medical records online e-prescribing good?

[museabuse]

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Ok we know that by 2009 all doctor offices and hospitals must keep online medical records. With that comes e-prescribing...
I was under impression the pharmacists role would be to verify e-script and bill insurance and deal with DUR. THe only difference is we do not need to enter orders into the computer anymore.

My professor says he is looking into a system where not only does the doctor enter the order but the doctor also submits to insurance, does DUR review, and deals with P/A and other insurance issues.

That leaves us with filling and counseling. Actually in some/most places by then maybe just counseling.

I think the doctors will push back, but my question is if this happens then where does that leave pharmacists? If we are strickly counselors is that good or bad... or does that begin to dissolve our role in the health care? Doctors already question our career and if we push more off on them then what?

What do you guys think?

 

[alwaystired]

Ok we know that by 2009 all doctor offices and hospitals must keep online medical records. With that comes e-prescribing...
I was under impression the pharmacists role would be to verify e-script and bill insurance and deal with DUR. THe only difference is we do not need to enter orders into the computer anymore.

My professor says he is looking into a system where not only does the doctor enter the order but the doctor also submits to insurance, does DUR review, and deals with P/A and other insurance issues.

That leaves us with filling and counseling. Actually in some/most places by then maybe just counseling.

I think the doctors will push back, but my question is if this happens then where does that leave pharmacists? If we are strickly counselors is that good or bad... or does that begin to dissolve our role in the health care? Doctors already question our career and if we push more off on them then what?

What do you guys think?

I see where you are going, but technically, the pharmacy technicians are the insurance experts.......

 

[Aznfarmerboi]

First thing first, eprescription as of right now is too expensive for most pharmacies to install. I think its about 30 cents+ for each prescription? Bottles are about 30 cents, labels are about 50 cents a piece, plus other costs. . . means that we cant afford it. If the nurse made a mistake and send u the prescription twice, u just lost 60 cents.

Concerning the future of pharmacy, more or less. . . we will end up as clinical pharmacists and counselors. Once the chains kick out the independent pharmacies and then start to buy each other up. . . , there wont be a need for that many pharmacists. Mail order will only speed up that consolidation. You factor in robots that costs about 100k (a pharmacists yearly wage), pharmacists are only good to counsel and approve scripts.

 

[konkan]

First thing first, eprescription as of right now is too expensive for most pharmacies to install. I think its about 30 cents+ for each prescription? Bottles are about 30 cents, labels are about 50 cents a piece, plus other costs. . . means that we cant afford it. If the nurse made a mistake and send u the prescription twice, u just lost 60 cents.

Concerning the future of pharmacy, more or less. . . we will end up as clinical pharmacists and counselors. Once the chains kick out the independent pharmacies and then start to buy each other up. . . , there wont be a need for that many pharmacists. Mail order will only speed up that consolidation. You factor in robots that costs about 100k (a pharmacists yearly wage), pharmacists are only good to counsel and approve scripts.

Pharmacists are only good to counsel and approve scritps? Isn't that only what they do now🙂?

 

[kwizard]

I think the doctors will push back, but my question is if this happens then where does that leave pharmacists? If we are strickly counselors is that good or bad... or does that begin to dissolve our role in the health care? Doctors already question our career and if we push more off on them then what?

What do you guys think?

The theory is that all or at least the majority of operational task within a pharmacy will either be handled by automation and/or pharmacy techs. Whether this is a realistic expectation or not is largely debatable. I worked as a tech for severals years prior to completing pharmacy school as for all practical purposes working as a tech was my career at the time and I was certified and all. Like everything else there are great pharm techs and not so great ones. However particularly in the retail/long term care/home infusion setting you are typically dealing w/ someone w/ no previous healthcare and/or pharmacy experience. Not to say that the avg technician in a hospital is much better but hospitals typically don't take techs w/o previous experience. Anyways I just don't see the quantity and/or quality of pharmacy techs being able to handle bulk of operational issues w/i a pharmacy (the training is too far behind). Secondly the automation devices aren't always that reliable. The robots are great if they never break down, but all of the hospitals are all making that push toward electronic medical records and it is a major pain and slow process.

But to answer your question the "thinking tanks" in pharmacy saw this writing on the wall (i.e. advanced technology potentially minimizing the role of the pharmacist if the pharmacist is primarily focused on operational duties) which is why you had the push for all Pharm.D. back in the early-mid 80s and there is so much of a push for the recognition and reimbursement for clinical services. If pharmacists don't collectively develop some clinical autonomy that we can bill for then yes we may be in some trouble as a profession. Having said all of that I'm not sure how soon "the sky may be falling" as the average hospital and/or retail store can't find enough people to cover all of their shifts to fill these various predominantly operational tasks. Yeah the # of pharmacists will increase over the yrs, but the number of pts (in particulary the elderly) continue to rise as well and most of us in our 20s and early 30s haven't had kids yet so there are still potentially many more scripts to come. So I am a little skeptical about the things changing that much, but without the ability to bill for service the profession will definitely lack a necessity that all other health care professionals have.

