Pennsylvania Pharmacist January/February 2019

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PHARMACIST January/February 2019 • Volume 100 • Issue 1

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2018 CONFERENCE

Recap

THE OFFICIAL PUBLICATION OF THE

Tomorrow.

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CONTENTS ON THE COVER: PPA BOARD OF DIRECTORS PPA OFFICERS President: Lauren Simko, PharmD President Elect: Richard Demers, MS, RPh, FASHP Vice President: Chuck Kray, RPh Immediate Past President: Nicholas Leon, PharmD, BCPS, BCACP REGIONAL DIRECTORS Central Region: Deron Shultz, RPh Northeast Region: Vick Shah, PharmD, BCPS Northwest Region: Nickolas Kernich, PharmD Southeast Region: David Stone, PharmD Southwest Region: Brian Sidone, PharmD PRACTICE DIRECTORS Academia: Nicole Pezzino, PharmD, BCACP, CDE Chain Pharmacists: Renee Richardson, PharmD Community Independent: Shawn Nairn, RPh Community Independent: Christopher Antypas, PharmD Health System Pharmacists: Darryle Tillman Jr., RPh MCO/Industry/Government/Other: John Barrett, MBA, RPh Associates: Pat Lavella, RPh STUDENT DIRECTORS Student Director East: Dylan Fox Student Director West: Shannon Ye

Nearly 350 people attended some part of the four day conference to grow our future. We thank our members and sponsors for helping us end our 140th Year celebration. Pharmacy in Pennsylvania has been strengthened by our pharmacists who make it their life’s work to care for the health and wellbeing of the community across the commonwealth. Here’s to 140 more!

DEPARTMENTS

ASSOCIATION NEWS

PPA OFFICE STAFF CEO: Patricia A. Epple, CAE pepple@papharmacists.com | Ext. 3 Conference and CE Manager: Linsley Gentile lgentile@papharmacists.com | Ext. 2 Government Relations Manager: Angela Zaydon azaydon@papharmacists.com | Ext. 6 Membership and Marketing Coordinator: Victoria Madonna vmadonna@papharmacists.com | Ext. 5 Membership and Program Coordinator: Rachel Stall rstall@paharmacists.com | Ext. 1 Bookkeeper: Michele Dibble mdibble@papharmacists.com | Ext. 4 PPCN Executive Manager: Stephanie McGrath, PharmD smcgrath@papharmacists.com

5

Calendar of Events

7

President’s Message

21 Growing our Future: 140 Years and Counting

9

Welcome! New Members

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

14 Student Member Profile

INDUSTRY NEWS

16 Member Profile

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.

18 Legislative Profiles

36 Pharmacy and the Law: Marijuana Development

EDITORIAL BOARD Hershey S. Bell, M.D.,M.S.,FAAFP Kim Coley, FCCP, PharmD, RPh, Chair Michael Gionfriddo, PharmD, PhD Yardlee Kauffman, PharmD, MPH, BCACP Jinsun Paek, PharmD, BCPS

10 Member News 11

Affiliated Member News

33 Campus Checkup

FEATURES

20 Pharmacy Spotlight

25 Leadership and Awards Reception and Dinner 28 Governor Signs HB 353 (Electronic Prescribing of Controlled Substances) into Law 29 PPCN Update

RESEARCH 37 Professional Development for the Practicing Pharmacist: Demystifying Research

Associate Editor: Victoria Madonna Editor/Manager: Pat Epple PUBLISHED BY GRAPHTECH Alexis Kierce, Publications Manager (717) 238-5751 x119 alexis@thinkgraphtech.com For Advertising Information: Kristen Bergmaier, Account Manager (717) 238-5751 x124 kristen@thinkgraphtech.com

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

DESIGNED BY GRAPHTECH PHARMACIST STATE BOARD OF PHARMACY MEMBERS Institutional: Gayle Cotchen, BSPharm., PharmD., MBA Independent Community: Rob Frankil, RPh Chain Community: Janet Hart, RPh Chain Community: Theresa M. Talbott, RPh Independent Community: Mark J. Zilner, RPh Board of Pharmacy Meeting Dates: March 5, 2019 April 16, 2019 June 4, 2019 July 16, 2019

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.

Calendar of Events January 16-19

International Association of Compounding Pharmacists – Fort Lauderdale, FL

24-27

International Association of Compounding Pharmacists Educational Conference – Fort Lauderdale, FL

25-27

2019 Mid-Year Conference – Gettysburg, PA

25

PPAEF Board of Directors Meeting – Gettysburg, PA

Advertisers Index Pharmacists Mutual 2 PRS 4 IPBG 6 Value Drug Company 8 McKesson 13 EPIC 15 MedSafe 15 AmerisourceBergen 17 R.J. Hedges & Associates 19 APMS 35

26

Jefferson College of Pharmacy 35

PPCN Board of Directors Meeting – Gettysburg, PA

PTCB 35

27

RDC Back Cover

PPA Board of Directors Meeting – Gettysburg, PA

February 3-5

Regional Chain Conference – Palm Beach, FL

20

CE Webinar: Opioid Crisis: Past, Present, and Future

March 5-6

RxImpact – Washington, DC

22-25

American Pharmacists Association – Seattle, WA National Alliance of State Pharmacy Associations (with APhA)

23

Pennsylvania Reception at APhA

25-28

Academy of Managed Care Annual Meeting – San Diego, CA

The Editorial Board is excited to celebrate the 100th volume of Pennsylvania Pharmacist.

We would like to thank all of those who have submitted articles for peer review. Sharing your

April 27-30

National Association of Chain Drug Stores Annual Meeting- Palm Beach, FL

May 2

PPA Board of Directors

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

practice and research experiences helps move our profession forward.

KIM COLEY, PHARMD, FCCP Editorial Review Board Chair

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President’s Message The Battle of Gettysburg occurred July 1st through the 3rd, 1863.

This battle was the largest of the Civil War and is often described as the war’s turning point. PPA’s 2019 Mid-Year Conference, “The Battle for Patient Care”, will be held January 25th through the 27th in Gettysburg, PA. The significance of such a battle is not lost on our profession. We, as pharmacists, must continuously strive to fight those areas that harm us, or risk unwanted change and lack of growth to pharmacy. Pharmacists must continue our battle for proper patient care and the ability to ensure our patients receive the best treatment possible from the experts in our field – all of us.

The mid-year conference hosts events such as Student Poster Presentation, OTC Competition, and Know Pain, Know Gain Competition. Besides these annual events, pharmacists can earn CE through valuable programs on immunization, medical marijuana, transitions of care, and more. Attendance at these CEs and other educational and informative events is an ever-evolving process; PPA staff dedicates countless hours to ensuring the conference hosts what pharmacists, technicians, and students need to remain compliant and up to date.

Every year, I find myself reenergized as a pharmacist after attending a PPA mid-year conference. It is easy to get caught up in the hustle and bustle of our every day lives, and forget that while we are busy raising families, taking care of loved ones, or traveling to new places, that we also must focus on furthering our education. While reading a CE article and taking an exam can fulfill requirements, that method doesn’t have the same impact of sitting in a room with colleagues and gaining knowledge in person. In the words of Benjamin Franklin, “Tell me and I’ll forget. Show me and I may remember. Involve me and I learn.” The impact of having live CE on valuable topics cannot be replaced! The conference also offers excellent networking, time to grow in our profession, and some downtime to reflect with friends.

Lauren Simko, PharmD PPA President 2018–2019

“Every year, I find myself reenergized as a pharmacist after attending a PPA mid-year conference..”

— Lauren Simko

The mid-year conference has an excellent spotlight on our students, the brightest of our up and coming pharmacy classes. These students spend a lot of time and effort preparing and studying for the competitions, and support and encouragement from our attending pharmacists is key to the success! I have seen a number of these past students grow into excellent pharmacists and continue to support PPA and our growth for our profession. Please be sure to visit and support our students in their various endeavors throughout the weekend.

Abraham Lincoln said, “be sure to put your feet in the right place.

Then stand firm.” You’ve already decided to put your feet into our profession. Now, it is time to stand firm for what we know we can do for our patients. We can immunize against the flu for a patient who may have otherwise gone to the hospital with complications.

We can prevent a deadly dosage mistake written by an overworked prescriber. We can flavor an antibiotic for a frazzled mom who just wants to get her sick child home. What else can we do? We may not know that answer today, but if we stand firm through legislation, education, and continued support of pharmacy programs and policies, we will look back at 2019 and say, “wow, look how far we’ve come.” Let’s leave a legacy so future generations will look back at pharmacy, see the battles we’ve won and victories we’ve scored, and know that we took the time to promote a profession valuable to the health and well-being of all citizens of our nation.

www.papharmacists.com 7

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Welcome! New Members PPA Welcomes the following New Members who joined the association on October 6, 2018 – November 30, 2018. Please make these new members feel welcome and part of Pennsylvania pharmacy!

PHARMACISTS Amrik Boparai, Cherry Hill, NJ, Walgreens Pharmacy Michael Cardosi, Boothwyn, Pentec Health, Inc. Sean Clark, Pittsburgh, Duquesne University School of Pharmacy Daniel Fadden, West Chester, CVS Pharmacy Barbara Goldman, Jim Thorpe, Long Island University Karen Gathagan, Philipsburg, Woodward Pharmacy Tom Gossert, Waynesboro, Savage Family Pharmacy Robert Gwin, New Castle, The Hometown Pharmacy Barbara Knightly, West Chester, Pentec Health, Inc. Stephanie Koontz, Monongahela, Dierken’s Pharmacy Katherine Medei, Walnutport, Walgreens Specialty Pharmacy Brittany Mengel, Sandy Lake, Care Capital Management, Inc. Caitlin Mitchell, Lancaster, CVS Health Sitora Muhamedova, Morgantown, WV, CVS Patrick Newsome, York, PA Health and Wellness Elisa Ragozzino, Philadelphia, Broad Street Apothecary David Riley, Waynesboro Susan Ruediger, Sandy Lake, Medicine Shoppe 1729

Jacqueline Starr, Curwensville, City Drugs of Curwensville

Jefferson College of Pharmacy

Dafonso Davage, Temple Hills, MD

Arden Gewirtz, Linwood

Holly Graber, Pennsberg

LECOM School of Pharmacy

Sejla Jukic, Pittsburgh

Tazifor Asong Tazoh, Erie

Brooke Kulusich, Hermitage

Andrew Trivino, Perkasie, Sellersville Pharmacy

Emily Caldwell, Erie

Emily Liu, Southhampton

Ashley Crandall, Erie

Tristan Thompson, Pittsburgh

Leeann Webster, Spring Mills, Geisinger Health System

Joseph DeDionisio, Harborcreek

Alecia Zika, Valencia

Kirk Guidotti, Erie

Philadelphia College of Pharmacy

ASSOCIATES

Lauren Howell, Erie

Vidhi Gandhi, Passaic, NJ

Jami Leavell, Duncansville, Value Drug Company

Thu Huynh, Erie

Thao-Quyen Truong, Wilmintton

Warren Melick, Ottsville, MoMed, Inc.

