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12/7/2000

ASHP President Outlines Society Priorities

Kate Traynor

ASHP President Mick Hunt presented the following address Dec. 4 during the Opening General Session at the 35th Annual ASHP Midyear Clinical Meeting and Exhibits.

 

Hello, and welcome to Las Vegas! We're glad you're here, and we hope you will find that your time is well-spent as you attend educational sessions that will stretch your professional horizons, walk around the Exhibit Hall to see the latest industry offerings, and talk with colleagues about today's most pressing pharmacy challenges.

Much like the nation's recent presidential election, the future of hospital and health-system pharmacy practice is a close call. Our profession is experiencing some profound changes. Compensation for our patient-care services, scientific advances in drug therapy, workforce changes, and the impact of information technology on effective patient care challenge us continually. But you can count on ASHP to help bring about positive change in our profession.

In stepping out to talk to administrators about the value of pharmacists, you can count on ASHP to provide public relations and outreach to back you up.  In your quest to be compensated for managing the drug therapy of ambulatory patients, you can rely on ASHP to knock on the doors of Congress on your behalf.  In striving to provide the best and most cost-effective drug therapies, you can look to ASHP to provide the most-reliable drug information resources available today.

The Changing World of Information Technology

Technology advances are bringing about immense changes in the ways health professionals and consumers access and use drug information, now and into the future. Because drug information is one of ASHP's core strengths, we have committed substantial resources over the last two years to revolutionizing the usability of our publications.

We modernized the underlying coding of the information in ASHP's AHFS Drug Information to ensure its utility in the electronic age. Conversion of AHFS DI to a new data structure called SGML allows us the flexibility to offer the information contained within this popular resource in Web applications. It also will help you to navigate more quickly and effectively through the data, allowing you to do your job better.

And that's not all.  In this day of "personal digital assistants," ASHP has gone beyond the book and CD-ROM versions of AFHS Drug Information. We are debuting at this meeting the new "eBookMan" hand-held computer here at the meeting—this small but powerful resource allows you to take this much information along as you make well-informed therapeutic decisions right at your patient's bedside. We hope you agree that our focus on the future of drug information resources matches your need for easy-to-access therapeutic data to help patients make the best use of medicine. The eBookMan device also performs the basic organizing functions that many pharmacists have come to rely on in personal digital assistants.

Broadening Our Reach

A recent ASHP consumer survey found that three out of four Americans are going online for answers to their medication questions. That's understandable, according to the results of another ASHP survey that found almost half of all Americans take an average of three prescription medications per day. To ensure that consumers have a reliable place to go with their medication questions, ASHP launched a consumer Web site called Safemedication.com in June. This user-friendly site—which is part of our successful public relations program—features a searchable database of FDA-approved medications that is based on ASHP drug information resources.

We've received great reviews from consumers and media alike, and I encourage you to go online to see what the site offers. Safemedication.com leaves no question that the drug information comes from pharmacists, and we prominently feature the role of the pharmacist in patient care.

We encourage you to direct your patients to Safemedication.com when they are discharged from the hospital or when they are going home after a visit to one of your ambulatory care clinics. And if your health system's Web site doesn't offer access to drug information, we are offering an easy way for your Webmaster to link directly to Safemedication.com. Be sure to tell your administrator about this opportunity as well—as patients go online, it's good to know that your health system can offer this important benefit.

Compensation and Patient Care

The uncertain outcome of the presidential election and the subsequent thinner margins in Congress has given pause to the future of a Medicare prescription drug benefit and overall Medicare reform. This new, essentially equal balance among the political parties will be the only way to make progress on any of the health policy issues facing the U.S. Whatever the debate, however, you can rest assured that ASHP continues to pound the pavement in Washington on the issue of pharmacist compensation for ambulatory patient care services.

For the past year, ASHP's Government Affairs Division has been working hard on a three-part action plan to position health-system pharmacists as providers of drug therapy management services for ambulatory patients. More than 60 ASHP council members who visited over 100 legislators on Capitol Hill in September focused on how pharmacists can enhance medication use and reduce patient care costs. We are dedicating a portion of our Public Relations Program to educate payers and legislators about the positive effect pharmacists can have on patients' health. And, through meetings like this Midyear, we are offering sessions on how to be compensated for clinical services for ambulatory patients.

