August 2015 Florida Pharmacy Journal

The Official Publication Of The Florida Pharmacy Association AUG. 2015

THE 125th ANNUAL MEETING & CONVENTION

A Pharmacist And A Lawyer Board of Pharmacy Licensure Disciplinary Proceedings Compounding Violations, Pharmacy Audit Disputes Mergers and Acquisitions Commercial, Civil and Criminal Proceedings KAHAN â—† HEIMBERG, PLC

Pharmacist Attorney

JOIN TODAY!

Brian A. Kahan, R.Ph., J.D. Licensed Florida Pharmacist and Attorney

STATEWIDE REPRESENTATION 561-392-9000 bkahan@kahanlaw.com 2300 N.W. Corporate Blvd., Suite 123 Boca Raton, FL 33431 The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience.

2 |

FLORIDA PHARMACY TODAY

Florida Pharmacy Association

florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 30 Buyer’s Guide

VOL. 78 | NO. 8 AUG. 2015 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

10 16 18 27

Interdisciplinary View: Utilizing Pharmacists as Healthcare Providers to Relieve Primary Care Shortages

Thank You to Our Sponsors The 125th Annual Meeting and Convention was a huge success – due in large part to the sponsors who contributed and made it possible. The FPA thanks our sponsors who participated.

Florida Pharmacy Association’s 125th Annual Meeting and Convention Social Media Healthcare: To Post or Not to Post

AUGUST 2015

|

3

Mission Statements:

FPA Calendar 2015-16

SEPTEMBER 1

Deadline to Submit Nominations for FPA Office

7

Labor Day (FPA Office Closed)

11

APhA Diabetes and Immunization Certificate Program

12-13 FPA Regulatory and Law Conference Ft. Lauderdale

11

of the Florida Pharmacy Today Journal Veterans Day (FPA Office Closed)

26-27 Thanksgiving Holiday (FPA Office Closed) DECEMBER 5-6

FPA Regulatory and Law Conference Sarasota

24-25 Christmas Holidays (FPA Office Closed)

OCTOBER

JANUARY

10-14 NCPA Annual Meeting Washington, D.C.

1

New Year’s Day (FPA Office Closed)

17-18 FPA Mid-year Clinical Conference Orlando

12

2016 Legislative Session Begins

17-18 FPA Nuclear Conference Orlando NOVEMBER

19-20 Health Fair and Legislative Day Event 23 - 24 FPA Law and Regulatory Conference

14-15 FPA Council and Committee Meetings Orlando

For a complete calendar of events go to www.pharmview.com Events calendar subject to change CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours’ LIVE Continuing Education as part of the required 30 hours’ general education needed every license renewal period.

Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2015 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2016.

For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office.

For more information on CE programs or events, please contact the Florida Pharmacy Association at (850) 222-2400 or visit our website at www.pharmview.com

The Florida Pharmacy Today Journal is a peer-reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

of the Florida Pharmacy Today Board of Directors

The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities.

The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the Journal in its goal of self-support.

Advertisers APMS.....................................................................9 THE HEALTH LAW FIRM ................................8 KAHAN HEIMBERG, PLC.................................2 PHARMACISTS MUTUAL..............................21 PPSC.......................................................................2

CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 U/F — Art Wharton (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER

Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association is engaged in rendering legal or other professional services through this publication.

If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

4 |

FLORIDA PHARMACY TODAY

E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com

The President’s Viewpoint

BY KATHY PETSOS, GUEST COLUMNIST

MEMBERSHIP IS A TOP PRIORITY

A

ll types of organizations are struggling with attracting new members and retaining current members. This is not a problem exclusive to the Florida Pharmacy Association. Last month at the Space Coast Gator Club planning meeting, the new president asked each of us why we belong to the University of Florida Alumni Association and what we needed to do to attract new members – especially younger members. As I sat there and listened to a familiar rehash of my last three years on the Membership Council, I was astounded as he just graduated last year and is a member of the most sought after demographic, a Millennial!

