Experts Discuss Specialty Pharmacy Accreditation, Re-Accreditation

In an interview with Pharmacy Times® at the American Society of Health-System Pharmacists Midyear Meetings and Exhibition, Stephen Davis, PharmD, senior director of Health System Strategy at Shields, and Erica Diamantides, PharmD, specialty pharmacy manager at UW Medicine, discuss the current guidance and best practice for specialty pharmacy accreditations.

Q: What is the current guidance and best practices for the compliance and maintenance of specialty pharmacy accreditations?

Stephen Davis: The current guidance for accreditation and best practices are for organizations to utilize self-audits and do that on a regular and consistent bases. A highly recommend a quality management committee as well as an opportunity to drive compliance to all of the standards, specifically the mandatory standards, so the combination of the Quality Management Committee, along with the self-audits will help ensure that organizations are compliant in meeting the accreditation standards.

Q: What strategies can be implemented for successful specialty pharmacy re-accreditation?

Stephen Davis: For successful Specialty Pharmacy re-accreditation, I highly recommend to take advantage of the opportunities that the accrediting bodies offer through the workshops. It's a great opportunity to not only understand the standards, and to understand update set of standards, but to also network in with other colleagues and get the best practices in order to meet those standards. It also gives you an opportunity as you're driving toward compliance to ensure that you have a game plan of meeting those requirements. It's specifically the ones with the long lead time, and so that's my recommendation.

Q: Why is it essential for pharmacies to focus on URAC 4.0 for their re-accreditation?

Q: Why is it essential for pharmacies to focus on URAC 4.0 for their re-accreditation?

Erica Diamantides: That's a great question. URAC came out with a major update moving from the 3.1 standards to the 4.0 standards and with that created a number of really important changes for specialty pharmacies to be able to improve the quality of the services that they're providing to our patients. One thing to note is that things have changed really fast and we're already into another major standard update, and so now the 5.0 standards are really the standards that pharmacies should be reviewing and pursuing in order to be prepared for their re-accreditation is coming into the future. It's really important with each of these standard updates, especially when they're major changes, that pharmacies are connected with workshops and resources being provided by the accrediting body like Stephen said, as well as for them to start that process of evaluating how do they become prepared for and upcoming re-accreditation as soon as possible.

Q: What are some additional specialty pharmacy accreditations, and what are some strategies for obtaining them?

Erica Diamantides: There are multiple organizations that a specialty pharmacy could look at to partner with for a third-party accreditation. Some examples are the Joint Commission, ACHC, as well as NCQA, and there are many others. The main thing in pursuing multiple accreditations is that specialty pharmacy evaluates where they already are in compliance with those different standards sets because there can be unique standards that may not be covered by another accrediting body. Creating a gap analysis to make sure that they identify areas that they may need to update their policy and process and educate their teams. Then the final thing that I think is really important is if an organization doesn't have any accreditation, and they're looking at potentially pursuing dual accreditation with specialty pharmacy. Something to consider is actually doing that process for both organizations at the same time. It can be fairly resource intensive upfront because that is a lot of coordination with 2 different accrediting bodies and different standard sets, but it does mean that when you're updating a policy, you may be able to do that for both organizations at the same time and potentially minimize the duplicate work the other way around.

Q: What is the biggest benefit of a health system working with a partner for accreditation and re-accreditation?

Stephen Davis: I will say one of the biggest benefits of partnering with a health system in order to ensure accreditation is you get an opportunity to have accreditation experts that know and understand all of the different standards, they understand compliance. We're able to partner with the leadership at the health systems and take their knowledge and their understanding to ensure that all the gaps are closed and to enhance the confidence of meeting the accreditation standards.

Erica Diamantides: When I think of health systems specialty pharmacies being able to partner I think there's so much opportunity to be able to leverage economies of scale by working together to be able to overcome some really challenging and resource intensive processes. Working with organizations like ASHP and other outside organizations are a great way to be able to meet other individuals who are also working on their accreditation or reaccreditation. Learning from their experiences, coming to meetings like this, and having content where you can speak to organizations that have maybe more experienced than you or have solved problems that you're actively working through is a great way to be well to help everyone to be able to be more successful and going through this accreditation process.

Q: Anything to add?

Stephen Davis: In addition to what Erica just said, the only additional thing that I'll add is, it's very important to ensure that there's a gap analysis done, specifically, when you're getting ready for the re-accreditation process. We understand that there are standards that are the same and some that are similar. However, the recommendation is really, at least a year before the re-accreditation process begins, is to ensure that you do a deep dive and so to standards. I would actually refamiliarize myself with the prior submission for re-accreditation as well. When you that way when you do that gap analysis, you can see what's changed and what you have done to continue to meet those existing standards that you are reapplying for and just ensure that you also just stand survey ready. It also gives you an opportunity to ensure that you are able to meet those standards and you are compliant. It gives you time to make sure that you're able to meet compliance with those standards.