How do you think pharmacy will be changing with healthcare reform

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Imagine pharmacogenomic screenings being commonplace, as pharmacists look at genetics to predict drug response and tailor treatments. So goes the perceived evolution of community-based pharmacists, from performing clinical interventions to becoming initial clinicians, ushering in a time when community pharmacies are considered essential to the healthcare landscape.

Washington state has been progressive on a number of pharmacy fronts since the s. MacLean and Dr. Julie Akers, clinical associate professor of pharmacotherapy at WSU, are finalizing a study on the effectiveness of pharmacy treatments, comparing the care pharmacists provide for minor illnesses and self-limiting conditions to what is offered at more traditional settings, such as physician offices, urgent care centers or hospital emergency departments. The study will inherently set a baseline to measure how enhanced pharmacy services are influencing quality of care and access to care.

Once analyzed, MacLean believes the study will provide evidence that community pharmacists can contribute to caring for patients, compelling other states and pharmacies to replicate services and treat common ailments such as strep throat, urinary tract infections and severe headaches, including migraines. Akers has found, through surveys and anecdotally, that patients are confident in receiving care from pharmacists.

At WSU, student pharmacists take an intensive, weeklong, point-of-care and clinical services course at the beginning of their second year. Rather than re-create the material the state pharmacy association had created for continuing education for practicing pharmacists, faculty collaborated with the association, giving students access to online modules that they complete over the summer before school begins.

Students spend the entire first day of class going condition by condition, reviewing key guidelines through patient cases, deciding whether to use prescriptive authority, refer to a more advanced care setting or recognize that over-the-counter self-care products are appropriate for that case.

Other days are dedicated to immunizations. Students are certified in immunization administration and receive specialty training on pediatric immunization. Students learn how to screen for HIV, strep and influenza, practicing throat and nasal swabs on themselves or a team member before going through a rubric-graded assessment, ensuring they can collect the sample without it being contaminated.

They have open practice laboratory sessions and breakout sessions where they learn how to run a travel consultation, interact with a patient and do the paperwork.

The Council of Deans formed a task force to find opportunities to improve community-based practice and give viable recommendations to AACP and member institutions to pursue such possibilities and make them realities. The task force chair, Dr. Jennifer Adams, associate dean for academic affairs, director of interprofessional education, clinical associate professor at Idaho State University College of Pharmacy, said the task force will structure recommendations in three separate areas.

First, advancing pharmacy technician practice. Pharmacists must have good support staff if they are going to take on new roles, so elevating pharmacy technicians is crucial. What needs to be reserved for pharmacists? Same with point-of-care testing: the pharmacist would decide to do the test but the technician could administer it. Some pharmacies are delegating the accuracy checking of the dispensing process to technicians. Second, advancing the scope of pharmacy practice.

The Idaho board looked at other boards of pharmacy, but also looked at medicine and nursing, examining how their licensees were regulated and found they regulate based on this concept of standard of care.

More involved direct patient care is the future of pharmacy practice, and schools need to ensure that they are graduating practice-ready pharmacists who are prepared to move into that role. Idaho has been the trailblazer for independent prescriptive authority. Pharmacists in Idaho can prescribe based on four parameters: when no new diagnosis is required, when a CLIA-waived test can guide diagnosis, when a condition is minor and self-limiting or in an emergency.

At first, the board of pharmacy made a list of medications pharmacists could prescribe for those categories, each year adding new medications to the list for legislators to approve. Legislators saw the same scenario playing out—they would hear opposition from the medical community, give pharmacists a chance and then see the positive outcomes. At the end of the legislative session, legislators eliminated the list.

Several states have passed emergency regulations during this crisis, allowing pharmacists to do more, like extend refills. Third, the task force will provide recommendations to advance payment reimbursement for services. What do the standards cover? They also set out our requirements for organisations providing initial education and training. Where can I find the new standards on your website? What are the key changes in the revised standards?