This is a widespread problem across the nation as baby boomers retire and move out of leadership positions in volunteer organizations. Who will replace them? How do we attract people, especially young people, who want and can contribute to the continued relevancy and vitality of our association? It is a sad fact that there are 30,173 Florida licensed pharmacists and only 1,811 are regular members of the Florida Pharmacy Association. If we add the categories of associate, recent graduate, graduate student, joint, retired and life members, it adds an additional 520 members. Still not impressive. Pharmacy students add another 857 members.

Also there are 33,880 registered technicians and we only have 398 technician members. What are we going to do? Where do we start?

Thanks to the untiring leadership of Don Bergeman, we at least have a place to start. He worked with the FPA Board of Directors to develop a core value statement so the FPA Membership Council could develop value proposition statements for the target membership groups - pharmacists,

pharmacy technicians and students.

The core value statement is: The FPA is the go-to source for current, reliable information on the legal and regulatory issues that affect YOU in your professional practice.

We provide YOU with valuable educational tools and networking opportunities.

How do we attract people, especially young people, who want and can contribute to the continued relevancy and vitality of our association?

We are your voice in protecting your profession at the state and national levels.

JOIN TODAY and be a part of that voice.

In March, the FPA Membership Council developed the following value proposition statements, which still need to be adopted by the Board of Directors:

PHARMACIST The FPA is your go-to resource for current, reliable information on the legal and regulatory issues that affect YOU in your professional pharmacy practice setting.

We provide YOU with valuable educational and business tools, and networking opportunities. We are your voice in protecting and advancing your profession at the state and national levels.

JOIN TODAY and be a part of that voice.

Kathy Petsos 2005-2006 FPA President

PHARMACY TECHNICIAN The FPA is your go-to resource for current, reliable information on the legal and regulatory issues that affect YOU in your professional pharmacy practice setting.

We provide YOU with valuable discounted continuing education, career advancement and leadership development tools and networking opportunities. We are your voice in protecting and advancing your profession at the state and national levels.

JOIN TODAY and be a part of that voice.

STUDENTS The FPA is your go-to resource for current, reliable information on the legal and regulatory issues that affect YOU now and in your future professional pharmacy practice setting.

We provide YOU with valuable leadership development and educational tools, networking opportunities and exposure to diverse practice settings.

AUGUST 2015

|

5

2015-16 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.

Suzanne Kelley..................................................................................................Board Chair Timothy Rogers..........................................................................................FPA President Alexander Pytlarz.................................................................................... FPA Treasurer Scott Tomerlin...........................................................................................President-Elect Jackie Donovan........................................................................Speaker of the House Carol Motycka................................................................Vice Speaker of the House Thomas Johns......................................................................................... FSHP President Jennifer Raquipo................................................................................. Region 1 Director Michael Hebb.........................................................................................Region 2 Director Tom Cuomo.............................................................................................Region 3 Director Linda Lazuka.........................................................................................Region 4 Director Robert Parrado...................................................................................Region 5 Director Luther Laite IV.....................................................................................Region 6 Director David Mackarey.................................................................................. Region 7 Director Humberto Martinez..........................................................................Region 8 Director Mitchell Fingerhut.............................................................................Region 9 Director

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair....................................................Cristina Medina, cmmedina@cvs.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary.............. Verender Gail Brown, brownvgrx4304@hotmail.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member.............................. Rebecca Poston, Rebecca.Poston@flhealth.gov Member.................................................Patricia Nguebo, notablep@hotmail.com Member................................................................Norman Tomaka, FLRX9@aol.com Member........................................................................Stuart Ulrich, Stuarx@aol.com Member............................................................. Don Bergemann, don@bceinfo.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com Journal Reviewer....................... Dr. Melissa Ruble, mruble@health.usf.edu Journal Reviewer....................................Dr. Angela Hill, ahill2@health.usf.edu

6 |

FLORIDA PHARMACY TODAY

We are your voice in protecting and advancing your profession at the state and national levels.

JOIN TODAY and be a part of that voice.

Now that we have these statements, we can start developing marketing materials specific to each group and, hopefully, highlight activities and products each group would be most interested in.

This will be dependent on these statements being adopted by the FPA Board of Directors.

