’t all be interprofessional.

Continued on page 26

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Features JHUZINEC: I always strive to do the best job I can in whatever role I have; always practicing with integrity.

I have always accepted additional responsibility when asked. I feel that those who have worked with me know my commitment and that I can be counted on. Building strong interprofessional relationships is fundamental for a successful career. I can relate to people and make them feel comfortable (so I am told). This is a bonus when interviewing staff after an adverse event. No one feels good about something going wrong with a patient’s care.

Interprofessional Education

continued from page 24

Jill G Huzinec, RPh Director Patient Safety in the Department of Clinical Effectiveness and Quality Improvement (CEQI) at the Hospital of the University of Pennsylvania (HUP), Philadelphia, Pennsylvania

By Elena Umland

Jill G. Huzinec

EUMLAND: Can you tell me a little about yourself, your training and how you came to be in this position?

JHUZINEC: I graduated from the Philadelphia College of Pharmacy & Science. I have been at my current position as Director of Patient Safety at HUP for 5 years. Before that, I was the Medication Safety Pharmacist for Crozer Keystone Health System.

EUMLAND: Tell us a little about your practice, in particular, how is it interprofessional?

JHUZINEC: I oversee the patient safety programs for HUP and the Clinical Practice of the University of Pennsylvania (CPUP). CPUP are the physician outpatient practices, encompassing most of the same physicians who work in the hospital. Part of my role is to review any events (not limited to medication events) submitted within our reporting system and determine which would benefit from a root cause analysis (RCA) as a means of improving patient care. My practice is interprofessional in that I am responsible for interacting with many professionals throughout the hospital. In my role, I do not challenge clinical decisions, but rather focus on the system issues and the processes. I work closely with individuals involved in errors. For example, I started a second victim support program which is referred to as “Care for the Care Provider”. My practice is also interprofessional via administrative responsibilities that include chairing multiple patient safety related committees and leading numerous activities within the hospital and the health system.

EUMLAND: Explain how this collaborative relationship started.

26 I Pennsylvania Pharmacist I May/June 2014

EUMLAND: Does your teaching reflect the interprofessional nature of your practice?

JHUZINEC: Absolutely. I routinely have students attend meetings that demonstrate interprofessional collaborations. My primary patient safety team is comprised of physician Patient Safety Officers, nurses, various allied health staff and pharmacy. Students are often involved in Safety Team meetings that include multidisciplinary groups from various hospital departments where we discuss events that have been escalated to determine if we should conduct RCA. They also participate in RCAs which give them direct exposure to other providers.

EUMLAND: There are four core competencies of interprofessional education. These include roles/ responsibilities, ethics/values, teamwork and communication. How are these core competencies addressed in the learning experience for students?

JHUZINEC: I often discuss teamwork and collaboration and the importance of building professional relationships. Communication is another key factor that has been identified by TJC as one of the leading factors of serious adverse events. The lack of communication between disciplines, the lack of handoff communication at change of shifts, and lack of communication from any clinician to the patient/ patient family leads to errors, non-compliance and misunderstanding.

EUMLAND: What do they suggest to other preceptors to make IPE a more robust experience for our students?

JHUZINEC: I think we need to share personal experiences with our students; tell them what we think made us successful. There is a lot of literature about storytelling as a way that adult learners

Features retain information. We find in safety that when we share events, it helps staff relate to the situation as it occurred and to understand the key factors that contributed to the adverse event.

Justin D. Scholl, PharmD, MS, BCACP Ambulatory Care Pharmacist, Eastside Medical Center (ESMC) and Assistant Professor of Pharmacy Practice at the Lake Erie College of Osteopathic Medicine

I joined the LECOM School of Pharmacy as a faculty member in January, 2011. Teaching has always been one of my passions and is absolutely vital to helping advance the profession, which is one of the reasons I enjoy it.

HBELL: Tell us a little about your practice.

Justin D. Scholl

By Hershey Bell

HBELL: How long have you been at this position?

What brought you here?

HBELL: Tell me about your training.

JSCHOLL: I graduated from the University of Pittsburgh’s School of Pharmacy in 2007 with a Doctor of Pharmacy degree. In 2013, I earned a Master’s Degree in Medical Education from the Lake Erie College of Osteopathic Medicine (LECOM).

