Pharmacists have long been recognized as one of the most trusted healthcare professions. Throughout the evolution of the modern pharmacy practice model, they have increasingly become integral members of the patient care team and taken on more responsibility for the overall patient experience. Despite published literature demonstrating the value of having a pharmacist on the care team, establishing their permanent position on the frontlines within a health system can be a “hurdle to overcome” financially, according to Staci A. Hermann, PharmD, MS, FASHP, FACHE, Vice President, Embedded Clinical Decision Support Content at Wolters Kluwer Health.
“The justification for putting a pharmacist on the care team is usually based around preventing adverse drug events from happening or other quality improvements,” Hermann explains. However, quantifying the absence of an event can be a cumbersome metric to track and hard to assess at a hard dollar amount to understand return on investment (ROI).
Pharmacists are expensive resources and challenging to justify based on soft-dollar ROI numbers, especially in times of financial pressure, Hermann says. So, the integration of pharmacists to direct care teams is often unevenly applied from institution to institution and the pharmacy practice model can look different in various organizations. Many times, a pilot program is needed to demonstrate the value, or the pharmacist integration may be limited to high-risk patient populations (i.e., critical care, neonatal/ pediatrics).
As financial pressure along with workforce shortages continues to challenge health system pharmacy teams, leadership is finding ways to streamline workflows, prioritize ongoing efforts to improve outcomes, manage the ever-growing medication budget expense, and devise new ways to generate revenue for their institutions to help elevate their roles within their organizations and continue to earn trust for their expertise.
Pharmacists’ contributions on multidisciplinary clinical teams
While pharmacists’ roles on multidisciplinary clinical care teams remain primarily to help optimize medication therapies and provide medication consults, according to an article in The Pharmacy Times, they also contribute by:
- Researching alternative and more cost-effective therapies.
- Leading antimicrobial stewardship.
- Working with institutional and legal leadership regarding use of experimental therapies.
- Providing preventive care services, such as immunizations.
- Facilitating access to care.
- Providing patient education and educational counseling.
There is a wide range of level of acceptance of pharmacists taking on larger care roles and integrating fully onto multidisciplinary teams, possibly The Pharmacy Times postulates, due to lack of visibility or role definition.
The value of pharmacists’ contributions has been observed in a number of studies:
- In a cross-sectional survey in California, 90% of physicians said that integration of pharmacists in their team improved medication management, and 93% considered pharmacists’ recommendations clinically meaningful.
- A study in Ontario, Canada, found that, when a pharmacist was integrated in a primary care team, at least one drug-related issue was identified and prevented in 93% of patients.
- The American Journal of Pharmacy Education reported that for every $1 invested in pharmacist integration on teams, more than a $4 benefit was seen, largely related to savings from:
- Reducing drug discrepancies and improving medication adherence.
- Providing preventive care.
- Decreasing demand for physician-provided care.