ASHP has recommended to Congress that the Social Security Act be amended to explicitly recognize pharmacists as providers under Medicare and Medicaid. When we achieve this, other payers will follow suit. At this Midyear, we are launching a major lobbying and education campaign focused on the key federal legislators who are in a position to help us achieve provider status for the pharmacist. We will be working closely with selected affiliated state societies who have a relationship with these Representatives and Senators. At the right time, we will be calling on all ASHP members to help us with their letters and telephone calls. Stay tuned for more details in the coming months.

ASHP is also working in coalition efforts designed to maximize our influence on this issue. Together with the American College of Clinical Pharmacy, ASHP has identified provider status as our number one advocacy priority.

We are also working with a Joint Commission of Pharmacy Practitioners coalition that is focused on prescription drug reimbursement. The federal government traditionally looks at the Average Wholesale Price—or AWP—to set drug pricing levels that do not adequately reflect patient care services. The JCCP coalition is developing a new, more realistic formula to reflect the true costs of medication use to home care providers, hospitals, and outpatient pharmacies. Revising the longstanding AWP formula will help us to gauge the product element more accurately, thus freeing us to focus clearly on compensation for pharmacist patient-care services.

Patient access to these services is such an essential issue that the ASHP Board of Directors added this initiative as a new action plank in the Leadership Agenda. Although this is likely to be a long battle, it is a battle that can be won.  We plan to win it because it is vital to the future of our profession.

Pharmacy Workforce Shortages

We know that many ASHP members are struggling with pharmacy staffing shortages. Hospitals and health-system pharmacy directors continue to have real difficulties recruiting qualified staff as they compete with other sectors of practice for personnel. This gap is evident in workforce surveys ASHP conducted in 1999 and 2000. In the 2000 study, the percentage of pharmacy directors reporting that their current vacancy rate was much higher than five years ago almost doubled in just one year. Eighty-seven percent of respondents reported that they believe the supply of entry-level frontline practitioners has also diminished.

This evidence about the difficulties of maintaining adequate staffing in hospitals and health systems is why it was so critical that ASHP provide input to the federal study of the pharmacist shortage. The report on this study will be delivered to Congress within the next two weeks. To ensure that hospital and health-system pharmacy practice is accurately portrayed and measured, ASHP provided extensive comments to government officials. We highlighted the complex duties of health-system pharmacists, pointing out that prescription medication order volume is not an appropriate measure of staff needs in hospitals or health systems. We also explained the diversity of professional services our members provide.

The current lack of balance in pharmacist supply and demand is a complex systems issue that will not be fixed by any one bold action. But ASHP leaders believe that there are many positive steps that can and should be taken by various stakeholders in the issue. Just one example: We need to move assertively toward a national standard for the education and training of pharmacy technicians, which will give pharmacists in all sectors of practice added confidence in delegating tasks to technicians.

There are changes we need to make in hospital and health-system pharmacy practice. We must ensure that we are using pharmacy technicians to the maximum degree. We must ensure that we have in place good quality assurance measures in drug distribution, which will guarantee patient safety as we expand the responsibilities of technicians. We must ensure that we are identifying the patients at greatest risk for preventable adverse drug events, and that we are concentrating our precious pharmacist resources on helping those high-risk patients make the best use of medicines.

Conclusion

In conclusion, let me ask you—everyone of you in this audience—to redouble your personal support for ASHP and its assertive agenda. The challenges we face in hospital and health-system pharmacy are immense. Collectively, through ASHP, we will be far more effective in meeting those challenges than by trying to face them alone, or by pretending that these issues are not important to each of us personally:

  • We need your support through your volunteer contributions as a committee member, reviewer, author, or meeting presenter.  
  • We need your support through use of ASHP public relations materials in telling patients and nonpharmacy professional colleagues what the modern pharmacist is all about.  
  • We need your support through ASHP membership.  
  • We need your support through encouraging your colleagues to join the Society.

If more of us join forces through ASHP, if we focus our energies on the most critical issues, if we reinforce our core messages to the public and policymakers, we will make a difference...a difference for our profession and for the patients we serve.

My message is simple. Do not stand apart. Be a part of ASHP. Thank you!