In addition, I recently became board certified, in Ambulatory Care Pharmacy, by the Board of Pharmacy Specialties (BPS).

JSCHOLL: I’m one of several faculty from the LECOM School of Pharmacy who practice and teach.

My site is at Eastside Medical Center (ESMC), an outpatient, multidisciplinary medical clinic which is part of LECOM’s clinical practices. My focus is on clinical work, such as discussing with patients the most appropriate medications based upon their needs, educating patients on the proper use of their medications and helping resolve other medicationrelated problems such as non-adherence or insurance issues. I work collaboratively with the physicians at ESMC to make recommendations to providers around drug therapy to help patients reach treatment goals.

Continued on page 29

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Features

JSCHOLL: The rotations are extremely valuable in that they allow students to see pharmacy practice in a new and different light. The rotations help reinforce for the students the notion that pharmacists are much more than dispensers of medication. Students also see firsthand the importance of interprofessional collaboration.

Act and other changes to healthcare regulations, I feel interprofessional collaboration will be the model in health care going forward. Even though pharmacists and physicians may differ in their approach to patient care, we ultimately have the same goal -- returning patients to wellness, which means that communication and a team approach will be absolutely essential.

Because of our clinical training, pharmacists are ideally positioned to help improve outcomes and reduce costs. Ideally, seeing a pharmacist will become a routine part of a patient’s visit to their physician.

HBELL: Explain how this collaborative relationship started. What barriers or challenges have you faced?

Nick Zaksek, PharmD

Interprofessional Education

continued from page 27

HBELL: What are the benefits to the students?

JSCHOLL: When I began serving as a preceptor at ESMC, I had to gain the trust of the physicians and other staff, and I had to develop a sense of what my colleagues expected of me, as a pharmacist professional. I sought to be a resource to the practice and to contribute in any way I possibly could. My roles and responsibilities have expanded, to where I’m working with more patients across a broader spectrum of conditions and illnesses to ensure they’re taking the optimum medications and taking them as prescribed.

Excela Health Westmoreland Hospital in Southwestern Pennsylvania

By Janet Astle

HBELL: Can you give examples of learning experiences for your students that expose them to other health care providers or students?

JSCHOLL: The pharmacy students on rotation at ESMC interact with multiple disciplines on a daily basis. I’ll have discussions with my students and other providers related to care plan recommendations for patients or to answer questions that arise during the course of patient care. From an interprofessional education perspective, we often bring the pharmacy students and medical students and residents together for specialized topic discussions and meetings.

Something as simple as talking about the ways in which their approaches to patient care are different and the ways they’re the same can be very beneficial.

As the next generation of health care providers, it’s important that they embrace this model early on.

The more they see interprofessionalism as the norm rather than the exception, the better we’ll be able to care for patients.

HBELL: Where do you see this going?

JSCHOLL: Mostly because of the Affordable Care

(l to r) Dean Matanin, Jessica Geary, Nick Zaksek

JASTLE: Can you tell me a little about your background?

NZAKSEK: I graduated from the University of Pittsburgh School of Pharmacy in 1977. After graduation, I worked as a staff pharmacist at Uniontown Hospital. I recently earned my PharmD from the University of Florida in 2006 and accepted an offer to work at Excela Health. I have had the opportunity to engage in collaborative practice with the Director of Pharmacy, Dean Matanin.

JASTLE: Tell us a little about the interprofessional nature of your practice.

NZAKSEK: Interprofessional interactions are integral to practice at Excela. Comprehensive unit safety program (CUSP) rounds have been conducted daily Continued on page 30

Pennsylvania Pharmacist I May/June 2014 I 29

Features Interprofessional Education

continued from page 29

in the ICU since 2008. This interprofessional team consists of a physician, nurse, dietician, pharmacist, respiratory therapist and associated students. The team is responsible for reviewing each patient’s medications and vital signs with daily goals in mind.

An example of a daily goal would be weaning the patient off a ventilator. After each patient is reviewed, the team immediately plans the next course of action in collaboration. As of January, the CUSP model has been expanded to include a 15-bed medical unit at the hospital that is specifically designated as a collaborative care unit. The physician hospitalist, nurse, pharmacist, and any other associated health care professionals are involved in the daily rounding and care of patients with complex medical problems.