These changes include: incorporating the skills, knowledge and attributes for prescribing, to enable pharmacists to independently prescribe from the point of registration introducing a new set of learning outcomes that will be used to assess the full five years of education and training, and which can link to a continuum of development into post-registration emphasising the application of science in clinical practice and including a greater focus on key skills needed for current and future roles, including professional judgement, management of risk, diagnostic and consultation skills including for remote consultations making the fifth year of initial education and training a foundation training year with strengthened supervision and support and collaborative working between higher-education institutions, statutory education bodies and employers having a greater emphasis on equality, diversity and inclusion to combat discrimination and address health inequalities.

We reviewed the standards and learning outcomes to take account of learning from the pandemic and sought feedback from our Advisory Group on this issue. We have made a number of changes to the standards in response, including increasing the focus within the learning outcomes on: collaborative working with other professionals remote engagement and consultation with patients person-centred care, including greater emphasis on addressing health inequalities and understanding communities and cultures How do the new standards reflect the move to digital learning and remote consultation?

There is a key focus within the standards on developing capable, confident pharmacy professionals who are dedicated to person-centred care, both in person and via remote consultations We have included specific learning outcomes in relation to digital learning and remote consultation, including keeping abreast of new technologies and using data and digital technologies to improve clinical outcomes and patient safety, complying with information governance principles What practical experience will people get during their education and training?

To achieve the learning outcomes, curricula, teaching and learning strategies, programmes and training plans will need to provide experiential learning and inter-professional learning; with students from other health and care professions, and provide experience in different pharmacy settings As students advance through their MPharm degree they will be expected to demonstrate the learning outcomes to a greater depth, breadth and degree of complexity.

The foundation training year will enable trainee pharmacists to experience new situations and environments, providing opportunities to build upon their knowledge and skills and demonstrate these with patients in clinical settings.

The standards also include a requirement for a period of learning in practice, during the foundation training year, of at least 90 hours of supervised practice, specifically related to prescribing to consolidate their learning and allow them to achieve independent prescribing annotation following the completion of a foundation training year, passing the registration assessment and registering with the GPhC.

We recognise that different models of learning in practice might be implemented in the different countries of Great Britain. MPharm degree When and how will the new standards be implemented in MPharm courses? Higher education institutions will be asked to transfer all new students who start on an MPharm degree in or later to the new standards.

Why are admissions processes to the MPharm changing? We have strengthened the admission requirements in the standards Selection processes must be fair and give all applicants an opportunity to demonstrate their ability and suitability to be a trainee pharmacist. Everyone involved must proactively seek to identify and reduce discrimination in selection and admission processes. Selection processes must also give applicants the guidance they need to make an informed application. Selection criteria must be explicit.

Foundation training year What is the foundation training year? The foundation training year will involve NHS Education Commissioners, employers and higher-education institutions working together in new ways, with a clear set of accountabilities, including systems of quality management and quality control, and with oversight of the outcomes from the GPhC and the PSNI.

This means that trainees will receive enhanced support and supervision throughout the foundation training year. Once the foundation training year will be fully implemented, trainees will complete at least 90 hours of supervised practice, specifically related to prescribing, during their foundation year, to strengthen their competence and allow them to achieve their independent prescriber annotation upon registration. When and how will the foundation training year be implemented? We published a mapping of the interim learning outcomes to the pre-registration performance standards [PDF KB] to enable those involved with the upcoming foundation training year and to support training providers to align their training plans with the interim learning outcomes.

Please note that this is only one example, provided by NHS Education for Scotland and reviewed by the GPhC, and should be used as intended, as a guide.

The interim learning outcomes describe the knowledge, skills and attributes a trainee must demonstrate by the end of their foundation training year. We expect to include the requirement for independent prescribing in later iterations of transitional learning outcomes and will keep providers updated on when this will happen in each country of Great Britain. During initial iterations, trainee pharmacists will develop better clinical reasoning and decision-making skills demonstrating their readiness to progress as effective prescribers once they meet our standards for education and training of pharmacist independent prescribers.

