Developing A Community
Pharmacy Practice Site
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Pharmacy Management
4/9/2015
2 Working Definitions of ‘Developing a Practice Site’
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Starting from scratch and creating a practice environment that
does not exist.
Taking a practice site that already exists and growing or
shaping it into “your” ideal practice site.
From your perspective – what you want to do – we will address
consumer demand in the next lectures.
Pharmacy Management
4/9/2015
Possible Practice Sites & Activities
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 Traditional sites:
 chain, independent or hospital setting
 staff to ownership positions
 Non traditional opportunities:
CVS Pharmacare (formerly ProCare), Kroger initiatives
 Head to Toe Wellness and Research
 APC Pharmacy Care Clinic
 Cherokee Pharmacy
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Terry Forshee at the Pharmacy Clinic (and related businesses)
http://www.cherokeepharmacy.com/
Barney’s Pharmacy; coumadin clinics; kinetics; long term care
Nuclear pharmacy; Government; Insurance industry (ESI,
Medco); Pharma, VA, etc.
Pharmacy Management
4/9/2015
Possible Practice Sites & Activities
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Specialty compounding
 Oncology
 Board certification, specialized practice sites
 Wellness
 Workplace interventions such as Asheville project http://theashevilleproject.net/
 Fitness, lifestyle management
 Immunizations
 Long term care consulting
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Pharmacy Management
4/9/2015
Decide:
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DOES YOUR IDEAL “PRACTICE SITE” EXIST?
IF NOT, THEN:
Pharmacy Management
4/9/2015
Thinking about your ideal practice site, could you actually
create it?
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What is your “mission?”
What services will you offer?
Are you clinically competent?
Are you competent in terms of management, accounting,
marketing, advertising and promotions?
Is this a new idea, or is there already competition?
Pharmacy Management
4/9/2015
Thinking about your ideal practice site, could you actually
create it?
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 Location?
 What will you need in terms of:
 Cash / Loans
 Staff
 Equipment
 Lawyers, builders, insurance agents…
 How does the State BOP / Pharmacy Practice Act
view your idea?
 How will you get paid?
 Is there sufficient demand?
Pharmacy Management
4/9/2015
APC Pharmacy Care Clinic
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Pharmacy Management
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Pharmacy Management
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4/9/2015
Balancing Clinical and Business Interests
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Business
Clinical
Pharmacy Management
4/9/2015
APC Pharmacy Care Clinic
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 APC Pharmacy Care Clinic
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Disease management programs
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Smoking cessation, asthma, lipids, coumadin, diabetes, HTN, general
medication use.
Clinical Trials
Pharmacotherapy Reviews
Immunization programs
 Payment / Reimbursement
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Billing incident to physician
National HC Provider ID Number
Contracts with insurers
Direct payment from patients
Pharmacy Management
4/9/2015
Current status of APC
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 Independently operated
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Clinical trials & clinical services
 Drs. Aull, McElhannon, Cook, Johnson, Herist have
created similar-expanded service sites
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Monroe, Clinton SC, Raleigh NC, Athens
Pharmacy Management
4/9/2015
Getting Started at the PCC
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 Develop physician relationship
 Identify needs:
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space
equipment
personnel (not just clinical)
 Billing and reimbursement
 Develop clinical protocols
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Must have MD input and approval
 Legal:
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Develop the collaborative practice agreement
Develop the annual operating plan
Check in with State BOP
 Take good care of patients
Pharmacy Management
4/9/2015
Important Documents:
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The collaborative practice agreement
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Usually, required to be on file at State Board of Pharmacy
Annual operating plan or business plan
Clinical protocols
Note: these documents will be very different for the
many types of practice sites
Pharmacy Management
4/9/2015
Collaborative Practice Agreement
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 Spells out the legal issues between the providers
(pharmacists and physicians) specifically, the
boundaries of care are, and how care will be
monitored.
Pharmacy Management
4/9/2015
Annual Operating Plan
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 Defines the financial arrangements:
 For APC, it was:
MD handles all billing (insurance and cash payments)
 First $2,000 goes to APC for their cost of operations
 For each $1 over $2,000 revenues are split 65% to PCC and 35% to
APC
 When payments will be made
 Financial controls to be used
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 Could be between you and a physician group,
pharmacy, other retail establishment, etc.
Pharmacy Management
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Clinical Protocols / Care Tools
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Detailed documentation of the specific procedures as to how
care will be provided.
From a patient care perspective, these are the most important
documents.
Clearly delineate the parameters of the providing care.
Pharmacy Management
4/9/2015
Success Metrics
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 How will you define success?
 Satisfaction
You
 Your patients
 The professionals you work with
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Revenue / salary
 Student training site
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Pharmacy students
 Pharmacy residents
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Scholarship
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Dissemination of the practice concept; Clinical / economic /
outcomes studies
Pharmacy Management
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What about developing more traditional practice sites?
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 Are these kinds of practice environments possible?
 Will you be able to find a practice site that you will
truly like?
Pharmacy Management
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Your ideal practice site could be right in your own back yard.
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Pharmacy Management
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So remember (from first year): If you don’t want to be
replaced by a robot, don’t act like one. Find or create
the kind of practice site where you will be happy.
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THIS STRATEGY IS ALSO KNOWN AS
SUCCESS.
Pharmacy Management
4/9/2015