The ultimate goal is to expand the collaborative care model to the entire hospital by identifying those patients who would most benefit from such an approach. Interprofessional care has also been expanded to include medication reconciliation.

Pharmacy is intimately involved in conducting patient interviews and working with other health care professionals to resolve medication discrepancies.

There will be continued growth in this area as we work towards ensuring that transition of care upon patient discharge occurs in a seamless fashion.

JASTLE: Reflect on your preparation for this position.

NZAKSEK: Having earned a PharmD degree as a working pharmacist provided me with the necessary context for collaborative care. Experiential education was situated in environments that integrated other health care professionals.

JASTLE: How did this collaborative relationship get started?

NZAKSEK: The collaborative relationship was initially prompted by the ICU intensivist at Excela who wanted to minimize patient complications and improve outcomes. The thrust of the new collaborative care initiative is to improve outcomes and decrease patient length of stay. Our patient satisfaction scores reflect the success of this new approach.

JASTLE: Describe your role as preceptor and how teaching is integrated into the practice.

30 I Pennsylvania Pharmacist I May/June 2014

NZAKSEK: Students and pharmacist preceptors are fully integrated as part of the interprofessional team. Students are given the opportunity to compare their own recommendations and rationale against those provided by the preceptor. This makes for an opportune teaching/learning moment. Through their engagement on the team, students learn how to make recommendations to other health care professionals and gain confidence in their role. The IPE experience also allows students to identify with the roles and responsibilities of other health care professionals and gain an appreciation for the challenges they encounter. For example, students begin to appreciate the challenges that nurses must face when dealing with family members. Students can also begin to appreciate the emotional toll that physicians and nurses bear when a patient dies.

JASTLE: What barriers or challenges have you faced with interprofessional care?

NZAKSEK: One of the challenges that we encounter is the interaction with private physicians who may not always be on-site. In such cases, pharmacy recommendations may need to be communicated to private physicians through the nursing staff. It has been our experience that fewer recommendations are accepted when direct face-to-face communication does not exist.

JASTLE: What do you suggest to other preceptors to make IPE a more robust experience?

NZAKSEK: Establishment of trust relationships among team members is critical. Once trust has been established, other team members are more understanding when problems such as drug shortages arise and are more receptive to proposed solutions.

It is important to clearly identify a purpose for the collaborative team and develop a defined team approach to patient care up front. An appreciation and respect for one another leads to the best outcomes for our patients.

References: (1) Foote EF, Meyer SM, Astle J, Scaramastro T, Umland EM. Interprofessional Education: An Overview and Implications for Pharmacy Preceptors. Pennsylvania Pharmacist. 2014;95:27-37.

(2) Foote EF, Astle J, Umland E et al. Interprofessional Education: Ongoing and Planned Activities at Pennsylvania Schools of Pharmacy. Pennsylvania Pharmacist. 2014;95:35-43.

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Industry News

Small Doses: Medicare Star Ratings: What It Means for Your Pharmacy Elliott M. Sogol, PhD, RPh, FAPhA Vice President Professional Relations Pharmacy Qualtiy Solutions

D

id you know that your pharmacy is being evaluated

by Medicare prescription drug plans? If not, read on.... The Centers for Medicare & Medicaid Services (CMS) has been evaluating all Part D prescription drug plans using a Star Rating system for several years. Medicare prescription drug plans receive a summary “star rating” on quality that is based on their performance across 15 individual measures.

Five measures are specifically related to medication management and use. Because CMS more heavily weights these 5 measures than other measures, they account for nearly half of the plan’s Part D summary rating. These measures are: • 2 measures of medication safety o High risk medications in the elderly o Appropriate treatment of blood pressure in persons with diabetes

32 I Pennsylvania Pharmacist I May/June 2014

• 3 measures of medication adherence o Oral diabetes medications o Cholesterol medication (statins) o Blood pressure (reninangiotensin system antagonists) CMS also evaluates prescription drug plans on “display measures” which includes metrics on drugdrug interactions, excessive doses of oral diabetes medications and the use of atypical antipsychotics in nursing home patients. During this past year, CMS also began evaluating MTM programs by measuring the “Comprehensive Medication Review (CMR) completion rate” for all drug plans. It is expected that this CMR measure will be added to the Star measure set in the next round of ratings.