Emily Kulesza, Erie

Nina Vo, Richboro

Mataya McPherson, Galeton

Wilkes University Nesbitt School of Pharmacy

Kelsey Sucre, Coraopolis Kaitlyn Sullivan, Allison Park, Palmer Drug

TECHNICIANS Christan Gist, Pittsburgh, Asti’s South Hills Pharmacy Bethany Rietscha, Indiana, Gatti Pharmacy Madalyn Taylor, Indiana, Gatti Pharmacy STUDENTS Duquesne University School of Pharmacy Tarick Alayli, Pittsburgh Kathleen Dawson, Pittsburgh Joshua Dorazio, North Huntingdon Abigail Harvey, Lilly Madison Hawkins, Spring Brook Township Dennis Kiesel, Latrobe Lindsay Roberts, Avon, OH Michael Sevic, Pittsburgh

Linh Nguyen, Carlisle Chibuzo Ochiobi, Marietta, GA Michael Sapmee, Erie Nicole Simmons, Perry, OH Cody Staebler, Erie Wyatt Truba, Erie Marissa Zack, Erie Chantal Zony, Coatesville Ohio Northern University Raabe School of Pharmacy

Liam Bartko, Lake Ariel Shataya Buxton, Williamsport Maryann Chapin, Hanover Township Michaela Free, Williamsport Gabriella Karam, Easton Jacob Klock, Bloomsburg Ryan Michael, Nuremberg Allison Middernacht, Milton John Roberts, Old Forge

Courtney Smith, North Huntingdon

Patrick Speakman, Swarthmore

Abigail Staskiewicz, Mars

Maria Torsiello, Wilkes Barre

Elizabeth Tripp, Union City

Thanh Truc Vo, Greencastle

Emily Walck, Newmanstown

Jay Young, Pottstown

Temple University School of Pharmacy Harutyun Khachatryan, Philadelphia Zhijian Liang, Norwich, CT Dia Takiedine, Holland

Karli Sartorio, Eagleville

Benjamin Smeresky, Wexford

Lisa Scannapieco, Chester Springs, Pentec Health, Inc.

Sandhya Vijapurapu, San Jose, CA

University of Pittsburgh School of Pharmacy

Jasper Wolfe, McDonald

Patrick Booth, Middlefeild, CT

www.papharmacists.com 9

Member News Thank you Coleen!

PPA would like to recognize Coleen Kayden, RPh, who has served as the PPA representative on the State’s Medical Assistance Advisory Committee (MAAC) for over ten years. We thank you for your expertise and commitment to serving patients in Pennsylvania. Deron Shultz, RPh will be assuming this position starting in January 2019.

Congratulations to our Membership and Program Coordinator!

PPA’s Membership and Program Coordinator, Rachel Rhodes and her husband welcomed a baby boy, Jameson Joshua, to their family on August 22nd at 9.2lbs and 22 ¾ inches. Congratulations to Rachel and her family!

Congratulations to the PPA Couple!

Kyle McCormick, PharmD and Pam McCormick, PharmD, welcomed a baby boy, Theodore (Theo) on August 29th at 7lbs 9oz and 20.5 inches. Theo has already enjoyed his first PPA Conference/road trip to Lancaster in October.

Congratulations to Kyle and Pam!

In Memoriam Value Drug Company bids farewell to one of their longtime board members – Joe Cippel, owner of Klingensmith’s Drug Stores. Joe began his employment at Klingensmith’s at the age of 12 and later graduated from the University of Pittsburgh.

After taking over ownership of Klingensmith’s, Joe continued to expand the business and there are currently eight locations in the surrounding communities. PPA extends our condolences to the family and colleagues of Joe. It is with a heavy heart that we announce the passing of P4 student at Jefferson College of Pharmacy and PPA’s SAB Corresponding Secretary, Jose (Joey) Fernandez. We thank Joey for his service to Pharmacy in Pennsylvania and PPA. Our thoughts go out to his family, friends, and the Jefferson Community.

FOLLOW US ON SOCIAL MEDIA @PAPHARMACISTS

SHARE YOUR NEWS WITH US Send all snippets of achievements and honor to PPA’s Membership and Marketing Coordinator — Victoria Madonna at vmadonna@papharmacists.com

10 Pennsylvania Pharmacist — Jan/Feb 2019

Affiliated Member News ACPA Update ACPA was well represented at the PPA Annual Conference in Lancaster. ACPA President, AJ Greco and ACPA President-Elect, Amy Woods, led a contingent of members at our booth in the Exhibit Hall. ACPA members including Renee’ Richardson, Chiara Gessler, and Ashley Firm, presented continuing education sessions. And on Saturday night, several ACPA members were honored with awards, including: • Excellence in Innovation Award sponsored by Upsher-Smith winner, Lindsey Meston • PPA Preceptor of the Year Award winner, Kyle McCormick • George H. Searight Community Service Award winner, Nicholas Wytiaz

• George S. Maggio Memorial Award winner, Shawn Nairn • J. Allen Duffield Pharmaceutical Industry Award, Patrick Lavella We were proud to have ACPA Past President, Donna Hazel, install Lauren Simko, another ACPA Past President, as PPA President for 2018-2019. We have a lot to celebrate in southwestern Pennsylvania!

This fall, ACPA was busy on other fronts as well. Just in time for Halloween, ACPA members were treated to an educational program, presented by Dr. Belden, and hosted by Dana Sabatos and Janssen. ACPA members continue to volunteer with events for Greater Pittsburgh Community Food Bank, including Produce to People.

www.papharmacists.com 11

BMPA Update The BucksMont Pharmacists Association was once again well represented at this year’s annual PPA conference.

We had over 10 members in attendance and several of our members were recognized for their accomplishments and activities in service of PPA. Chanel Epstein was the proud recipient of the 2018 PPA Pharmacy Technician of the year award and Rick Demers was inducted as the president-elect of PPA. Our booth was well attended as meeting attendees were treated to some useful giveaways. At the Sunday morning breakfast BMPA Secretary Scott Himler announced that the recipients of the annual BMPA/PPA scholarship award were Temple pharmacy students Sarah Groome and Samuel Ewusie.

L-R: Rob Schreiber, Dave Cunningham, John Barrett, Melissa Barrett, Julie Gerhart-Rothholz, Charlie Palilonis, Jan Kitzen

L-R: Andrew Trevino, Rob Frankil, Eileen Frankil, Mike Brown, Taylor Shields, Chanel Epstein

On Thursday, October 25, BMPA hosted an informational dinner event sponsored by Pfizer, Inc. at the Hilton Garden Inn in Fort Washington, PA. Keynote speaker Dr. Matthew Hillis, Marple Medical Associates, presented an interesting lecture titled “Clinical Trial Results Complemented by an Independently Funded Real-World Database Analysis in Patients with Non-Valvular Atrial Fibrillation (NVAF).”

The prevalence of A-fib and the need for therapies such as Eliquis® (apixaban) prompted much discussion regarding coverage for Medicare Part D patients who are in the “donut-hole” gap.

Following the Pfizer presentation, immediate PPA past president Nick Leon delivered an interesting presentation on PPA’s Pennsylvania Pharmacists Care Network (PPCN).

After a lively interactive delivery, with much discussion, Nick met with various BMPA guest Nick Leon, immediate past attendees one-on-one to answer president, PPA, led a lively discussion on more specific questions. the benefits of joining PPCN. The evening concluded with BMPA VP Rob Frankil congratulating Samuel Ewusie, (pictured left) one of the recipients of our annual BMPA scholarship award. Event Manager Ashley Robold announced that a sponsor has offered to host a social event next Spring.

12 Pennsylvania Pharmacist — Jan/Feb 2019

LCPA Update In September, LCPA attended a presentation by Dr. Ashlyn Ritter, PhD through AbbVie Pharmaceuticals on endometriosis treatment and women’s health at The Press Room in Lancaster. It was an informative talk which brought new information on the disease, how it is currently treated, and how this new drug may fit into the current treatment regimen.

October brought a collaborative meeting between LCPA pharmacists and members of Lancaster General Health.

LGH physicians, nurses, and pharmacists hosted this discussion at their Lancaster Campus on how we, as a group, can make the transition from hospital to home more efficient for patients who utilize personalized packaged medications. Both groups were able to explain how their process is currently operating and helped identify potential areas for improvement.

October also hosted the annual LCPA Installation banquet held this year at Carr’s Restaurant in Lancaster. It was a well-attended event by both active and retired pharmacists which included the 2018 Bowl of Hygeia recipient, Richard H. Williams and a charter member of LCPA, Harold S. “Skip” Rhodes. The evening concluded with the swearing-in of the new board.

Members were eligible to earn two opioid CE credits at the November meeting hosted by LCPA and Wellspan Health at Wellspan’s Ephrata Campus. Physicians, pharmacists, and Philhaven mental health specialists spoke on both opioids and addiction. Information on the importance of step therapy with non-opioid options were presented as well as pharmaceutical and non-pharmaceutical treatments of addiction. Overall, the event was informative and well received.

Please visit our website for upcoming LCPA events at www.lancasterpharmacists.com.

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www.papharmacists.com 13

Student Member Profiles for school and other workrelated responsibilities.

Why did you choose to become involved in PPA?

Sara Groome Warminster, PA Temple University School of Pharmacy PharmD Candidate 2019 How did you hear about PPA? I first heard about PPA when I joined APhA as a PY1 student, so I automatically became a member via APhA. Favorite drug name to pronounce Latanoprost--Every time I talk to patients at CVS about this medication, they point out my Philly accent.

Flashback to your first year of pharmacy school; what advice would you give yourself knowing what you know now?

I would tell myself that it is important to balance school, work, and family-and sleep! During my first few years of pharmacy school, I was so focused on getting good grades that I barely made time for myself and my family. Now, spending time with my family and being cognizant of my mental health is of utmost importance, all while still ensuring that i make time

I became involved in PPA because I wanted to be a part of a pharmacy organization that felt close to home. I truly am passionate about pharmacy, and being a part of PPA has allowed me to become an advocate for our profession. I also knew I would have opportunities to showcase research through this organization, which was important to me.

of mine is to make an impact on combating antimicrobial resistance through community education in urban areas, such as Philadelphia.

Favorite food you have eaten on campus?

There’s always pizza at organizational meetings, which is always something to look forward to!

Where do you think you’ll be in 5 years?

I would like to think that I will be an infectious disease clinical pharmacist at a large tertiary care hospital in Philadelphia. I also wish to be part of an antimicrobial stewardship team. One career goal

14 Pennsylvania Pharmacist — Jan/Feb 2019

I like to pronounce Sulfamethoxazole!

Why did you choose to become involved in PPA? I want to be involved in spreading information about pharmacy to the community and to students on campus.

Have any professors influenced you since you have starting down this career path?

My freshman biology professor, Dr. Christopher, was one of the few female professors I have had at Duquesne. I love seeing strong women in STEM; it encourages me!

Have any professors influenced you since you have starting down this career path?

One professor in particular that has influenced me is my Infectious Disease teacher, Dr. Jason Gallagher. I never knew what area of pharmacy I would be interested in when I started school, but ever since he taught us our PY1 Intro to ID class, I have been enamored by ID. Dr. Gallagher has always made this area of pharmacy especially intriguing with each of his lectures, and because I have had such a great teacher, his influence has now made me want to pursue a clinical career in this field.

