The Pharmacist of Tomorrow

“The pharmacist of tomorrow is going to be unrecognizable to most of us. He might not be a vending machine, but he’s not going to be that quiet old white-haired guy up behind the counter either.” — Jim Ammen

Harnessing the power of a pharmacist’s knowledge and expertise to control health care costs and improve patient outcomes has been a difficult process.

Those promoting the transformation of the role of the pharmacist from a dispenser of medications to a dispenser of information have always been confronted with the question of who will pay for these services. Fortunately, the value of the pharmacist in providing cognitive services such as medication therapy management (MTM) has become more widely recognized since the implementation of Medicare Part D.

Even with this increased recognition, the profession is still facing a sort of identity crisis. Pharmacists play a flexible role in health care, but remain uncertain about the future.

Provider status has been a long time coming.

The decade-long push to recognize pharmacists as health care providers is finally seeing results.

In October 2013, California Governor Jerry Brown signed the state's provider status bill (SB 493) recognizing pharmacists as health care providers. Washington and Oregon followed suit by passing similar legislation this year.

Will this new legal recognition as providers get pharmacists a seat at the health team's table?

The team-based care approach continues to grow with pharmacists participating in patient-centered medical home models, accountable care organizations, and collaborative arrangements with other health care providers. But there's a long road ahead until we actually see a majority of pharmacists participating as members of the health care team on this level.

It just makes sense.

It’s been proven that pharmacists can serve as first-string members of the health care team.

Take medication nonadherence for example. The cost of nonadherence to prescribed medication therapy has been reported to be more than $300 billion annually in the United States. This is often a direct reflection of patients' lack of understanding about their disease state and how their medication therapy can control or improve their particular condition. This is where having a pharmacist on the health care team makes a great deal of sense, especially at any point of transitional care.

A major component of the patient care plan consists of properly treating the disease state with appropriate drug therapy. When there is a breakdown, pause, or discontinuation of medication therapy, there is almost always a breakdown in overall patient care. This can result in increased hospital readmissions, lack of disease control, increased complications, and higher health care costs. In fact, about 1 in 5 Medicare patients who leave the hospital are readmitted within 30 days.

Including a pharmacist in the patient care process can improve outcomes, especially during transitional care. Pharmacists should be given the role of patient care managers and perform services such as medication reconciliation, checking for potential adverse drug reactions, performing patient education, and other patient-oriented services whenever there is a transition of care.

Pharmacists should also be directly involved with follow-up services to ensure adherence and compliance with drug therapy and report them back to the patient care plan team. Adherence to drug therapy is critical in chronic diseases such as diabetes, hypertension, and heart disease, and community pharmacists are in an ideal position to improve it.

As providers of cognitive pharmacy services and educators who help patients understand their medications and conditions, pharmacists will be recognized as resources to ensure continuity throughout transitions of care, thereby changing lives, improving outcomes, and saving health care dollars.