But, what else? What are some outof-the-box ideas for increasing membership? One of President Tim Rogers’ goals is to increase membership by 50 percent over the next five years. He has proposed that the association offer a free, limited, one-year membership to pharmacist non-members. This limited membership would only include electronic communication such as “Stat News” and the online Journal. After the year is up, the question would be do you have a gradual increase in membership dues, or do you go straight to full membership dues? Obviously, this will have to go to the FPA Budget and Finance committee to determine the financial impact on the association. Another idea is to offer a discount to members who want to pay for two- to five-years of membership at one time. Offer as many avenues as possible for obtaining continuing education, especially membersonly offerings that have easy access.

Do you have any ideas for increasing membership? It is a very complex issue and there is no easy answer. Or maybe there is one simple answer. Are you proud of your profession and proud to be a pharmacist? Is your goal as a pharmacist to be a healthcare provider who improves the quality of healthcare for your patients and to advance the ability of your profession to provide every opportunity for you to do so? We need the help of all current members to recruit new members. There is power in numbers and our ability to successfully advocate for our patients and our profession. Please feel free to contact me at kpetsos@earthlink.net if you have any ideas or suggestions. n

Executive Insight

BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

N

Leadership Opportunities for You to Pass Up

ow, this is a subject that is worthy of discussion. It is in everyone’s nature to want to feel important, needed and a useful member of society. The contributions that we all make to society are the list of items that we would like to highlight on our résumés. These contributions are viewed favorably if they make someone else’s life better, improve health or build efficiencies and order in a world of chaos. It takes leadership to overcome obstacles which may be seen as barriers to success. A truly dedicated and committed leader is one who uses failure as a learning tool. This includes a low frustration threshold and a desire to use experiences, both good and bad, as a way to gain knowledge.

Ironically, the availability of leadership opportunities for pharmacists, pharmacy technicians and other pharmacy stakeholders is extensive in Florida. There is never a shortage of ways that volunteers can make a difference in this profession. There is a lot of work that needs to be done on issues that affect the ability of pharmacists to practice at the top of their profession, and to protect the business assets of pharmacies both big and small. All it takes is a commitment by the volunteer to give their time and their talents to the cause.

The Florida Pharmacy Association, by our last count, has about 21 unique leadership groups with various purposes. These 21 organizations are either appointed or elected opportunities that were available this past year. There is a group opportunity for all pharmacy stakeholders, whether you are a pharmacist, pharmacy student, technician or pharmacy owner. Even if being a leader within the FPA group structure

is not your thing, you can use the power of the keyboard to demonstrate your involvement in your profession and your organization. The Florida Pharmacy Today Journal is always looking for content, particularly from our mem-

There is never a shortage of ways that volunteers can make a difference in this profession. There is a lot of work that needs to be done on issues that affect the ability of pharmacists to practice at the top of their profession, and to protect the business assets of pharmacies both big and small. bers who are doing unique things within the profession. All you have to do is draft the article and send us your photograph, and if what you are submitting is relevant, we will work to get it published for you.

It is amazing that these leadership opportunities are passed-up on a regular basis. The FPA Board of Directors consists of volunteers who apply as candidates and are slated on the election ballot. The FPA will regularly publish

Michael Jackson, B.Pharm

a call for Board candidates in the Journal, which is published online each month, and is available as an online application through Pharmview.com. This fall we hope to slate two candidates for president elect and at least two candidates for Region 2 (Nassau, Duval, Marion, Volusia, Flagler, Putnam, St. Johns and Clay counties), Region 4 (Seminole, Orange, Osceola, Lake and Sumter counties), Region 6 (Brevard, Manatee, Hardee, Okeechobee, Highlands, Desoto, Sarasota, Charlotte, Glades, Martin, St. Lucie and Indian River counties) and Region 8 (Collier, Monroe and Miami-Dade counties). If you live in any of these counties and you are a Florida licensed pharmacist, you have two choices: First you can give thought to presenting your petition for consideration by the nominating committee for a seat on the FPA Board for your region; AUGUST 2015 |

7

FPA STAFF Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200

Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall, ext. 211

Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110

FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair................................Cristina Medina, Hollywood Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Verender Gail Brown, Orlando Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member.............................................. Patricia Nguebo, Ocala Member................................. Norman Tomaka, Melbourne Member..............................Stuart Ulrich, Boynton Beach Member.......................Don Bergemann, Tarpon Springs Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer-reviewed publication. ©2015, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today.