 

[bananaface]

Hospitals are notorious for not following guidelines set forth for lack of funding or practicality. If there isn't good software out there that hospitals can afford, not much will come of the requirement. At this time, the available software may not be adequate or within financial reach of all groups.

 

[Aznfarmerboi]

If pharmacists don't collectively develop some clinical autonomy that we can bill for then yes we may be in some trouble as a profession. Having said all of that I'm not sure how soon "the sky may be falling" as the average hospital and/or retail store can't find enough people to cover all of their shifts to fill these various predominantly operational tasks. Yeah the # of pharmacists will increase over the yrs, but the number of pts (in particulary the elderly) continue to rise as well and most of us in our 20s and early 30s haven't had kids yet so there are still potentially many more scripts to come. So I am a little skeptical about the things changing that much, but without the ability to bill for service the profession will definitely lack a necessity that all other health care professionals have.

Robots WILL get more accurate and reliable. Second of all, even though the patient population will continue to rise, mail order will take care most of the demand. What is more convienent than a 90 day supply mailed to your house, and at a CHEAP price. The internet is simply blowing away the business and chains like Rite Aid have already see a heavy decline in business ~20 percent? Another thing that we got to take into consideration is what is driving the demand for pharmacists? In NYC, we have one totwo pharmacy on every block. (two chains on each block and then every other block, an independent pharmacy). Sooner or later, the chains are going to start buying out independent pharmacies and then merge. When they start to reconsolidate. . they will not need one or two pharmacy on every block since the pharmacist now have all the time in the world to counsel. The pharmacist shortage is only estimated to last to 2012. With thousands of students rushing to take up pharmacy due to high wages, i predict a surplus in the next decade.

I agree with kwizard, unless pharmacists can find a niche. . . the profession will be in trouble. What else can we do besides basic pharmacology stuff and providing information to doctors and patients that they can get form the books anyway. Any other things that we do, nurses and PA's can do for cheaper. We sure are not worth 100k a year .

 

[alwaystired]

Robots WILL get more accurate and reliable. Second of all, even though the patient population will continue to rise, mail order will take care most of the demand. What is more convienent than a 90 day supply mailed to your house, and at a CHEAP price. The internet is simply blowing away the business and chains like Rite Aid have already see a heavy decline in business ~20 percent? Another thing that we got to take into consideration is what is driving the demand for pharmacists? In NYC, we have one totwo pharmacy on every block. (two chains on each block and then every other block, an independent pharmacy). Sooner or later, the chains are going to start buying out independent pharmacies and then merge. When they start to reconsolidate. . they will not need one or two pharmacy on every block since the pharmacist now have all the time in the world to counsel. The pharmacist shortage is only estimated to last to 2012. With thousands of students rushing to take up pharmacy due to high wages, i predict a surplus in the next decade.

I agree with kwizard, unless pharmacists can find a niche. . . the profession will be in trouble. What else can we do besides basic pharmacology stuff and providing information to doctors and patients that they can get form the books anyway. Any other things that we do, nurses and PA's can do for cheaper. We sure are not worth 100k a year .

More and more these type of thoughts push me to residency and clinical pharmacy.

 

[Jeddevil]

The pharmacist shortage is only estimated to last to 2012.

Well, this report seems to say the opposite of what you are saying, actually stating that the shortage will get worse into the next decade.


http://home.businesswire.com/portal...d=news_view&newsId=20060317005015&newsLang=en


It was released by a pretty credible organization, APHA, and is going to be in the next JAPhA issue.

I keep seeing these "sky is falling, demand will go away in a few years" type of posts, but I never see any data to support those claims. I only see data stating that demand will stay high for years to come.

If you can, please post the report you cite above about the demand going away in 2012. I would love to read it. Thanks.

 

[kwizard]

Well, this report seems to say the opposite of what you are saying, actually stating that the shortage will get worse into the next decade.

If you can, please post the report you cite above about the demand going away in 2012. I would love to read it. Thanks.

I think it is fair to say that none of us can really gauge what the future holds. The "sky is falling" routine has been thrown out there alot over the past 2 decades and in some instances you see progress and in the others the more things change the more they stay the same. When calculating market impact and/or when supply of pharmacists meet demand I wonder whether they calculate that everyone going to pharmacy may not ever practice pharmacy. For example for every new pharmacy school you need that many more people on pharmacy faculty and many of the current faculty members at currently existing schools of pharmacy are set to retire w/i the next 5-10 yrs in addition to those who may go straight to industry/research positions so there are a lot of variables to consider. However the technological advances are indeed making significant progress in some sectors, but even w/ mail order or any bulk form of delivery you still need a pharmacist to check all of those meds. I hope it never comes down to technician verification w/ bar codes being used everywhere.