The Part D plans are now evaluating their pharmacy networks on these CMS star ratings measures. Some plans are also creating incentives for pharmacies to improve performance on these measures while others are planning to re-formulate their preferred

networks with pharmacies that perform well on the star measures.

The implications for community pharmacy are significant!

What can you do? Pharmacies can learn how they are performing on the star measures by subscribing to a new program named EQuIPP. The EQuIPP program is a web-based platform to which health plans submit their prescription claims data for benchmarking. EQuIPP also calculates the star measures for each pharmacy and makes this information available to the pharmacies via a secure website.

EQuIPP is a service offered by Pharmacy Quality Solutions (PQS), a company owned by Pharmacy Quality Alliance (PQA), a nonprofit that develops medication performance measures used by CMS for the STAR ratings process.

A growing number of Medicare plans are participating in EQuIPP including Humana, Wellcare, Coventry, and Cigna-HealthSpring.

For more information, visit www.

EQuIPP.org Continued on page 34

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Industry News Small Doses

continued from page 32

Pharmacists and the Medical Reserve Corps Pharmacists are valuable professionals that are “remarkably underutilized in the U.S. healthcare delivery system given their level of education, training, and access to the community” (Giberson et al, 2011). Not only can pharmacists contribute in traditional healthcare settings, but they can also be an important asset to public health entities. The Medical Reserve Corps (MRC) offers pharmacists opportunities to utilize their unique skill sets to support the health and safety of their communities.

The Medical Reserve Corps is a network of over 200,000 volunteers, organized in almost 1,000 local units across the United States, with a mission to strengthen public health, improve emergency preparedness and response capabilities, and build community resilience. MRC volunteers can contribute to a range of activities,

such as providing flu vaccinations, promoting obesity prevention and healthy lifestyles, teaching neighbors how to prepare a disaster kit, and assisting with emergency responses.

Pharmacists are valuable professionals that are “remarkably underutilized in the U.S. healthcare delivery system given their level of education, training, and access to the community.”

—Giberson et al 2011

MRC’s volunteer pharmacists have demonstrated their value to local communities on many occasions. For instance, MRC pharmacists have provided assistance and information at prescription drug take-back events, administered vaccinations in

response to Hepatitis A outbreaks, joined healthcare teams to provide preventive healthcare and health education to vulnerable members of society, guided the proper identification and labeling of medicines in preparation for mass prophylaxis events, staffed functional needs shelters, and vaccinated neighbors and other community members against influenza ­— including a large-scale response to the H1N1 influenza epidemic in 2009–10.

The MRC can also connect pharmacist members to valuable trainings, oftentimes with continuing education credits. This training improves the pharmacists’ capacity to assist and increases their comfort in being involved.

For instance, research has indicated that non-traditional vaccine providers, including pharmacists, have less experience administering vaccines and have indicated that they are less confident in responding during an emergency.

A study of 800 vaccine providers in Continued on page 36

Poison Prevention Month Recap PPA member Stanton Jonas, B.S. Pharm, RPh, M.P.H., was featured in the news release “Local Retired Pharmacist Educates Students and Community About Poison Prevention” for his efforts to raise awareness about Poison Prevention in Allegheny County. To read the news release please visit www.papharmacists.com and click on the Archived News Releases tab under Communications.

In honor of Poison Prevention Week 2014, Pharmacy Podcast created a special show to raise awareness about Poison Prevention. To listen to the full show please visit http://pharmacypodcast.com/poison-prevention-weekmarch-17-22/.

34 I Pennsylvania Pharmacist I May/June 2014

Stanton Jonas

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Industry News Small Doses

continued from page 34

Rite Aid Introduces Innovative Health Alliance Program to Improve Patient Health, Treatment Outcomes Rite Aid Corporation announced a new program, Rite Aid Health Alliance, a pioneering health management collaboration among various healthcare providers that provides comprehensive care and support to individuals with chronic and poly-chronic health conditions and helps them achieve health improvement goals established by their physicians.

Rite Aid’s Health Alliance integrated care model is a first for the drugstore industry, as it uniquely leverages the combined expertise of community pharmacists, who are one of the most accessible and trusted resources among healthcare providers, along with specially trained in-store healthcare coaches.