The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today.

The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board.

FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax.

FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY

second, you can follow the title of this article and pass up this opportunity for volunteer leadership. You have two other options, if serving as a regional director is not your interest: You could take a step up into the FPA “captain’s chair” and submit your nomination as president-elect of the FPA. You could also nominate a colleague who you feel has leadership potential and is interested in helping to shape pharmacy policy.

Nominations are reviewed by a nominating committee appointed by the president and consisting of the past Chair of the Board of Direc-

tors and a representative from each of FPA’s six standing councils. All nominations will need to be submitted into the FPA office by September 1st.

Of course, you may be more interested in letting this opportunity pass you by and hope that someone else will do it. Remember that society is filled with those who watch what happens, wonder what happened and make things happen. Which one of those are you? Don’t be content to just sit in the stands and cheer for your FPA team.

Suit up and get into the game! n

Remember that society is filled with those who watch what happens, wonder what happened and make things happen. Which one of those are you?

Representing Health Care Professionals

• DOH Investigations • Licensure Discipline • Medicare/Medicaid Defense • Administrative Hearings • Contract Litigation George F. Indest III, J.D., M.P.A., LL.M.

1101 Douglas Avenue Altamonte Springs, FL 32714 Telephone: (407) 331-6620 www.TheHealthLawFirm.com

“I’M ALWAYS WATCHING OUT FOR MY PATIENTS, BUT WHO’S WATCHING OUT FOR ME?”

WE ARE. We are the Alliance for Patient Medication Safety (APMS), a federally listed Patient Safety Organization.

Our Pharmacy Quality Commitment (PQC) program: • • • •

Helps you implement and maintain a continuous quality improvement program Offers federal protection for your patient safety data and your quality improvement work Assists with quality assurance requirements found in network contracts, Medicare Part D, and state regulations Provides tools, training and support to keep your pharmacy running efficiently and your patients safe

Call toll free (866) 365-7472 or visit www.pqc.net PQC IS BROUGHT TO YOU BY YOUR STATE PHARMACY ASSOCIATION AUGUST 2015

|

9

Interdisciplinary View: Utilizing Pharmacists as Healthcare Providers to Relieve Primary Care Shortages AUTHOR IDENTIFICATION:

Megan D. Dezan, Pharm.D. Candidate megan1.dady@famu.edu Juan F. Mosley II, Pharm.D., AAHIVP Assistant Professor of Pharmacy Practice juan.mosley@famu.edu Marcus M. Gurley Jr., Pharm.D. Candidate marcus1.gurley@famu.edu Lillian L. Smith, Pharm.D., MBA, CPh. Assistant Professor of Pharmacy Practice lillian.smith@famu.edu April S. Prather, Pharm.D. Candidate april1.prather@famu.edu

Florida A&M University College of Pharmacy and Pharmaceutical Sciences Crestview Education Center 153 W. Woodruff Avenue Crestview, FL 32536 DISCLOSURE: The authors do not possess personal or financial association with any commercial entities that may or may not have been involved at any time during the research process.

Primary Author: Juan F. Mosley II Corresponding Author: Lillian L. Smith

Dr. Juan F. Mosley II is an assistant professor of pharmacy practice at Florida Agricultural and Mec h a n ic a l Un iversit y’s (FAMU) Col lege of Pha rmacy and Pharmaceutical Sciences. He works concomitantly with the Escambia County Health Department and the Escambia County Community Clinics, Inc., where he provides HIV and primary care services, while facilitating hands-on clinical experiences for student pharmacists. Dr. Mosley is an advocate for the advancement of the profession of pharmacy and is passionate about expanding his clinical knowledge, serving the community and giving back to his profession.

10

|

FLORIDA PHARMACY TODAY

INTRODUCTION Since the induction of the Affordable Care Act, millions of Americans are now eligible to seek healthcare. Unfortunately, the resultant exponential rise in demand for healthcare services was faced with an insufficient supply of general practitioners. According to the U.S. Department of Health and Human Resources, America is starving for primary care physicians and this deficit will remain beyond the year 2020.1 Due to an increased emergence of subspecialty training centers and the associated increase in reimbursement potential, a vast percentage of current medical students are avoiding the practice of general medicine.2 It is not astonishing for medical students to accrue substantial student loans; as a result, primary care reimbursement rates are simply not enough to allure aspiring medical doctors. Although highly trained professionals like physician assistants and nurse practitioners are aiming to offset the demand, the need is still unmet.