Favorite drug name to pronounce

Where do you think you’ll be in 5 years?

Cassandra Patterson New Castle, PA Duquesne University School of Pharmacy PharmD Candidate 2023 How did you hear about PPA?

In 5 years, I would like to be working as a clinical pharmacist in a hospital.

Favorite food you have eaten on campus?

My favorite food to eat on campus is Chick-fil-A!

I’ve heard about the pharmacy related activities that PPA does on campus and in the community.

If you, someone you know or a pharmacy would like to be featured in a future issue of the magazine, please contact Victoria Madonna, Membership and Marketing Coordinator at vmadonna@papharmacists.com

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Member Profile How has becoming a member of PPA made you grow professionally?

Frank Konzelman Jr., PharmD, BBA Inpatient Pharmacist Einstein Healthcare Network Philadelphia

What is the most important piece of advice you would give a newly licensed pharmacist on their first day of work?

It’s ok to not know everything. Take your time and look it up. Ask a mentor. Don’t be afraid to tell a patient you need to get back to them.

I’ve been connected with so many great pharmacists across the state. I get to see how pharmacy is practiced in all different settings.

I have become more comfortable bragging about myself. I’ve been encouraged by mentors to get involved in leadership positions and am currently a participant in the current LEAD class.

Name the number 1 reason why you became a pharmacist?

I was working as a technician in a retail setting and enjoying it. I was figuring out what I wanted to do with my bachelor’s degree and my mom, who is a nurse, encouraged me to look into becoming a pharmacist. At that point I did the prerequisites and applied to pharmacy schools.

16 Pennsylvania Pharmacist — Jan/Feb 2019

Is there anyone in your professional career that helped shape you into the Pharmacist you are today?

All of my mentors have shaped me in one way or another. The biggest influence while I was an intern was my manager, Bill Rolland. He gave me experiences of counseling patients, making therapy recommendations and just let me work to the fullest extent of my license as an intern. It is something I now try to emulate when working with technicians and students who rotate through my practice site.

Out of anywhere in the world, if you had to choose a different place to live and practice pharmacy where would it be and why?

I’ve practiced in Honduras with an organization called Global Brigades and love it.

I get to help people in areas that are poorly funded.

Sometimes we have to come up with a way to treat a patient without all the resources we take for granted here in the United States. The patients there just are so very grateful for everything we do for them.

It’s why I continue to go back as often as possible.

Best thing you ever ate?

My dad’s BBQ pulled pork.

It marinates for 3 days and then cooks on low overnight. So tender and so good.

Call for Nominations! Nominations Being Accepted for PPA Officers and Members of the Board of Directors The following positions are available: President Elect and Vice President Regional Directors – Northwest and Southeast Practice Network Directors – Community Independent/LTC, Health-System, Academia.

And Associates Student Pharmacists – East and West Directors Help lead your profession and pharmacy forward!

Officers PPA’s Nominating Committee is seeking nominations from our membership for the officer positions of President Elect and Vice President. This is a great opportunity to help lead the profession.

Candidates for the office of President Elect and Vice President must be Active Pharmacist members of PPA. Job descriptions for officer positions and the Board may be found by clicking on the respective position on the PPA website, under About PPA, and selecting Leadership Team. While it is recommended that Officers have prior Board experience it is not a Bylaw requirement.

Regional Directors PPA is also seeking pharmacists interested in serving as the regional director for their region. The position is a two-year term and individuals are eligible to serve two consecutive terms. The Director serves on the PPA Board of Directors and generally represents that region. PPA is comprised of five regions and this year the regions that are up for election are: Northwest and Southeast. To see what areas comprise a region – please go to the PPA website, then under About PPA, select Leadership Team. On that page, click on Regions. You can also find a job description for the Regional Director.

Practice Network Directors The Nominating Committee also needs individuals willing to lead their practice setting through their Practice Setting

Network. A Director is needed for each Practice Network up for election this year. Terms are two years and individuals may serve two consecutive terms. The Director serves on the PPA Board of Directors. The following Practice Setting Networks are electing a Director this year: Community Independent/ LTC, Healthsystem, Academia and Associates.

Student Directors Student Directors, of which there are two, one from the Eastern schools (Jefferson, PCP, Temple, or Wilkes) and one from the Western schools (Duquesne, LECOM, Ohio Northern University or Pitt), elect every year for one year terms.

Any individual member or group of members may nominate someone for consideration. However, prior to submitting a nomination, the individual’s consent must be secured. Individuals may also nominate themselves. All nominations are to be received at the PPA Office by Friday, March 1, 2019.

Letters/faxes/emails of nomination should be sent to: Pennsylvania Pharmacists Association, 508 North Third Street, Harrisburg, PA 17101-1199, Attention: Nominating Committee or faxed to 717-236-1618. They may also be sent to the general PPA email to the committee’s attention, ppa@papharmacists.com.

Nominations may initially be a simple statement of interest.

Candidates will then be requested to submit photos, additional information, and bios or CVs.

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www.papharmacists.com 17

Legislative Profiles Sen. Lisa Boscola What are the key issues you would like to see addressed this session?

1. Property Tax ReformBringing relief for seniors and working families.

2. Redistricting ReformMay be too late for next census, but still needs to be addressed.

3. Expediting the implementation of the new fair funding formula for public education.

Senator Lisa Boscola The funding formula was D-18 approved unanimously by the Basic Education Funding Commission. School Districts in my Senatorial District were underfunded in the 2018-19 budget by nearly $41 Million.

4. Election Reform: Allowing greater access to voting.

5. Allowing Initiative and Referendum in PA Tell our members a little about your background and why you are a legislator?

I grew up in the City of Bethlehem, went to Villanova for my bachelor’s and master’s degree, and came home where I worked as Deputy Court Administrator for Northampton County.

I went in to Public Service because my mother at a young age instilled in me the belief in public service and how public officials can be agents of change. I also learned a lot from the late Senator Jeannette Reibman, who my mother supported, and whose district I now represent. I jumped into to an open State House race in 1994 when I was told to wait my turn, but I knocked on thousands and thousands of doors to upset the Democratic establishment candidate and bucked the R trend to win the general election.

How do you see pharmacy and its role in health care evolving in the future?

Pharmacists are no longer just the person behind a wall dispensing and filling prescriptions. Pharmacists are now looked upon as another spoke in the wheel of providing health care through interacting with patients and other health care professionals. And, with the cost of health care being an important issue, their role in ensuring patients are provided cost effective medicines will only increase.

18 Pennsylvania Pharmacist — Jan/Feb 2019

Advice for pharmacists about the political process?

Never hesitate to make your voice heard! When issues impacting your profession are up for consideration or should be up for consideration, reach out to your local legislators and provide them with your professional knowledge on how a proposed bill or regulation will impact not only the profession, but more importantly, how it will impact the lives of your customers.

What do you do for relaxation or enjoyment?

I enjoy reading, preferably a good fiction series such as Game of Thrones that provide an escape. Also, I enjoy exercising whether it’s a spin class or a swim or even participating in great events like the City to Shore. And, last but not least rooting on my Villanova Wildcats and the Super Bowl Champion Philadelphia Eagles!

Rep. Tarah Toohil What the key issues you would like to see addressed this session?

School property tax relief is my number one fight for the upcoming session. We have many of our senior citizens, on a limited income, who choose between paying for their prescription drugs and paying for their school property taxes. They are literally Representative choosing between necessary Tarah Toohil medications and having a R-116 roof over their head. We have seniors who lose a spouse and are immediately one step away from losing their homes. We need to immediately reform the way we fund our public schools because the system is antiquated and restricts investment in education based upon the zip code in which a child lives.

Tell our members a little bit about your background and why you are a legislator?

My parents fostered over 42 foster children when I was growing up. The poverty, neglect, and abuse that some of these children had endured had a profound impact on my life. I saw the Capitol building as a place where I could advocate for voiceless children and try to change the laws to add more protections for children against predators and abusers. I am proud to sit on the Children and Youth Committee where we work to change the cyclical nature of the child welfare system.

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Legislative Profiles continued How do you see pharmacy and its role in health care evolving in the future?

The role of the pharmacist is becoming more crucial than ever as science is modernizing medicine and there is less human contact between doctors and patients.

With the growing price tag on health care, the rise of telemedicine, cell phones, and skyping, it is very important that pharmacists serve their patients as a checkpoint.

Sometimes the pharmacist is the gatekeeper who catches conflicting prescriptions and sees the symptoms when the patient comes to pick up their drugs. Pharmacist have played a huge role in combatting the opiod crisis with the implementation of our statewide database. We need to fight to preserve the Pharmacist- Patient relationship and not let it get outsourced completely to the large Mail Order organizations.

Advice for pharmacists about the political process?

desperately need your input! Even if you aren’t someone who enjoys politics please get in touch with your state legislator and make your voice be heard. There is no replacement for the real world experience and real life examples that a pharmacist can share with a legislator to explain an issue that needs a regulatory or legislative change. I need as much information as possible in order to make an educated vote that will have a positive impact on patients, their medication, and the health care available to them.

What do you do for relaxation for enjoyment?

Any spare time I have I like to spend with my husband, Scot, and our 5 children at one of their many sporting events. Our children are active in baseball, soccer, football, basketball, golf and wrestling so there is always a sporting event. Reading books and watching sports have become my favorite ways to relax.

As a pharmacist you are the expert in your field. I do not know any legislators who are former pharmacists, so we

www.papharmacists.com 19

Pharmacy Spotlight The Comeback Pharmacy In 1980, Mayank Amin’s parents migrated from India with only a 5 dollar bill and two pairs of clothes. Born and raised in Lansdale, Amin grew up hearing stories of his parent’s struggles to provide for their family.

In high school, he started his career in pharmacy by taking a job as a technician at a local pharmacy just a few miles away from his home. “I was initially unsure if I wanted to pursue pharmacy but as I got a better understanding of how important pharmacies/pharmacists are in the community, I decided I want to make a difference and I chose pharmacy” said Amin. Fast-forward a few years, he graduated from the Philadelphia College of Pharmacy in 2009.

Flashing back to 1968, Skippack Pharmacy was a staple in the Skippack, Schwenksville, and Collegeville areas (Montgomery County) when Marvin Frankil and his son, Rob Frankil, the original owners, were operating the pharmacy. During that time, Skippack was one of the only local shops in town, which meant it was the go-tostore of its time. Over many years, Skippack became a friendly face in the name of pharmacy by showing compassion for their patients, employees, and community. In 2013, Skippack went through a change in ownership and soon enough was sold to a major chain down the street. Thus, Skippack had closed its doors for the first time after nearly 50 years of business. On one day patients were coming in to get their medications and without any notice the next day they were welcomed to red signs which were placed in the store’s windows stating that their prescriptions had been transferred. Nearby pharmacies placed signs outside their businesses welcoming Skippack’s patients. “I did not think much of it initially but then took a drive by the old pharmacy and each time I would drive by I would see patients distraught looking in through the windows as if they had lost something very dear to them. Some of these patients were coming here for nearly 50 years and did not know where to go” said Amin.