“At Rite Aid, we’re committed to actively working with our customers to keep them well and that includes developing new ways to improve access to high-quality healthcare,” said Rite Aid Chairman and CEO John Standley. “Through our innovative Rite Aid Health Alliance program, we will help patients with the resources and support necessary to successfully manage their conditions and improve their overall health and wellbeing.”

The full range of services available to patients participating in Rite Aid Health Alliance includes medication compliance support; comprehensive medication reviews and reconciliation; nutrition and weight management information; disease education; exercise coaching and tobacco cessation support.

Records of all interactions, which occur in Rite Aid pharmacies, as well as updates from the physician, are stored electronically, along with patient profiles including medications and lab results. This supports continuity of care and provides convenient access of information to other members of the patient’s healthcare team.

California revealed that a lack of training for emergency response situations reduced their likelihood and comfort level with responding to emergencies. The study authors suggested that additional training opportunities would allow these non-traditional vaccine providers to feel more comfortable responding during a surge (Seiba et al, 2012).

The MRC provides a way to train the volunteers, increase their ability to respond, and reduce risks. The trainings may cover a variety of topics, including Point of Dispensing (POD) and Strategic National Stockpile procedures,

36 I Pennsylvania Pharmacist I May/June 2014

Incident Command System, Psychological First Aid, and responding to radiological events.

To find out more about the Medical Reserve Corps, please visit http://1.usa.gov/1gYz5cz. The “Find MRC Units” page is a great place to start. You can also contact the MRC Program Office (Office of the Surgeon General/Division of the Civilian Volunteer Medical Reserve Corps) at MRCcontact@ hhs.gov for information.

Visit http://1.usa.gov/1gYz5cz to learn more and to find MRC units in your area. Click on “Volunteer”,

enter your zip code, select a unit near you, and submit your contact information to enroll.

References: Giberson, S., Yoder, S., & Lee, M. (2011).

“Improving patient and health system outcomes through advanced pharmacy practice.” A report to the U.S. Surgeon General. Office of the Chief Pharmacist, U.S. Public Health Service. Retrieved from http://www.accp.com/docs/positions/ misc/improving_patient_and_health_ system_outcomes.pdf.

Seiba, K., Barnett, D., Weiss, P., Omer, S. “Vaccine-related standard of care and willingness to respond to public health emergencies: A cross-sectional survey of California vaccine providers.” 2012.

Vaccine. 31: 196–201. z

For over 60 years, Kinray has been the full-line, full-service pharmaceutical wholesaler for independent pharmacies.

877.857.9881 | www.kinray.com | email us at allaboutyou@kinray.com Š 2013 Cardinal Health. All rights reserved. KINRAY and the Kinray LOGO are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners.

Association News Pennsylvania Pharmacy Legislative Day

continued from page 19

Adult Services Committee; Wayne Crawford, Executive Director, House Professional Licensure Committee; Tom Snedden, Director, PACE Program, PA Department of Aging; Robert Gardner, Director, Office of Medical Assistance Programs and Terri Cathers, Chief Pharmacist, Office of Medical Assistance; Alison Beam, Policy Director, Pennsylvania Insurance Department; Kari King, Deputy Chief of Staff, Governor’s Administration.

In less than six hours, we made a difference in the legislative and media arenas. PPA thanks everyone who took time off and traveled to Harrisburg for Pennsylvania Pharmacy Legislative Day. We chose to hold this event on a Wednesday in early spring based on the legislative calendar and the session schedules, along with the pharmacy school schedules. We hope you will consider adding your voice to the more than 325 pharmacists and pharmacy students next year.

Thank you again to everyone who came to Pharmacy Legislative Day, we appreciate your efforts.

More photos can be viewed on PPA’s Facebook page at www.facebook.com/PAPharmacy. z

USciences/Philadelphia College of Pharmacy

Wilkes University Nesbitt College of Pharmacy

“Pharmacists: We Make A Difference” Rally

38 I Pennsylvania Pharmacist I May/June 2014

PQC_

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Our Pharmacy Quality Commitment (PQC) program helps you implement and maintain a continuous quality improvement program that offers strong federal protection for your patient safety data and your quality improvement work. PQC also helps you comply with quality assurance requirements found in network contracts, Medicare Part D, and state regulations. We offer flexible and powerful tools, ongoing training and support to keep your pharmacy running efficiently, and most importantly, to keep your patients safe.