Clinical pharmacists in select settings and states have prescribing rights and are deemed qualified to provide efficient healthcare. They manage minor acute complications and chronic diseases on an outpatient basis, due to their general medical knowledge, patient interaction skills and extensive medication expertise. Perceptibly, medical students, physicians, nurse practitioners and physician assistants may receive the impression that pharmacists are expanding beyond their scope of practice. However, healthcare is becoming more complex and requires a team of professionals working collectively. Despite substantial endorsements for integrating clinical pharmacists into primary care practices from the Office of the Chief Pharmacist for the United States

Public Health Service,3 pharmacists currently remain excluded from being legally classified as healthcare providers on a national level. Nevertheless, pharmacists are highly regarded as one of the most trustworthy and accessible health professionals who have shown to significantly improve patient and health system outcomes.3 In March 2014, a bipartisan bill, H.R. 4190, was introduced into Congress to amend Title XVIII of the Social Security Act with regard to pharmacists’ provider status.4 This legislation would allow for pharmacist-provided services to be reimbursed under Medicare Part B if they are provided to medically underserved populations, or in health professional shortage areas.5 Although the bill was originally tabled, it was reintroduced in January 2015. The passage of this bill into law would allow 85 percent of the physician fee schedule to be reimbursed for these services.6 By proactively highlighting strengths and identifying possible barriers to increase the responsibility of pharmacists, there could be a reduction in interdisciplinary tension. If the legislation passes, healthcare providers would have to accept, to a certain degree, an expanded role of pharmacists in order to effectively provide optimal patient-centered care.

PURPOSE The purpose of this study is to examine the views of individuals in various disciplines of healthcare on the utilization of pharmacists to relieve the burden of America’s shortage of primary care providers. The study investigated the opinions of healthcare professionals who had obtained advanced degrees in the fields of medicine, nursing and pharmacy, as a representation of current interdisciplinary teams. Furthermore,

the inclusion of prospective professionals, such as pharmacy and medical students, aims to extrapolate future points of view of interdisciplinary teams. The study performed showed that other professionals believe that the nation is in need of primary care physicians.

Subsequently, if there is a need for primary care services, would a pharmacist, in their opinion, be able to meet this demand?

METHODS This investigation was approved by an investigational review board (IRB).

Participants in this study were required to be currently or formerly licensed U.S. healthcare providers or pharmacists (BPharm or Pharm.D.). For the purposes of this study, healthcare provider was defined as medical doctor (MD, DO), physician assistant (PA), or nurse practitioner (NP/ FNP/ ANP). Students actively pursuing a graduate degree in the aforementioned fields at an accredited college of pharmacy or medicine were also eligible participants in this study. Eligible research participants were able to participate, regardless of state(s) of practice. Any pharmacist or healthcare provider who had not been legally licensed at some point during his or her lifetime to practice in the U.S. were excluded from the study. Additionally, medical assistants, licensed practical nurses (LPN) and registered nurses (RN) were not considered primary healthcare providers for the purposes of this investigation.

All qualified participants were contacted via email or in person at their respective practice sites or colleges. Contact was made by either investigators, selected administrative personnel of healthcare facilities, or student liaisons.

Participant consent was obtained prior to the completion of each survey. Individuals were encouraged to spread the recruitment letter amongst their eligible colleagues to obtain additional participation. All selected representatives and liaisons were solely asked to distribute the electronic form via an email link and were not held responsible for the distribution or collection of hard copy survey forms. All hard copy sur-

vey submissions were manually transposed to electronic format by the study investigators for the purpose of uniformity and graphical analysis. The survey consisted of a total of 28 Likert scaleformatted questions with an additional open-ended question for comments and feedback. All survey results were completed and analyzed during October and November 2014 using Survey Monkey software.