Amin quickly contacted the property manager and expressed his interests in opening the pharmacy back up in the exact original location so that he could create new

20 Pennsylvania Pharmacist — Jan/Feb 2019

patient encounters and a family of employees for the next generation. Several months later, the space was flipped, renovated and is now open for business to the community.

In order to keep the Skippack name relevant, Amin places a big emphasis on a sense of community and supporting small businesses as well as community partners. “We have tried to use local shops for nearly everything we have done to reopen, including signage, interior design, and construction. We also have a charitable program that for every patient we see, we will provide a medication review and health essentials to an individual in an underserved area” said Amin. While this program is in its infancy, Amin plans to start from ground zero and gain a customer base one patient at a time. Amin and his staff will be able to track, monitor, and continue to grow this program as their patient family grows.

If you’re in the area and need to fill a prescription or want to meet the friendly staff, Skippack Pharmacy is located in an antique-village setting in Skippack Village, a strip of independent, family-owned shops that serve a variety of needs.

When asking other pharmacists including the last owner about owning a pharmacy many advised him not to do it. “They told me that right now is not a good time for pharmacy and gave me a whole bunch of reasons why I should not open this pharmacy. I come from a background where when someone says why, I ask why not? Patients still need medication, patients still want the family-feel they’ve gotten for generations, and patients still need to be taken care of. While there may be lower reimbursement rates from insurance companies along with other current issues, pharmacy owners can and will stick together to push pharmacy forward” said Amin.

Skippack’s story is one of inspiration in this age of everclosing small businesses. The sense of determination and the passion to serve for the greater good of others will never go out of business.

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www.papharmacists.com 21

Growing our Future: 140 Years and Counting Double Tree By Hilton – Lancaster, PA Thank you to everyone who joined us in Lancaster on October 18th-21st for the 2018 Annual Conference ‘Growing our Future: 140 Years and Counting. More than 350 people attended some part of the four day conference! For additional photos from conference, please visit PPA’s website and Facebook page!

A Special Thanks to our Conference Sponsors!

Keystone Level Conference Sponsors: DermSource, Rite Aid Contributor Level Conference Sponsors: PerformRx, Walgreens, Kinray, First National Bank Saturday Breakfast Sponsor: DataScan Sunday Breakfast Sponsor: PharmPAC Thank you also to…RDC’s coordination of the golf-tee sponsorships, Rx Systems for providing the themed note pads for the conference, and S & L Solutions, LLC for sponsoring the lanyards!

Residency Showcase: PPA held their Annual Residency Showcase on Saturday with an overwhelming number of residency programs looking for potential residents! This year’s showcase featured over 40 residency programs from Pennsylvania and the surrounding areas! We would like to thank the following programs for attending this year’s showcase: We would like to thank the following programs for attending this year’s showcase: Abington Hospital Jefferson Health Albertsons Pharmacies Allegheny General Hospital Asti’s Conemaugh Memorial Medical Center Duquesne University Forbes and West Penn Hospitals Geisinger Geisinger Wyoming Valley Medical Center Giant Eagle Guthrie Robert Packer Hospital Howard County General Hospital

22 Pennsylvania Pharmacist — Nov/Dec 2018

Johns Hopkins Johns Hopkins All Children’s Hospital Johns Hopkins Bayview Medical Center Johns Hopkins Home Care Group Lancaster General Health LECOM Mainline Pharmacy Moses Taylor Hospital Nemours-Alfred I DuPont Hospital for Children Penn State Health St. Joseph Penn State Hershey Performrx Reading Hospital/Tower Hospital Rite Aid Rutgers University Sibley Memorial Hospital Sinai Hospital St. Luke’s University Health Network Suburban Hospital Thomas Jefferson University Hospital University of Pittsburgh School of Pharmacy University of the Sciences UPMC Pinnacle Harrisburg UPMC St. Margaret Winchester Medical Center

Achieving Independence Competition: This year, four schools of pharmacy competed in the 9th Annual Achieving Independence Competition! The teams that participated were from Duquesne University, Jefferson College of Pharmacy, Philadelphia College Philadelphia, University of Pittsburgh, and Wilkes University.

The University of Pittsburgh came out victorious! Team members included: Katie Van Golen, Alyssa Lear, Spencer Schlecht, and Julianna Slomer; faculty advisor was Dr. Karen Pater and Independent coach was Dan Asti, RPh. A big thank you to the competition judges: Ed Bechtel, Rob Frankil, Deron Shultz, Brian Sidone and Billy Thompson!

Exhibit Hall: Thank you to the companies who exhibited with us this year!

Abbvie US, LLC. Women’s Health Division Alchem Life USA Allegheny County Pharmacist Association Ananda Professional Beekan The Inventory Co Inc Best Rx Pharmacy Software Bucks Mont Pharmacists Association Cardinal Health Claritas P.S.M Datascan DermSource Epic Pharmacies First National Bank Florajen Probiotics Freesnius Kabi HabitNu Diabetes Prevention Program Ideal Protein of America Independent Pharmacy Cooperative Integral Rx Independent Pharmacy Buying Group Kinray a Cardinal Health Company Lancaster County Pharmacist Association

Mass Mutual McKesson Medicare’s Limited Income NET Program (LINET) Micro Merchant Systems, Inc. Pennsylvania Pharmacist Care Network PerformRx Pfizer Pharmacists Mutual Insurance Company PharmaDiversion LLC PharmPAC PPA Membership PPA Educational Foundation Prescribe Wellness PRS Pharmacy Services Pure Plant Health LLC QS/1 Real Value Rx Rite Aid RJ Hedges Rochester Drug Cooperative, Inc. (RDC) Rx Disposal Strand Clinical Technologies Temple University Value Drug Company Walgreens Wilkes University

Rite of Roses: We extend our deepest sympathy to the families, friends, and business associates of these members. Their contributions to the profession of pharmacy and the Pennsylvania Pharmacists Association will be forever etched on our memory to not be forgotten

In Loving Memory Of… Bob Maycon, PARD Board member – March 2018 Barbara Parsons, Cumberland Apothecary, Camp Hill, PA – 9/22/17 Robert J. Wasserman, Sproul Pharmacy, Broomall, PA – 12/16/2017 William Pronzato, Life Member from Montgomery County and regular conference attendee Irwin Reich, PPA Past President and community pharmacy owner before joining faculty at PCP – 6/26/2018 Joe Smith, former Director of Pharmacy at Jefferson Hospital – September 2018 Farzana Javid, a Temple University graduate and community pharmacist – 7/26/10 Joe Cippel, owner of the Klingensmith pharmacy chain in Western PA – 10/18/18

www.papharmacists.com 23

Golf Outing

We are especially grateful to the Tee Sponsors:

The PPA Annual Golf Outing benefiting PharmPAC and the Educational Foundation took place on Thursday, October 18th at Meadia Heights Golf Club. Thank you to all of the golfers who participated, and to all of our Golf Tee Sponsors. A special thanks to RDC for their coordination of the golf tee sponsorships!

• • • • • • • • • • • • • • • • • • • • • • • • • •

A smaller but enthusiastic group hit the links at Meadia Heights in conjunction with the PPA Annual Conference. It was a beautiful day and the course was challenging. The winning group with a score of 150 was Chuck Kray, Pat Lavella, Darrin Silbaugh, and Randy Tracy additionally – longest drive was won by Jerry Musheno, Closest to the Pin by Brandon Antinopoulos, Longest Putt by Rob Frankel, and Straight Drive by Darrin Silbaugh. Several others won the door prizes and Mulligan 50/50. The Annual Golf Outing raises money for PharmPAC and The PPA Educational Foundation.

AmerisourceBergen Becton, Dickinson and Company Drive Medical Harrisburg Pharmacy HD Smith Independent Pharmacy Buying Group Johnson & Johnson Consumer Keystone Pharmacy Purchasing Alliance Klingensmith’s Pharmacy McKesson/Healthmart Pharmacy La Pointique Lifescan Mill Street Pharmacy Mueller Sports Medicine Nature’s Truth/Sundance Vitamins Owen Mumford Pharmacists Mutual Companies Phillips Respironics Principle Business Enterprises Quality Care Pharmacies RDC RJ Hedges Scott Specialties, Inc. Sellersville Pharmacy Surgical Appliance Value Drug Company

PPA Leadership:

SPPA Student Advisory Board

PPA Board of Directors

From left to right – Front Row: Shannon Street, Amanda Schwenk, Jamie Celento, Shannon Ye, and Victoria Blake Back Row: Joey Fernandez, Andrej Quatrone, JJ Lapin, Elizabeth Leonard, Abigail Koi, and Dylan Fox

PPA Foundation Board of Directors From left to right – Front Row: Brian Sidone, Chuck Kray (VicePresident), Lauren Simko (President), Rick Demers (President Elect), Nicholas Leon (Immediate Past President), and Pat Epple (CEO) Second Row: Dylan Fox, Nicole Pezzino, Renee Richardson, Nickolas Kernich, Shawn Nairn, Pat Lavella, Shannon Ye, Darryle Tillman John Barrett and Chris Antypas.

From left to right – Front Row: Megan Weigand, Kyle McCormick, Maria Osborne, Janet Astle, and Victoria Blake Second Row: John DeJames, Missy Krause, Nick Wytiaz, Jerry Musheno, AJ Greco, Sarah Dombrowski, Ed Bechtel, and Pat Epple

24 Pennsylvania Pharmacist — Jan/Feb 2019

Leadership and Awards Reception and Dinner And the 2018 Award Winners Are… Richard Williams: Bowl of Hygeia Sponsored by the APhA Foundation, NASPA, and Boehringer Ingelheim Dick Williams, RPh is a 1960 graduate of the Philadelphia College of Pharmacy. He has owned and operated Williams Apothecary since 1970. He is a long time member of the American Society of Consultant Pharmacists (ASCP), National Community Pharmacists Association (NCPA), Lancaster County Pharmacists Association (LCPA) and the American Pharmacists Association (APhA). He is also a past board member of both Pharmacists Mutual and Teacher’s Mutual Insurance companies.

His history of community service spans many years from serving on the board for Lancaster County Mental Health and Retardation and as a member of the Antique Truck and Car Club of America.

He is also a Eucharistic Minister and active member of St Anthony’s Church of Padua located in Lancaster County.

Eric Esterbrook: Pharmacist of the Year Award Eric Esterbrook, RPh is a 1998 graduate of the Philadelphia College of Pharmacy and is the owner and operator of four independent pharmacies in the state of Pennsylvania. Besides his business savvy and strong work ethic, he has greatly contributed to the pharmacy profession through involvement in many organizations and groups. He is a PPA past president, has served as a PPA legislative committee member and chair, past– president of Berks County Pharmacists Association and tirelessly supports the Philadelphia College of Pharmacy. Eric is also active in his local community, serves on the Opioid Task Force for the Borough of Wyomissing and serves on the Board of Directors of Threshold Rehabilitation Services

Nicole Pezzino: Pharmacists Mutual Companies Distinguished Young Pharmacist Award Nicole Pezzino, PharmD, BCACP, CDE is a 2014 graduate of the University of Pittsburgh School of Pharmacy and is currently an Assistant Professor of Pharmacy Practice at Wilkes University Nesbitt School of Pharmacy. Moreover, Pezzino has a clinical practice site at Weis Markets where she works as a community pharmacist and Certified Diabetes Educator. In this role she has also initiated an accredited Diabetes Self-Management Education and Support

(DSMES) program and the Diabetes Prevention Program. Pezzino was also recently named a 2018-2019 Faculty Scholar by the National Association of Chain Drugstores Foundation and was previously one of PPA’s Top Ten Under Ten Award recipients. She is also a member of the board of directors of the Lehigh Valley Pharmacists Association and serves as the Academia Practice Director on PPA’s Board of Directors.