On the other side the demand for clinical pharmacists is hard to gauge b/c the profession of clinical pharmacy has yet to reach its full potential so its hard to figure out how much it will be in demand prior to realizing its true role. Eitherway I think we can all agree that only time will tell exactly which way things will go.

 

[Aznfarmerboi]

Well, this report seems to say the opposite of what you are saying, actually stating that the shortage will get worse into the next decade.


http://home.businesswire.com/portal...d=news_view&newsId=20060317005015&newsLang=en


It was released by a pretty credible organization, APHA, and is going to be in the next JAPhA issue.

I keep seeing these "sky is falling, demand will go away in a few years" type of posts, but I never see any data to support those claims. I only see data stating that demand will stay high for years to come.

If you can, please post the report you cite above about the demand going away in 2012. I would love to read it. Thanks.

Jeddevil, what data have you seen that says demand will stay high for years to come? In your other posting, you linked us to http://pharmacymanpower.com/. From the first page, you can see that one, the pharmacy shortage is declining instead of increasing. 2, Supply and demand is almost or in balance in many states with a few states having a surplus of pharmacists. Concerning the article that you just linked me to, they cite the pharmacist shortage to part time workers and people going into retirement. Yet you do not account for how many people are coming out of pharmacy schools in addition to the new pharmacy schools that were open.

The link that you request is according to the Occupational Outlook handbook issued by the BLS.gov . I would link you but I cant get into their site right now.

I am not saying that you are wrong about the pharmacist shortage but how do you answer my claims. Mail order means a less need for pharmacists, robots means freeing pharmacist time allowing them to do more, closing of hospitals or merging of hospitals all over the nation, and buyinig up of independent pharmacies by chains, merges (cvs and eckered) all mean a less need for pharmacists. The chains are hurting from a lack of reembursement by insurance companies (medicare part D anyone???), to common sense business. This may be offset from numerous blockbuster generics entering the market. The NYT recently wrote an article in their national page saying how a lot of pharmacists are going bankrupt or taking moneys from their saving to cover their losses.

I agree with Kwizard as clinical pharmacy is the key. We need to see where this leads us as it has not reach its full potential.

 

[Jeddevil]

From the first page, you can see that one, the pharmacy shortage is declining instead of increasing. 2, Supply and demand is almost or in balance in many states with a few states having a surplus of pharmacists. Concerning the article that you just linked me to, they cite the pharmacist shortage to part time workers and people going into retirement. Yet you do not account for how many people are coming out of pharmacy schools in addition to the new pharmacy schools that were open.

The first page shows a slight decrease in demand from a month ago. I would not base everything on a month to month figure. I believe the figure more worthwhile on that page would be the current compared to the same month last year, which is very stable. If they put figures on there to compare to demand five years ago, that would be even more worthwhile for watching the trend.

Supply and demand are in balance in 9 states and towards the supply side on one state. That tells me that 40 states and the DC still have pretty good demand in them, not that "Supply and demand is almost or in balance in many states". It states the opposite. Most of the states with adequate supply are midwestern states where people have been flooding from for years. I wouldn't want to try to set up a pharmacy practice in those states. People may have to move to find demand.

The article posted talking about the pharmacists working part-time etc. is put out by APhA. I tend to trust that organization a bit more than some government outfit putting out an occupational outlook. How many times is the gov. right? As a pharmacy student, I tend to trust the major pharmacy organization over concerns about my occupation than a government site, but maybe that is just me.

Your claims are the same ones that people have been bringing up on here and in the industry for the last decade. Mailorder was supposed to bury the industry over 5 years ago, it hasn't. Mergers have been happening at record paces over the last decade, but the demand is at highs. Robots may hurt the industry, as far as techs go, but I don't worry about them personally as a pharmacist. People will never feel comfortable getting advice from a robot, not the majority of people, especially senior citizens. If pharmacists are going bankrupt it is because they can't manage their money. That doesn't concern me. There will always be people that make decent money, think they make great money, spend like they make great money and go bankrupt, in every profession. That is not a threat to the industry, just bad personal finance.

You should be able to use medline or pubmed to find plenty of studies on the future job outlook for pharmacists. I don't have the time to find them. I didn't post here to get in a pissing match with you. I do not understand why people would invest the money into this degree if they felt that demand would just dry up in a few years. But to each his own. Take care.