The platonic image of pharmacists spending their days behind a desk, counting pills, and answering phones might just be over. Health systems are increasingly redefining the role of the pharmacist—and this new paradigm may soon be etched into law: New proposed California legislation aims to give pharmacists a more direct role in patient care, putting into law a practice model that is becoming increasingly popular with hospitals nationwide.
Senate Bill 493 aims to give pharmacists a wider scope of practice, including the creation of an official “advance practice pharmacist” certification, which would allow pharmacists, in collaboration with physicians and nurses, to adjust or discontinue drug therapies, and administer hormonal contraceptives and smoking cessation medications. California Senator Edward Hernandez, who introduced the bill, expects the new law to also help alleviate the effects of any future physician shortages.
Only 16 out of 56 California counties have enough primary care physicians, and the state expects to have an additional 7 million insured individuals with the implementation of the Affordable Care Act in 2014. With increased demand for health care services and a shortage of physicians, the onus falls on pharmacy and nursing to bridge the gap and provide direct patient care in accordance with each profession’s training.
In fact, California’s pharmacists, nurses, and even optometrists are collaborating in support of the Bill 493 with a “Bridging the Provider Gap” campaign, through their coalition Californians for Accessible Healthcare (comprised of the California Association for Health System Pharmacists, the California Society of Health System Pharmacists, the California Optometric Association, and the California Pharmacists Association). This initiative is part of a larger trend in health system management that has long-reaching effects not just from a staffing perspective but from an outcomes perspective as well.
According to Elizabeth Coyle, clinical professor and assistant dean at the University of Houston College of Pharmacy, the evolving role of the health system pharmacist is a necessary step in the development of interprofessional collaboration: “Effective health care focused on improving patient outcomes cannot occur in a vacuum, so most – if not all – health professions are integrating the their practice collaborative team model into and educational curriculum,” Coyle told the Houston Chronicle. “The stereotype of pharmacists as counting and dispensing pills is long gone. Regardless of the setting – whether it’s in a community pharmacy, hospital pharmacy, neighborhood clinic or office – today’s pharmacists play an integral role in direct patient care on the health care team.” Coyle also noted that in addition to a more hands-on role in patient care, pharmacists also conduct clinical trials and efficacy studies for new drug therapies.
In recent years, California has served as a pioneer among the states for innovative healthcare initiatives, and the new legislation seeks to add increased practice scope for pharmacists and nurses to the list, which already includes the nation’s first online health exchange.
As we move into an era that depends less on primary care physicians and more on the clinical expertise of pharmacists and nurses, health systems must implement solutions that not only bridge the gap caused by the physician shortage—administrators at innovative facilities also bridge the gap that forms when pharmacists and nurses spend more time with patients and less on support tasks, such as manually retrieving medications and following up on orders by phone. Automated logistical solutions like MedEx real-time medication tracking and the TUG robot delivery system are designed to not just free up hospital personnel’s time but reduce common errors such as adverse drug events, missed doses, and late deliveries.
Healthcare law in 2014 and beyond should not only reflect the public’s need for affordable care—it should also reflect the hospital’s need to utilize staff efficiently, and the potential for technology to bridge the gaps that the new paradigm creates.