RESULTS A total of 139 participants in varying disciplines of the healthcare field completed a survey. As shown in Figure 1, 44 percent of the responses came from pharmacy students, and more participation was seen among females than males. Table 1 displays the various questions participants completed regarding this research, along with the correlating response options chosen.

Overall, when survey participants were asked if they felt there was a healthcare shortage in the United States, 85 percent of participants strongly agreed or agreed with this statement. Sixty-seven percent of practicing healthcare providers and medical students strongly agreed that there is a shortage of primary healthcare providers. However, pharmacists and pharmacy students were slightly less aware of this fact, as

only 33 percent and 38 percent respectively strongly agreed that there is a primary care shortage.

In addition, 78 percent of participants either agreed or strongly agreed that pharmacists are capable of providing primary care services, in conjunction with other healthcare providers.

Pharmacists and student pharmacists felt more confident with providing primary care services; 65 percent of pharmacists and 61 percent of student pharmacists strongly agreed in their confidence to provide these services.

However, only 21 percent of healthcare providers strongly agree with this statement. A vast majority of participants (71 percent) strongly agreed that pharmacists should provide counseling services to patients about their drug therapy.

Furthermore, healthcare practitioners feel that patients will be comfortable with the transition of pharmacists taking a more active role as a healthcare provider. Survey results showed that 69 percent of participants strongly agreed or agreed that patients would feel comfortable with this change. More than 80 percent of survey participants also felt that additional pharmacist assistance will have a positive impact on patient outcomes. However, only 32 percent of participants strongly agreed that pharmacists serving as an extension of AUGUST 2015 |

11

medical doctors could help relieve the healthcare shortage. Figure 2 shows the resulting views of pharmacists filling the gap as an extension of healthcare providers.

Study results regarding pharmacist education showed mixed confidence levels in pharmacists’ abilities among healthcare practitioners. As shown in Figure 3, there is also a great concern on whether pharmacy schools adequately prepare pharmacists to be qualified as healthcare providers. Overall, survey participants are not confident that pharmacy schools prepare students for the role of a healthcare provider. Only 33 percent of survey participants agreed or strongly agreed that the current curriculum is adequate, while 37 percent of survey participants strongly agreed that pharmacists receive sufficient training to conduct patient assessments regarding demographics and history. Twenty-nine percent of providers and three percent of medical students agree that pharmacists receive sufficient training in patient assessment. Most participants (89 percent) agree that a residency or an additional year of training in relative diagnostic skills (60 percent) should be completed to better prepare pharmacists for the role of healthcare providers.

DISCUSSION There was little apprehension to the notion that America’s shortage of primary care providers is coupled with an increased need for accessible healthcare.

The majority of research participants (84 percent), irrespective of professional association, agreed that there was a present shortage of healthcare providers and 82 percent agreed that pharmacist assistance with patients in a capacity exceeding medication management will have a positive impact on patient outcomes. Despite the acknowledgement of a benefit in using the clinical services of pharmacists in conjunction with other health professionals, several obstacles were highlighted including reimbursement, infringement upon another’s profession and time available to provide services. The most prominent concern identified was a pharmacist’s ability to effectively diagnose and treat patients with the training provided by 12

|

FLORIDA PHARMACY TODAY

current pharmacy school curriculums.

While this study was unable to adequately assess the opinions of healthcare providers due to time constraints, medical students consistently reported lack of training as reasons why pharmacists were not suitable alternatives for providing primary care services.

Most current pharmacy curriculums do not provide adequate training to enhance diagnostic capabilities; however, pharmacy schools nationwide have adapted to facilitate pharmacy students’ abilities to provide holistic patient-centered pharmaceutical care.7The evolution of the healthcare marketplace and the increased demand of an enhanced inter-professional collaborative healthcare team to improve patient outcomes, has prompted the Accreditation Council for Pharmacy Education (ACPE) to require all professional pharmacy programs to develop a curriculum that “Meets the criteria of good science; professional skills, attitudes and values; and the ability to integrate and apply learning to both the present practice of pharmacy and the advancement of the profession.”7 In order to achieve the professional competencies and outcome expectations set forth by ACPE, pharmacy schools nationwide have aimed to facilitate pharmacy students’ abilities to provide patient-centered pharmaceutical care and disease prevention

using sound therapeutic principles and evidence-based data, while taking into account relevant legal, ethical, social, cultural and economic factors that may impact health outcomes.