Lindsey Meston: Excellence in Innovation Award Sponsored by Upsher Smith Laboratories Lindsey Meston, PharmD is a 2015 graduate of the University of Pittsburgh School of Pharmacy. After completing PGY-1 pharmacy practice and PGY-2 ambulatory care residencies at the Ohio State University Wexner Medical Center, she joined Asti’s South Hills Pharmacy as a Clinical Pharmacist and Director of Clinical Innovation in 2017. Moreover, Meston has been instrumental in getting Asti’s recognized by the Centers for Disease Control and Prevention as a Diabetes Prevention Program provider. She has personally been commended for her efforts in shifting patient and provider perceptions of community pharmacists into more of an appreciation for them as clinical practitioners. She is also a member of the Allegheny County Pharmacists Association.

Kyle McCormick: PPA Preceptor of the Year Award Kyle McCormick, PharmD received his degree from University of Pittsburgh in 2014 and currently works at Gatti Pharmacy in Indiana, PA where he is the lead clinical pharmacist and preceptor for visiting pharmacy students. As a clinical pharmacists and preceptor, he goes above and beyond for his patients becoming a shining example of a community pharmacist and healthcare provider. He allows his students to work independently but guides them towards their set goals to better themselves as future pharmacists and to best prepare them for their chosen career following graduation. He is also able to teach his students about pharmacy in the 21st century and how we can help patients utilize technology to access their medications.

www.papharmacists.com 25

Megan Weigand: Pauline Montgomery Leadership Award

Thomas Franko: Cardinal Health Generation Rx Champions Award

Sponsored by Value Drug Company

Tom Franko, PharmD, received his Pharmacy degree from the Philadelphia College of Pharmacy in 2011. He currently serves as co-chair of the Pain, Palliative Care, and Addiction Education Committee through APhA. He led efforts to coordinate the first Pennsylvania Pain and Addiction Summit. He is currently the chair of the naloxone subcommittee for PPA and developed a live naloxone training program for the PPA Mid-Year meeting in 2017. Since 2013 he has presented over 22 hours of CE credit at PPA conference through PPA webinars, most of which was focused on drug abuse and appropriate management of pain. He is also a part of the “Know Pain Know Gain” competition that PPA offers.

He teaches pain management and substance use disorder to all pharmacy students at Wilkes University.

Megan Weigand, RPh, is a 1995 graduate of Duquesne University School of Pharmacy and is currently a Pharmacist at Ferri Pharmacy located in Westmoreland County. After graduation in 1995, she worked and eventually managed Ferri Nursing Home Pharmacy, a long-term care pharmacy serving over 1000 beds. She directed the pharmacy and also consulted for several hundred skilled and assisted care beds in various facilities.

When Ferri Nursing Home Service was sold in 2009, she took over the Ferri Pharmacy retail store and has managed it ever since.

Chanel Epstein: PPA Pharmacy Technician of the Year Award Epstein has worked as a technician at Sellersville Pharmacy located in Bucks County for last ten years. During this time she has sharpened her pharmacy and computer skills and has recently become lead technician in Sellersville’s high volume operation. She is now responsible for work flow and production even among the pharmacists. Epstein is versatile and can jump in at any of the pharmacy locations and is able to use the complicated medicine-on-time-system at our LTC pharmacy locations.

Epstein was also recently elected to the BucksMont Pharmacists Association Board of Directors as the first ever Technician representative on the Board and is an active PPA pharmacy technician member.

Honorable Judy Ward: PPA Legislator of the Year Award Representative Judy Ward has had a huge impact on the district she represents as well as her service in Harrisburg. She has served as the state representative for Pennsylvania’s 80th House District, which encompasses parts of Blair County and will begin her term as a Senator in 2019. Judy is a Registered Nurse, as well as a former small business owner, development professional and wellness coordinator for Ward Transport and Logistics. In the 2017-2018 legislative session, Representative Ward was the prime sponsor of House Bill 2211. This bill was a major priority for the pharmacy community and with Representative Ward’s diligent advocacy, it passed the House unanimously. This bill prohibits gag clauses and allows pharmacists to freely discuss less costly options, including a patient not using their insurance. Representative Ward is also a co-sponsor of HB 2212, our Fair Reimbursement in Medicaid legislation. Representative Ward has been instrumental to PPA’s advocacy efforts in her role as a member of the House Health Committee and House Human Services Committee and is actively involved in our Pharmacy Caucus.

26 Pennsylvania Pharmacist — Jan/Feb 2019

Nicolas Wytiaz: George H. Searight Community Service Award Wytiaz is a 2012 graduate of the University of Pittsburgh School of Pharmacy and is currently a Clinical Staff Pharmacist at West Penn Hospital located in Allegheny County. Wytiaz was very involved with PPA as a student pharmacist and after graduation was quickly elected to the Allegheny County Pharmacists Association Board of Directors as the Programming Committee Co-Chair and Vice President. He has enhanced the image of the profession of pharmacy within the community as a member of the Catholic Medical Association and Allegheny County Medical Reserve Corps. He volunteers for a local soup kitchen and with the Catholic Diocese of Pittsburgh as a lector, Eucharistic Minister, and volunteer pharmacist at Catholic Charities Free Health Care Clinic. He has also participated in medical mission trips to the Philippines, Peru, and the Dominican Republic.

Patrick Lavella: J. Allen Duffield Pharmaceutical Industry Award Pat Lavella, RPh graduated with his degree in Pharmacy in 1985 from the University of Pittsburgh School of Pharmacy. He is currently the Manager of Pharmacy Compliance for Value Drug Company.

Over the course of 20 years, Lavella owned and operated four independent pharmacies before getting involved in the wholesale distribution industry seven years ago. Lavella has been an asset to PPA by helping on various committees and projects including the formation of the PA Guidelines for Opioid Dispensing, the Independent Owners Forum and Advocacy Committee. He has been a strong advocate for independent pharmacy and presented testimony on many important legislative and regulatory issues.

Shawn Nairn: George S. Maggio Memorial Award Shawn Nairn, RPh received his pharmacy degree from Duquesne University in 1992.

He has become one of the most active and outspoken advocate west of Harrisburg for fair pharmacy treatment. His legislative involvement is unmatched. He is constantly contacting his legislators and rarely misses a meeting or conference. He is on the PPA Board of Directors and heads a very active email communication group notifying us of pertinent 3rd party and legislative issues. He also freely shares business tips with other owners so they can practice at the top of our game.

Daniel Hussar: PPA Mortar and Pestle Award Hussar graduated from the Philadelphia College of Pharmacy in 1962. For over 50 years he was a professor at the Philadelphia College of Pharmacy and touched the lives of more than 10,000 students. He recently entered retirement in June of 2018. In 2017, he received the Remington Honor Medal, an award that recognizes distinguished service and achievement from the American Pharmacists Association (APhA). He has served has a member of numerous professional organizations including the APhA, the American Society of Health-System Pharmacists (ASHP), and the Pennsylvania Society of Health-System Pharmacists (PSHP). He has also served as a member of the Board of Trustees for the APhA and is a Past President of the Drug Information Association and PPA.

Student Organization Awards Wilkes University Nesbitt School of Pharmacy: Membership Award

The Membership Award is presented to a school that has made outstanding efforts in membership, participation, and recruitment of students in order to strengthen PPA and Pharmacy in Pennsylvania. Points were awarded for overall membership numbers, conference attendance, membership activities, and also special credit was given for creative and innovative efforts.

In selecting Wilkes University as the winning entry, their creative touch in developing unique events including their Oprah styled membership event with vials under each P1’s seat. Everyone won a small gift in their vials which included a PPA membership form.

Wilkes University did all of this while focusing on growing and retaining their current membership. This school has a total of 140 student members – 50 of them being new members.

University of Pittsburgh School of Pharmacy: Government Relations Award The Government Relations Award appropriately salutes the school which has gone above and beyond in the area of advocacy work. Points were awarded for participation in legislative day, meetings with legislators, PAC awareness, and other innovative advocacy efforts. The University of Pittsburgh School Of Pharmacy made a major impact in advocating for pharmacy by sending almost 70 students to Pharmacy Legislative Day and participating in 51 legislative meetings. Additionally, this school had the highest number of GRASP graduates in the 2017-2018 school year and exceeded their GRASP goal for the year.

Wilkes University – Nesbitt School of Pharmacy: Public Relations and Awareness Award The Public Relations and Awareness Award recognizes the school that really worked at developing and participating in public awareness and community activities like promoting the role of the pharmacist and participation in generation Rx and Katy’s Kids.

Credit was also provided based on communications activities with PPA through the Student Voice, articles in the journal, and media outreach and of course imagination and creativity were rewarded. Wilkes held six Katy’s Kids throughout the year, as well as had an active presence on their social media sites promoting PPA. This group even created a photo collage video to promote their chapter and all the great activities they provided for the community! The student group received a commemorative plaque and a $200 cash prize for their organization.

www.papharmacists.com 27

Governor Signs HB 353

(Electronic Prescribing of Controlled Substances) into Law House Bill 353, the E-Prescribing bill, was signed into law by Governor Wolf at a ceremonial bill signing in November. Pat Epple, CEO and Angela Zaydon, Government Relation Manager attended the bill signing along with others who worked with the PPA and were instrumental in the bill’s passage.

Known as Act 96 of 2018, the E-Prescribing bill amends the Controlled Substance, Drug, Device and Cosmetic Act to require electronic prescriptions of Schedule II, III, and IV controlled substances.

The bill was legally signed on October 24 and will go into effect in one year. Some of the key aspects of this legislation.

A pharmacist who receives a written, oral or faxed prescription shall not be required to verify that the prescription properly falls under one of the exceptions provided in subsections (a) and (b) from the requirement to electronically prescribe. A pharmacist may continue to dispense medications from the otherwise valid written, oral or faxed prescriptions that are consistent with current laws and regulations.

All electronic prescription applications shall meet the requirements outlined in 21 CFR § 1311.120 (relating to electronic prescription application requirements).