As part of this process training providers should map the performance standards to the interim learning outcomes. Training providers do not need to share the updated plan with us — we will not review plans that have already been previously approved unless they are part of a new training arrangement or part of an application where the current approval expires in We would encourage any training providers who have not submitted their training plans yet to use the interim learning outcomes if possible in their plans, but this is not necessary if training providers have already drafted their plan.

We will approve training plans using the performance standards and training providers can map them to the learning outcomes later on as part of their preparation for the trainee starting. If a training site was pre-approved until or this will be re-aligned to the 30 November date to ensure training providers receive further guidance and information sent regarding training plans and the foundation training year going forward.

The date for submissions will be 1 March and training providers will receive an expiry date of 30 November to cover the next training period. The application process will remain the same and the same format will apply, see current criteria for more information.

The closing date is 1 April to submit application forms and training plans to guarantee applications will be processed in time for a trainee to start from 12 July All plans approved going forward will be approved until 30 November In Scotland approval through NES will occur as normal. How will training sites be approved where there has been a variation to training that cuts across more than one training year? If a trainee is a part-time trainee or requires an extension to the 52 weeks for any other reason then please apply for re-approval via a new training plan and application form as well as a Change of Training Details form with the new end date of the training for the trainee.

No, we are expecting training providers to use the same assessment format currently captured in the pre-registration manual.

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Date Range: To. September 30, High prescription drug costs are a leading concern among Americans. Americans pay higher prices for prescription drugs than any other country in the world, with prescription drug prices in the U. September 6, Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment VBP programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume.

February 22, This issue brief analyzes changes in health insurance coverage and examines trends in access to care among Black Americans using data from January 13, The Affordable Care Act provides premium subsidies for Marketplace eligible individuals to improve health insurance affordability, as well as cost-sharing reductions CSRs for many enrollees that limit out-of-pocket spending such as deductibles. Administrative Costs Most of the health systems and hospitals will increase the minimum rate of their job since they need to take care of their new patients.

They need to give ample time in checking their paper works and care management for their new-fangled insured patients. Coverage The coverage of healthcare reform that is under the sheer act is associated with new challenges. If the access will not be totally improved, they will experience problem especially when it comes to providing care. It is indeed that most of the Medicaid and Medicare patients already find difficulty to seek for physician due to the high attrition of doctors.

They will encounter shortage in supplying doctors to their new insured patients. Cut of Payments According to the Congressional office, there is a big chance to increase the Medicare reimbursements for about billion dollars. They will also experience tax breaks and they will find a hard time to meet the hospital costs. The downside of healthcare reform will serve as your guide to have a better understanding with the said matter before you attempt to avail their services.

The significance of healthcare reform is still in demand nowadays even though there are downsides that are being associated with healthcare reform. It is very important that you give ample time to know the pros and cons of healthcare reform as well as to have a better understanding with their benefits and disadvantages.

So, what can you say about this matter now? The 3 Pros of Healthcare Reform Here are the benefits of healthcare reform: 1.

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High prescription drug costs are a leading concern among Americans. Americans pay higher prices for prescription drugs than any other country in the world, with prescription drug prices in the U.

September 6, Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment VBP programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume.

February 22, This issue brief analyzes changes in health insurance coverage and examines trends in access to care among Black Americans using data from January 13, The Affordable Care Act provides premium subsidies for Marketplace eligible individuals to improve health insurance affordability, as well as cost-sharing reductions CSRs for many enrollees that limit out-of-pocket spending such as deductibles. This Issue Brief presents current estimates of enrollment in health insurance coverage obtained through the ACA Marketplaces and the Medicaid expansion and the subsequent reductions in state-level uninsured rates since the ACA was implemented in Related Products.

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