LearN MOre: Call toll free (866) 365-7472 or visit www.pqc.net PQC is brought to you by your state PharmaCy assoCiation

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4.5.2012 20.52

Association News

Pennsylvania Student Pharmacists Attend PPAâ&#x20AC;&#x2122;s Annual Government Relations Advocacy for Student Pharmacists (GRASP) Program Thank you to everyone who attended GRASP being involved in professional organizations. Featured 2014! PPA selected 18 students from Duquesne guest speakers included Representative Seth Grove University Mylan School of Pharmacy, Jefferson School of Pharmacy, Lake Erie College of Osteopathic Medicine (LECOM) School of Pharmacy, Philadelphia College of Pharmacy (PCP), Temple University School of Pharmacy, University of Pittsburgh School of Pharmacy and Wilkes University Nesbitt College of Pharmacy to participate in the Seventh Annual Government Relations Advocacy for Student Pharmacists (GRASP) program held February 28-March 2, 2014 in Harrisburg, PA. Program attendees this year included Duquesne University students Laura Brickett (class of 2016), Hanna Cawoski (2017), Mariah Corso (2017), Michaela Palermo (2017), and Rachael Richter (2017); Jefferson Above: Representative Seth Grove (R-York) giving his presentation School of Pharmacy student to attendees Michelle Link (2015); LECOM students Mohamed Amer (2016), Alex Gragg (2016), and Paulina Trzcinka (2015); PCP students Kevin Farrow (2015) and Terry Pak (2016); Temple University student Nissa Tasnim (2016); University of Pittsburgh student Amanda Jaber (2015); and Wilkes University students Stephanie Horger (2016), Lauren Para (2016), Kishan Patel (2016), Trina Patel (2016), and Jennie Smith (2017).

The program included presentations on: advocacy, leadership, legislative issues and GRASP attendees in the Capitol 40 I Pennsylvania Pharmacist I May/June 2014

Association News (R-York), who spoke about a legislator’s prospective; and Terry Talbott, R.Ph., Chair of the State Board of Pharmacy, who spoke about the role of the State Board of Pharmacy.

Students arrived Friday evening and enjoyed a dinner where they discussed ways to impact the future of pharmacy and changes the profession is facing. On Saturday they interacted with the featured guest speakers and PPA CEO, Pat Epple, CAE and Government Relations Manager, Don Smith, along with Ron Raymond, a former State Representative, who now represents the Philadelphia Association of Retail Druggists. They also had the opportunity to tour the Capitol.

Saturday evening ended with a dinner and opportunity to network among themselves. GRASP concluded on Sunday with a presentation by PPA’s Membership Coordinator, Courtney Box and information about PPA’s Annual Legislative Day, held April 2nd.

The GRASP program is a weekend leadership and advocacy-building retreat, designed for students. A limited number of student pharmacists from across the Commonwealth are accepted to participate in the program through an application process. Upon successful completion of the course and related assignments, students are presented with a Certificate of Achievement and a GRASP lapel pin which can be proudly worn on their pharmacy white coat, or on other clothing to pharmacy events.

Those who participate in the program walk away with a better understanding of state government and its impact on pharmacy – information which is important for all areas of pharmacy practice.

Thank you again to everyone who participated! z

Terry Talbott, R.Ph., Chair of the State Board of Pharmacy, giving her presentation to attendees

Pennsylvania Pharmacist I May/June 2014 I 41

PPAâ&#x20AC;&#x2122;s 2014 Annual Conference September 18 - 21, 2014 Four Points Pittsburgh North Mars, PA

Join us for CE, our Exhibit Hall, Annual Leadership & Awards Dinner, Student Programming and MUCH MORE!

What do the signs predict for your pharmacy future?

COME FIND OUT! Information coming soon to www.papharmacists.com.

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If you are looking for more reasons to begin your pharmacy career at Jefferson, consider this: • More than 98% of Jefferson School of Pharmacy graduates who took their national boards passed on the first try • Our students exceeded the national average in terms of students who pursued – and were selected for – accredited post-graduate training programs • Dr. Gerald Meyer, President of the American Society of Health-System Pharmacists (ASHP) – one of pharmacy’s largest professional organizations – teaches at Jefferson.

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