The electronic prescription requirement shall not apply if the prescription is issued: (1) by a veterinarian; (2) under circumstances when an electronic prescription is not available to be issued or received due to a temporary technological or electrical failure, and, in the instance of a temporary technological failure, a practitioner shall, within seventy-two hours, seek to correct any cause for the failure that is reasonably within his or her control; (3) by a practitioner and dispensed by a pharmacy located outside this Commonwealth; (4) by a practitioner who or health care facility that does not have either of the following: (i) Internet access; or (ii) an electronic health record system; (5) by a practitioner treating a patient in an emergency department or a health care facility under circumstances when the practitioner reasonably determines that electronically prescribing a controlled substance would be impractical for the patient to obtain the controlled substance prescribed by electronic prescription or would cause an untimely delay resulting in an adverse impact on the patient’s medical condition;

required by the Federal Food and Drug Administration or any other governmental agency that are not able to be accomplished with electronic prescribing; (8) pursuant to an established and valid collaborative practice agreement between a practitioner and a pharmacist, a standing order or a drug research protocol; (9) in an emergency situation pursuant to Federal or State law and regulations of the department; (10) under circumstances where the pharmacy that receives the prescription is not set up to process electronic prescriptions; or (11) for controlled substances that are not required to be reported to the Prescription Drug Monitoring Program system administered by the department.

(6) for a patient enrolled in a hospice program or for a patient residing in a nursing home or residential health care facility;

A practitioner, pharmacy or health care facility that does not meet an exception to the electronic prescribing requirements under subsection (a) or (b) and is unable to timely comply with the electronic prescribing requirements may petition the department for an exemption from the requirements based upon economic hardship, technical limitations or exceptional circumstances.

(7) for controlled substance compounded prescriptions and prescriptions containing certain elements

A prescription generated on an electronic system and printed or transmitted via facsimile is not an electronic prescription.

28 Pennsylvania Pharmacist — Jan/Feb 2019

If a pharmacist has a reasonable belief that a patient may be seeking a monitored prescription drug for a purpose other than the treatment of an existing medical condition, the pharmacist shall have the responsibility described in 21 CFR § 1306.04 (relating to purpose of issue of prescription).

The department shall require the prescription origin to be submitted by dispensers under the authority of the department in compliance with the act of October 27, 2014 (P.L.2911, No.191), known as the “Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP) Act.” Fines: A practitioner is subject to an administrative penalty of one hundred dollars ($100) for the first through tenth violations and two hundred and fifty dollars ($250) for each subsequent violation after the tenth violation, up to a maximum of five thousand dollars ($5,000) per calendar year. Violations shall reset and shall not carry over to subsequent calendar years.

The assessment of an administrative penalty pursuant to this subsection by the department to a practitioner shall not be reported by the department to the practitioner’s appropriate licensing board and shall not be considered a disciplinary action or need to be reported by the practitioner as a violation to the practitioner’s appropriate licensing board.

For a full copy of the Act – go to: https:// www.legis.state.pa.us/cfdocs/legis/CL/ Public/cl_view.cfm then put in 2018 for the year and Act #96, click Search.

PPCN Update

FOLLOW PPCN ON SOCIAL MEDIA! This fall PPCN launched the #ShareYourCare campaign to highlight the great care that PPCN pharmacists are providing in their communities. PPCN is on Twitter and Instagram!

Follow us on Twitter @ PPCN_CPESNand Instagram papharmacistsnetwork to hear about the great work of our pharmacists!

Patient Care Campaign Winners!

PPCN is proud to announce the winners of the Share Your Care Campaign: PPCN Pharmacy with the Highest Number of Encounters through October: Hometown Pharmacy in New Castle, PA PPCN Pharmacies with the Highest Percentage of Encounter Completion through October: Hunter Pharmacy, Curtis Pharmacy (Washington) and Mainline Pharmacy (Portage) all had at least 100% case completion!

Ron McDermott, Senior Vice President of Pharmacy Operations of Hometown Pharmacy Solutions states, “Our team is successful due to two main factors; first off we realize the importance of this program for our patients and for proving the value of independent pharmacy, and secondly, we measure our results and have fun with it! I’m proud of our team for the focus we have put on this and the results we have gotten. Bigger and better to come!”

Thank you to all of our PPCN pharmacists who are making an

impact on patients, and in the cost of health care. Please check out our report of patient care encounters to see examples of what our pharmacists can do, and what they can save a health plan!

PPCN Innovation and Payer Forum a Success!

During the PPA Annual Meeting in Lancaster on October 19th, PPCN hosted its first Innovation and Payer Forum. Representatives were present from 3 different Medicaid Managed Care Organizations- Gateway Health, United Health Care and Amerihealth Caritas Community Health Choices.

Discussion was active around the needs of health plan members and how pharmacists can meet those needs. The resounding theme was that “Data is powerful.” We need to be able to demonstrate our ability to improve patient health outcomes and reduce costs. PPCN is dedicated to showing the ROI that health plans will receive when they partner with PPCN. Stayed tuned for more news in 2019!

Expansion of Partnership with Gateway Health This fall PPCN expanded its partnership with Gateway Health to work more closely with the Gateway Health Care Managers. The care managers often have members that would benefit from the enhanced services that PPCN pharmacies offer, and they voiced an interest in learning how to refer members to a high-quality pharmacy. We “trained” the care managers on what makes a PPCN pharmacy different, and how to find one (www. papharmacists.com/locate) They are currently referring patients to PPCN pharmacies for the enhanced services that PPCN pharmacies offer!

Discussion of the Pharmacist’s Role in Public Health on a National Stage PPCN was invited to present at the American Public Health Association meeting in San Diego, CA in November. The presentation was titled - “A Network of Pennsylvania Pharmacists Reaching Patients Where They Are: Early Implementation of a Partnership with a Managed Care Organization.

Join Us in Gettysburg!

Please join PPCN during the PPA Mid Year Meeting in Gettysburg, PA on Friday January 25th, 2019. Start the day with the newly revised patient care training program, and join us in the afternoon for a PPCN forum and panel discussion. Hear from some of our PPCN All-Stars first hand on how they have been successful in implementing services into workflow, changing their business model, and connecting with other health care providers. We hope to see you there!

If you would like to learn more about PPCN, visit http:// papharmacistsnetwork.com/ or email PPCN Executive Manager Stephanie McGrath, PharmD at smcgrath@ papharmacists.com

Nick Leon, Pharm.D., BCPS, BCACP, FCPP, Associate Professor of Pharmacy Practice, Jefferson College of Pharmacy and PPCN Board Chair represented PPCN.

www.papharmacists.com 29

Patient Care Stories

from the dedicated pharmacists of the Pennsylvania Pharmacists Care Network Jeff Covelli, RPh, Hometown Pharmacy Reason for Encounter: �ncontrolled type � diabetes Encounter Summary: Patient A told Jeff that he wasn't taking his diabetes medications. The Pharmacist reached out to the Patient's prescriber to discuss the medication problems, to obtain lab work, and to request refills. The Pharmacist continues to follow-up with this patient to ensure that he keeps taking the medications and keep his blood sugar under control!

Referral: Prescriber Estimated Cost Savings: ���,��� for an E� visit for hyperglycemia

Ashley Firm, PharmD, Asti's South Hills Pharmacy Reason for Encounter: �ncontrolled type � diabetes Encounter Summary: Patient B reported that she stopped taking her insulin because she didn't feel any differently compared to when she did take it. The Pharmacist explained the necessity of insulin to the Patient and created a diabetes plan that the patient agreed to comply with. The Pharmacist discussed the plan with the prescriber and obtained medication refills for the patient.

Referral: Prescriber Estimated Cost Savings: ���,��� for an E� visit for hyperglycemia

Jill Lavella, RPh, Owner, Hilltop Pharmacy Reason for Encounter: Frequent headaches and blurred vision Encounter Summary: Patient C reported that she has been to the emergency room � times in the past � months for headaches and blurred vision. The Pharmacist took the Patient's blood pressure and noticed that it was elevated and most likely causing her symptoms. The Pharmacist provided education to the Patient and reached out to the Patient's primary care provider to discuss the encounter and encouraged the Patient to be seen as soon as possible!

Referral: Primary Care Provider Estimated Cost Savings: ���, ��� for an E� visit for headaches

Dominique Gross, PharmD, Hartzells Pharmacy Reason for Encounter: Weight gain Encounter Summary: The Pharmacist assessed that Patient D was at high risk for diabetes due to recent weight gain and lifestyle factors. The Patient reported that she was motivated to make lifestyle changes to decrease her risk and lead a healthier life� however, she has transportation and financial barriers. The Pharmacist created a follow-up schedule that worked for the Patient that includes phone and in-person appointments!

Referral: Weight management education Estimated Cost Savings: pending follow up

Sarah Audi BS, PharmD, CTTS, Mainline Pharmacy

Reason for Encounter: Smoking cessation and mental health Encounter Summary: Patient E expressed that she has been feeling depressed and is looking for help with smoking cessation, especially since she is pregnant. The Pharmacist provided education on "a healthy gut, a healthy mind" and information on safe treatment options that will help with her depression and help her quit smoking. The Patient followed-up with the Pharmacist and stated that the Pharmacist's recommendations have been really helping her mood!

Referral: Prescriber Estimated Cost Savings: ��,��� for annual health care cost of smoking, ���� for increased neonatal costs

These 11 examples highlight patient encounters from July to November 2018 and represent 10 of the 64 participating pharmacies. Estimated cost savings is based on published health care expenditures in Pennsylvania.

30 Pennsylvania Pharmacist — Nov/Dec 2018

These patient cases were collected by�

Sarah Audi BS, PharmD, CTTS, Mainline Pharmacy Reason for Encounter: Help with smoking cessation Encounter Summary: The Pharmacist provided education to the Patient F on the importance of smoking cessation, benefits it has for his health, and available resources and medication options. The Patient was agreeable to nicotine patches and the Pharmacist reached out to his prescriber for a prescription. The Pharmacist has follow-up appointments scheduled with the Patient to help support him through the process!

Referral: Prescriber, Quitline Estimated Cost Savings: ��,��� for annual health care cost of smoking

Brittany L. Carney, PharmD, CTTS, Mainline Pharmacy Reason for Encounter: Uncontrolled asthma Encounter Summary: �� year old Patient � reported he frequently had trouble with breathing, was waking up throughout the night, and used his rescue inhaler multiple times a day. The Pharmacist reached out to the Patient's prescriber to discuss and provided recommendations for therapy changes. Since the Patient started his new medication, he has been able to run around, play sports, and hasn't been getting winded like he used to. The pharmacist is also helping his parents quit smoking!

Referral: Prescriber Estimated Cost Savings: ���,��� for an �� visit for asthma/COPD exacerbation

Andrew Thomas, RPh, President, FB Thomas Drug Store Reason for Encounter: Uncontrolled COPD Encounter Summary: Patient H reported that she was having difficulty with her breathing, frequently experiencing shortness of breath, and has been using her rescue inhaler multiple times a day. The Pharmacist discussed with the Patient that she may benefit from starting a maintenance inhaler to prevent these symptoms. When the Patient picked-up her new medication, the Pharmacist provided education on inhaler technique and administration.

Referral: Prescriber Estimated Cost Savings: ���,��� for an �� visit for asthma/COPD exacerbation

Natasha Singh, PharmD, PGY-1 Resident, Hometown Pharmacy Reason for encounter: Severe depression Encounter summary: The Pharmacist provided education to Patient I on different coping tactics and techniques that may help the Patient when she is feeling down. The Pharmacist recommended behavioral health services which the Patient said she would consider. The Patient expressed immense gratitude and told the Pharmacist that she really changed her life during this encounter!

