Pharmacists & Test Ordering: Roles and Responsibilities- Pharmacy Technician
Over the past decade, major changes in the healthcare landscape have challenged the profession of pharmacy. The Center for Medicare and Medicaid Services (CMS) is slowly but steadily spreading value-based healthcare service reimbursement, tying quality of care to payment. Outpatient clinics are seeking Patient-Centered Medical Home (PCMH) recognition as a credential for providing high-quality care. Hospitals are penalized financially when certain high-risk patients are readmitted shortly after discharge. Over the next several decades, the number of Americans over the age of 65 years will double from approximately 40 million to 80 million,1 requiring more medications for multiple chronic diseases and more monitoring to ensure treatment safety and efficacy. At the same time, new schools of pharmacy are opening so rapidly that the number of graduates over the next 5 to 10 years will be double that of a decade ago.2 While it may seem that the increasing number of new pharmacists is well-matched with the rising demand for prescription medication, dispensing automation is quickly taking over traditional pharmacist functions. The profession must evolve rapidly – and has the opportunity to do so – by developing programs and collaborations aligned with the clinical and financial risks / incentives of healthcare providers and payers. Improving healthcare quality and safety outcomes for highrisk patients requires more than basic medication reconciliation and education. Often, clinical tests are needed to verify disease status, establish baseline parameters, or monitor the progress ofmedication therapy. For example, selection of appropriate antihypertensive drug therapy may require at least basic metabolic panel laboratory tests (eg, serum creatinine, electrolytes). As provider status for pharmacists continues to spread among individual states and is considered nationally, pharmacists must be prepared to take responsibility for ordering and managing clinical tests. This issue of The Rx Consultant will present professional standards for pharmacists to follow when using such authority. The best practices shared are based on research, government reports, and decades of combined experience in California and other states. Pharmacists can utilize this information to ensure that tests are ordered only when necessary, and that results are managed appropriately and promptly. Moreover, this information can be used to educate other healthcare professionals, testing organizations (eg, clinical laboratories, imaging centers, pulmonary function test labs), and health plans about the role of pharmacists in ordering and managing tests.