Referral: Behavioral health services Estimated cost savings: pending follow up

Dustin Murdoch, PharmD, Primary Care Pharmacy Services Reason for Encounter: Uncontrolled pain Encounter Summary: Patient J mentioned to the Pharmacist that his pain medication wasn't working for him and he couldn't afford to continue paying out-of-pocket for it. The Pharmacist reached out to the Patient's prescriber and recommended alternative therapy that is on the formulary and is preferred for the type of pain the Patient has. The Pharmacist provided education and counseling on the new prescription that the Patient was started on.

Referral: Prescriber Estimated cost savings: ���,��� for �� visit for pain

Thomas Tritinger, RPh, Kevin's Pharmacy Reason for Encounter: New opioid prescription Encounter Summary: Patient K brought a new opioid prescription to the Pharmacy and the Pharmacist recommended that the Patient also have naloxone on-hand along with the opioid. The Patient was agreeable to this recommendation. The Pharmacist then provided the appropriate counseling to the Patient and her family on the signs and symptoms of an overdose, what to do if this occurs, and how to use the naloxone if an overdose is suspected in order to save a life.

Referral: N/A Estimated Cost Savings: ���,��� for an �� visit for overdose

Call to Action for PPCN Pharmacists- we need you to share your stories!

Please keep sharing them with the PittPharmacy team, on social media using #shareyourcare or email Stephanie McGrath, Executive Manager of PPCN at smcgrath@papharmacists.com www.papharmacists.com 31

�oin the Pennsyl�ania Pharmacists Care Net�ork.

NOW IS THE TIME. Make a difference in the health of your patients, in your community. Sustain and GROW your business. �oin the Mo�ement.

Improve Health Outcomes Evaluate and monitor your patients' health Get paid for the quality care you provide Lower the total cost of health care

Sustain your Business Get paid for services you provide now Innovate and expand your model of practice Market your pharmacy to payers, providers and the community

Join the Movement Connect with over 1,500 pharmacies nationwide through CPESN USA Join Pennsylvania in leading the nation in community pharmacy innovation

�isit http���papharmacistsnet�ork.com� to learn more about PPCN and find a PPCN Pharmacy!

32 Pennsylvania Pharmacist — Jan/Feb 2019

Campus Checkup

LECOM School of Pharmacy

Ohio Northern University Raabe College of Pharmacy

Contributed by: Maria Peluso, Communication Ambassador

Contributed by: Morgan Augustine, Communication Ambassador

The last few months have been very exciting for LECOM Erie PPA chapter. Over the past couple of weeks, we have been participating in a membership drive, and have officially reached our membership goal for this year! Much interest was developed in PPA after we started completing GRASP modules together in our monthly meeting.

Both P1 and P2 students showed up to complete these modules in preparation for Legislative Day.

Classes are almost coming to a close with the holidays drawing near. As a chapter, ONU PPA had a successful membership drive. In addition, two of our members, Ryan and Mimi, attended the annual PPA conference in October.

We recently had our first general meeting where we discussed the goals of PPA and what we can do on campus.

We are trying to get outreach going through our chapter so members have the opportunity to get experience working in patient settings. As the fall semester comes to end, we are looking to plan another general meeting in the spring semester.

Also, LECOM Erie PPA had the opportunity to participate in World AIDS day, an event that was held on the LECOM Erie campus. Multiple clubs from the school participated in constructing squares to place into a quilt to support and acknowledge sufferers of AIDS. Three members were able to attend PPA annual in Lancaster, and especially enjoyed the residency showcase and diabetes ImPAC challenge. We are all looking forward to midyear!

Temple University School of Pharmacy Contributed by: JJ Lapin, Communication Ambassador Amid our busy schedules, our Temple PPA chapter has been busy organizing and executing a sale of embroidered Patagonia quarter zips that will help raise funds that we will split between the Temple alumni scholarship fund and PPA’s building fund. In terms of events, we presented a poster on the growing issue of antibiotic resistance and will be planning a Katy’s Kids event shortly after the new year, interacting with the elementary school students at a local charter school! The students that attended the annual meeting had a great time and enjoyed both the student programming as well as the CEs that we were able to attend, and we look forward to attending the upcoming mid-year conference in January!

University of Pittsburgh School of Pharmacy Contributed by: Emily Dell, Communication Ambassador Erica Jackson and Mekensie Huggler holding a membership drive in the cafeteria.

Elyssa Johannesen, Erica Jackson, and Christina Bizzarro creating the PPA square for the World AIDS Day quilt.

The Pitt Chapter of PPA has had a great semester, and we are excited for what we have to come in the next few months. We are very proud to recognize four of our Pitt Pharmacy students and PPA members for winning the Achieving Independence Competition at this year’s Annual Conference. The team members included Spencer Schlecht, Katie Van Golen, Alyssa Lear and Julianna Slomer. Please congratulate them if you see them! During the last week before the deadline for voter registration in October, we held a week-long tabling event to help people register to vote. With our efforts, we were able to get 10 people registered, 5 changes of address to Allegheny County, and 15 absentee ballots. Another fun event that

www.papharmacists.com 33

Campus Checkup continued we held this semester was called Phinance: Improve Your Financial Health. At this workshop, we had a Certified Financial Planner and University of Pittsburgh Alumnus talk to us about financial responsibility and planning after graduation. We learned a lot of valuable information, and

we hope to have other events like this in the future. So much more is to come in the following semester with the Mid-Year conference and Legislative Day in April. Next semester will be here before we know it! Have a fun and safe break!

Philadelphia College of Pharmacy Contributed by: Kayla Askey, Communication Ambassador The PPA Annual Conference from October 19-21st was very busy for the students, faculty, and alumni of the Philadelphia College of Pharmacy PPA student chapter. P3 students Samantha Frear and Sara Skoritowsi represented PCP in the first ever Diabetes Competition. Additionally, P4 students Karen Patel, Dhuval Patel, and Ina Pajo presented their business plan at the Achieving Independence Competition. For the PCP faculty, Drs. Harris and Melody presented a continuing education presentation titled “Developing a Community Pharmacy Technician-Driven Transitions of Care Program” to pharmacists from across the state (pictured). Finally, our alumni were very active in the Awards Ceremony. Dr. Daniel Hussar, P’62, MS’64, PhD’67, was awarded the Mortar and Pestle award, an award recognizing service to the pharmacy profession. Additionally, Eric Esterbrook, P’98, owner of Esterbrook Pharmacy, was awarded the Pharmacist of the Year Award. This award is given to a pharmacist who dedicates themselves to and furthers the pharmacy profession, shows great leadership, and contributes extensive time and effort in everything they do. We are very proud and excited for our alumni awardees.

Wilkes University Nesbitt School of Pharmacy Contributed by: Rachel Wood, Communication Ambassador The Wilkes’ PPA chapter has been in full force this semester. The Annual Conference was a blast for our 21 members in attendance. We were proud to see our professors, Dr. Shah and Dr. Franko present CE’s. We are also proud of our two P4 students, Abby Stevens and Taylor Hodle who presented on “The student pharmacist’s role in providing MTM services during care transitions” and “Medical marijuana 101: what you should know about the Pennsylvania Act” respectively. We were fortunate enough to have our hard work pay off and receive the Membership and Involvement Award and the Public Awareness and Communication Award. Lastly, Meghan Muretta and Erika Zarfoss represented us well and took first place in the Diabetes Competition.

In addition to the conference, we have held 9 Katy’s Kids Events so far and are excited for the many we have coming up next semester. We also had our club social at Roba Family Farms and held our mini OTC competition to determine who will represent Wilkes at the Midyear Conference. We hope to have an even more successful spring semester!

34 Pennsylvania Pharmacist — Jan/Feb 2019

Jefferson College of Pharmacy Gina Bellottie, PharmD Associate Professor of Pharmacy Practice

love being able to observe and provide individual “Ifeedback to our students when we have classes in our Pharmacy Practice Simulation Center. Through hands-on activities and simulations, our students take what they are learning in the classroom and put that knowledge into action, ensuring they are practice ready.

”

Advantages of being a Jefferson student include: • Individual attention toward learning • Individual career mentoring • Immediate patient care experiences Outcomes are demonstrated in our NAPLEX scores and postgraduate match rates. Learn more at Jefferson.edu/PharmDOutcomes

www.papharmacists.com 35

Pharmacy and the Law: Documentation in the Modern World

By Don. R. McGuire Jr., R.Ph., J.D. This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

The world continues to change and the way that we communicate with each other continues to evolve. This includes communication between you and your patients, and you and the prescribers. Pharmacists need to be able to sufficiently document their communications to support the actions taken in the care of their patients.

Early in my career, prescriptions were written on paper or called into the pharmacy. If clarification was needed after hours, it meant a call to the prescriber’s answering service. The response time was seldom fast. The next great improvement in communication was the introduction of pagers. The prescriber got a message to call the pharmacy directly, but didn’t know who the patient was or what the issue was. About this same time, faxing of prescriptions began to become more common. This included faxing refill requests to the prescriber’s office and the return fax of the authorization. This format created its own documentation.

The next step forward was electronic transmission of prescriptions from the prescriber to the pharmacy. No paper copy is generated with this method, but significant electronic documentation is available.

In today’s world, the speed of communication in the 1980s seems like the Stone Age. And as the speed of communication has increased, keeping a record or documenting these communications is not at the forefront of most people’s minds. Communications happen in the now. Keeping them for the future doesn’t seem important.

But it is important in professional communications. Texting patients and prescribers has become more prevalent as a fast and efficient means of communication. While nothing is ever truly deleted from cyberspace, trying to recover texts from two years ago should not be your documentation plan. Approach the documentation of texting as you would a phone call.

Documentation should be readily retrievable. In the past, documentation on the prescription itself was the favored location. That is still a good place for it, but we do not always have a paper prescription today. Computer systems have expanded documentation functionality today. You can also use a log book (paper or electronic) to document all communications. Documentation for texts is analogous to that for phone calls. The typical entry for a phone call includes date, time, person talked to, the question at hand, and the resolution. Documentation created out of a pattern of consistent behavior is every bit as admissible as a document itself. Documentation of texts should include date, time, the number texted, the question, and the resolution.

36 Pennsylvania Pharmacist — Jan/Feb 2019

In today’s world, the speed of communication in the 1980s seems like the Stone Age. And as the speed of communication has increased, keeping a record or documenting these communications is not at the forefront of most people’s minds.

Pharmacists should also take HIPAA into consideration when using texts to communicate about prescriptions.

What protected health information (PHI), if any, is being transmitted? If PHI is being transmitted, is the PHI protected from disclosure? The pharmacist should be careful that correct phone number is used for this type of communication. If the pharmacist is using their personal phone for such communications, is the information protected so that family members don’t accidentally have access to the PHI? This is another good reason to not let your children play with your phone.

In the fast pace of today’s world, documenting texts can be forgotten, but it is as important as documenting phone calls. Most pharmacists have developed a habit for documenting phone calls. This habit needs to be expanded to include the information that is being communicated by text. While those with Luddite tendencies might say that it would be better to eliminate the use of texting in this situation, I doubt that we will be able to stem the tide. Texting is becoming the preferred method of communication with many people. Proper documentation of those transactions is essential to complete your patient care records. © Don R. McGuire Jr., R.Ph., J.D., is General Counsel, Senior Vice President, Risk Management & Compliance at Pharmacists Mutual Insurance Company..

This article discusses general principles of law and risk management.

It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly.

Professional Development for the Practicing Pharmacist: Introduction to a new series in Pennsylvania Pharmacist Michael R. Gionfriddo Pharm.D, Ph.D; Geisinger Center for Pharmacy Innovation and Outcomes On behalf of the Editorial Board of Pennsylvania Pharmacist I am proud to introduce a new series entitled “Professional Development for the Practicing Pharmacist”. This is part of an ongoing effort to provide tools and resources to help our members thrive in today’s health care landscape. The series will cover a variety of professional development topics, solicited from and written by our members. A general overview of the research process will begin the series. Research is a key component of pharmacy practice but can often be intimidating.

Research, however, can be a rigorous tool that can help identify opportunities to improve your practice and potentially reduce costs. The first article in the series presents the basic steps in the research process. Future articles will cover specific topics related to research as well as other important professional development topics.

It is our hope that this ongoing series will be a useful resource for practicing pharmacists. If you have ideas for future articles or would be willing to write an article, please contact me at: mgionfriddo@geisinger.edu.

Professional Development for the Practicing Pharmacist: Demystifying Research Michael R. Gionfriddo Pharm.D, Ph.D; Geisinger Center for Pharmacy Innovation and Outcomes Research is vital to advancing the science and practice of pharmacy. Research is a systematic process that aims to produce generalizable knowledge. There are many different types of research that can be applied to many different types of problems.

Regardless of how the research is conducted, there are several common steps. More detailed information on each step will be covered in future articles.

1. Develop a research question The first step in any research project is to come up with a welldefined question. These questions can arise from something you observed in practice, something you have read, an unanswered question, or a topic of interest (see Box for examples). Questions that come from problems you face in your everyday practice are probably of significant interest to others and could have immediate practical impact if answered.

2. Search the literature Once you have defined your question, then it is important to determine if anyone has already answered it. This step is vital as it might lead you to conclude that you do not have to do your own original research or it may help you further refine your question.

While non-specific search engines (e.g. Google, Bing, etc.) may be used, there are more specific search engines available, some of which are freely accessible. One example is PubMed (www.ncbi. nlm.nih.gov/pubmed). PubMed is run by the National Library of Medicine and indexes articles from thousands of journals from across the globe. Some of these articles will be freely available, while others will be behind a paywall. PubMed Central (www. ncbi.nlm.nih.gov/pmc) is a subset of PubMed where all indexed articles are freely available.

3. Design your research After you have refined your question and determined that existing research does not adequately answer your question, then it’s time to design your research project. There are many different designs to choose from so it’s important to choose the one that best fits

not only your question, but also your available resources. You will need to determine your outcomes and how you will collect data to assess them and then how you will analyze that data. In addition to picking a general study design (including relevant outcomes and an analysis plan), you need to determine who will be involved in your study, both as participants and those who will help you conduct and analyze study results. At this point, it is often helpful to discuss your proposed research project with a statistician or other expert in research design to ensure that the design and analysis plan you choose is appropriate.

4. Submit your research to an Institutional Review Board (IRB) An IRB reviews research to ensure participants’ safety and privacy. An IRB consists of at least five members with varying backgrounds. Most IRBs are either affiliated with a university or health system. To find an IRB near you, the Department of Health and Human Services Office for Human Research Protections maintains a database of active IRBs: https://ohrp.cit.nih.gov/ search/irbsearch.aspx?styp=bsc. You need to have your research proposal reviewed by an IRB to determine if your project is considered human subjects research, if it is minimal risk, or if it presents greater than minimal risk to participants. If you plan on publishing your project, most professional journals will require a statement regarding this designation by the IRB. Generally speaking, most studies using previously collected data with no participant contact, especially if the data is de-identified, will be classified as exempt, and studies with minimal risk can be expedited (meaning review by a few members of the IRB but not the whole board). Finally, studies that are deemed greater than minimal risk will undergo a full board review.

5. Conduct your research/Gather your data Once your project has been reviewed by an IRB, you are ready to conduct your research. As you conduct your research, be sure to keep track of any problems or deviations from what you wrote in your research proposal as this may need to be reported.

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6. Analyze your results After you have finished collecting the data, it is time for analysis.

How you analyze your data will depend upon your study design and what type of data you collected, but generally falls into two categories: qualitative and quantitative. Broadly, qualitative data are words and quantitative data are numbers. Regardless of the type of data, if you are not experienced in data analysis it might be important to consult with someone who can assist you with your analysis. As mentioned above, it is often best to include these experts from the beginning of your project, so they can provide input on the study design and analysis plan.

7. Write up your results The last step in the research process is writing up your results.

This is arguably the most important step because if you do not document it, then neither you nor anyone else will have a record of what you did. Although listed last here, it is a lot easier to put it all together if you are building your report/article as you go along. Writing up your results helps communicate what you did and enables others with similar questions to use your answers rather than doing their own projects. There are useful guides for reporting research available from the Equator Network (www. equator-network.org) and most journals have specific guidelines for articles they publish.

38 Pennsylvania Pharmacist — Jan/Feb 2019

Example research questions What are patient’s attitudes towards tech-check-tech programs?

What is the risk of cough in patients taking statins?

What impact does a hand washing protocol have on infection rates compared to not using the protocol?

What are the cost implications of utilizing medication synchronization programs?

Key points • Research can improve the care we provide to our patients.

• Anyone can do research!

• There are many different approaches to research, but all have a similar structure.

Further Reading Hulley SB et al. eds Designing Clinical Research 4th ed.

Jacobsen KH. Introduction to Health Research Methods: A Practical Guide Freely Available: Office of Research Integrity Introduction to Research: www.ncbi.nlm.nih.gov

Making a Difference in the Opioid Crisis A real life story in pharmacists encouraging Narcan provision About 2 years ago, I attended the Pennsylvania Pharmacists Association Conference where then Physician General (now Secretary) Dr. Rachel Levine spoke. Dr Levine provided a comprehensive overview and plea to help in Pennsylvania’s Opioid crisis and urged pharmacies to stock and provide Narcan.

She stated that patients will come in and will ask for Narcan, and then she reviewed the procedure to use the standing order she had executed for just this purpose.

and very importantly “who is this Doctor Levine!” After answering their questions, and thoroughly counseling them, I would implore them to watch the YouTube video on administering Narcan.

I asked Dr. Levine, at that time, if the pharmacist could initiate the conversation and offer Narcan directly. Dr. Levine stated that by all means this would be very appropriate and in fact, she encouraged pharmacists to take an active role. Honestly though, while we would occasionally offer Narcan, we did not take an aggressive approach. At least until June 2018, when the Value Drug newsletter stated how disappointed Dr Levine was in regards to pharmacies dispensing Narcan on the standing order.

She especially voiced her concern that independent pharmacies had not more fully embraced this effort.

Additionally, my student pharmacists quickly embraced this opportunity to assist in counselling these patients. This is a perfect student experience opportunity! Since we started this initiative in late June 2018, we have dispensed 84 boxes of this life saving drug at Thompson Pharmacy, Broad Avenue, Altoona.

At that time I took note and decided to make a difference in this area. I worked with my technician, Brad Wigand, and together we started flagging patients that were taking over 100MME of opioids on a daily basis. We especially noted all of our Suboxone patients, who when they use two of the 8/2 strips , are ingesting 480 morphine milligram equivalents. Brad would run the prescriptions through, include Narcan, and then I would go out and counsel the patients on the appropriate use of Narcan.

Patients asked - why we were giving them this lifesaving drug,

At first a couple of patients were resistant when I approached them. However, usually after a couple of minutes of listening, they quickly understood what we were doing. More than a few said, “I’ve been on this drug for quite a while, but you are the first pharmacist that ever showed they gave a damn.”

Unfortunately some other pharmacists working for other pharmacies, especially chains, dismiss my approach to helping “those kind of people.” This is a sad statement on charity to our fellow man. I would encourage all pharmacists, but especially those in independent pharmacies where it is easier sometimes to implement programs such as this, to undertake a similar endeavor and get more Narcan into the hands of these people who, for whatever reason, desperately need it. This may be our one chance to make a difference - we can’t help people who are dead.

Peter A. Kreckel, RPh. Clinical Pharmacist and Manager Thompson Pharmacy

Pennsylvania MCOs Must Now Provide Oversight on Their PBMs The Pennsylvania Pharmacists Association, along with many of our partners, worked tirelessly with the Department of Human Services over the last year and a half to have these necessary changes placed into their contracts. Much of the language seen in the 2019 revised contract amendment to the PA managed care organizations outlining what they must do in terms of their PBM contracting is taken from our drafted legislation. So while we did not get the legislation passed, we still got something that will help! This is an important win for all community pharmacists, Pennsylvania taxpayers, and the Department of Human Services who will now have more oversight with taxpayer money.

The Pennsylvania Department of Human Services (DHS) has amended their contractual requirements for Managed Care Organizations which specify certain responsibilities for PBMs, including sharing their payment methodology and establishing an appeals process. The MCO’s are required to indicate their intent to use a PBM, identify the proposed PBM Subcontractor, the MCO’s payment methodology for payment to the PBM Subcontractor, the payment methodology for actual payment to the providers of covered outpatient drugs, and the ownership of the proposed PBM subcontractor. There are also new rules in place if the PBM is owned wholly or in part by an MCO, retail pharmacy provider, chain drug store or pharmaceutical manufacturer.

In addition, the MCO’s are required to include on each outpatient drug encounter the PBM received amount (ingredient cost and

dispensing fee) and the provider received amount - the actual amount paid by the PBM (ingredient cost and dispensing fee) to the dispensing pharmacy or prescribing provider. The MCOs must report administrative fees and submit the procedures that the MCO will put in place to monitor the PBM for compliance with the agreement. They will also be required to conduct an independent audit of the PBM’s transparent pricing arrangement. In addition, the MCO’s are required to develop, implement and maintain Second Level PBM Provider Pricing Dispute Resolution Process that provides for settlement of a dispute, along with a time frame that must be adhered to. All of these changes go into effect on January 1, 2019. Please let PPA know of any non-compliance you should encounter after this date.

The Pennsylvania Pharmacists Association would like to thank Ron Raymond, lobbyist for Value and KPPA, Mel Brosky of PARD, and the several pharmacists who also worked with Angela Zaydon and Pat Epple on many meetings, calls, and emails with the Department of Human Services to get this done. We are also appreciative of the ongoing support and help from NCPA and other important partners like RDC and IPBG, who helped us spread the word among our PA pharmacies. It was only through your help, information and support that we accomplished this!

This is a very big win and a strong step forward on this issue!

To view the document in its entirety: https://www.papharmacists. com/page/CurrentHotTopics and click on the link under PBM requirements. www.papharmacists.com 39

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