Most current curriculums do not provide courses to enhance diagnostic capabilities, but diagnosis is a single step in chronic diseases state management. Many common chronic ailments such as type 2 diabetes mellitus, hypertension, hyperlipidemia, asthma, anticoagulation and COPD can be readily diagnosed and managed using standard laboratory values and vital signs easily interpreted by current student pharmacists, as well as currently licensed pharmacists.8 Given the appropriate tools, pharmacists can identify certain ailments, notwithstanding limitations related to direct patient evaluations such as auscultation. The study revealed that 72 percent of study participants felt comfortable with pharmacist management of chronic disease states after initial patient assessment and diagnosis by a primary care provider.

Furthermore, it is universally agreed that these services should only be rendered by pharmacists who have undergone additional training in diagnostic skills through either an additional year of schooling or tailored post-graduate training, such as first- and second-year residencies, fellowships, master and

doctoral programs.2 A primary opposition to a transition into provider status for a pharmacist is the infringement upon the scope of another profession.8 The use of the clinical knowledge of pharmacists was endorsed by then-U.S. Surgeon General Regina Benjamin and U.S. Public Health Service (USPHS) under the title “advance pharmacy services” rather than primary care provider.2 This designation is primarily based on the precedent that expanded primary care services have successfully been delivered post-diagnosis within the present scope of pharmacy practice, through collaborative practice agreements (CPAs). According to the 2011 report, pharmacists have collaboratively managed disease states in a variety of healthcare settings through both cognitive and clinical pharmacy services for more than 40 years, and are currently able to “initiate, modify and/or discontinue drug therapy, pursuant to a collaborative practice agreement or protocol” in more than 40 states.2 While the American Academy of Family Physicians has agreed that non-physician healthcare providers are capable of delivering primary services, the organization has not explicitly listed pharmacists as this type of entity.9 Given their level of education, accessibility and extensive training, maximizing the role

of pharmacists in the U.S. healthcare delivery system can significantly improve healthcare reform, if effectively implemented.10 In general, pharmacists who are currently participating in CPAs and providing primary care to individual patients are obliged to perform medication-related patient assessments, order appropriate laboratory values based on medication profiles, interpret data related to medication safety, initiate and monitor patient care plans, identify barriers to continuity of care and provide patient or provider education about medication-related events.11 These services are routinely rendered post-diagnosis, similarly to the models practiced by other non-physician providers. Overall, survey participants feel that pharmacists are capable of providing healthcare services in conjunction with other providers, and select states such as California, Kansas, Minnesota, Tennessee and Wisconsin have expressed this assertion through recognition of the scope of advanced pharmacy practice through policies, legislation, or licensure.12 While separate licensure to provide advanced clinical services through CPAs on a state level is not mandatory, study results suggest that the federal designation of a pharmacist as a healthcare provider may require additional certification to

improve physician confidence, as well as promote a clearer definition in support of seeking reimbursement.13 Health legislations like the Social Security Act do not currently identify pharmacists as practitioners; consequently, this impedes the ability to receive payment for clinical pharmacy services.2 Pharmacists serving as healthcare providers would not only improve health outcomes, but also add clinical value to patient therapy. Several survey participants in varying disciplines documented concern for financial compensation for pharmacists providing primary care services. Transitions from fee-for-service models to accountable care organizations are forcing health systems to endorse innovative healthcare services that generate long-term revenue.14 Most pharmacists are currently only reimbursed for the dispensation of medication or devices; however, the increased value of advanced pharmacy services should be considered for additional compensation.15 However, pharmacists are getting closer to obtaining provider status as legislation was recently reintroduced in the U.S. House of Representatives and Senate during January 2015. This federal legislation would allow pharmacists to provide healthcare services to Medicare patients in underserved areas. The “Pharmacy and Medically Underserved Areas Enhancement Act” (H.R. 592, 2015) was introduced to the House of Representatives on January 28, 2015 and seeks to amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services.16 On January 29, 2015, a companion bill was introduced by the Senate (S. 314, 2015).17 Presently, the Florida Pharmacy Association has demonstrated strong support both statewide and nationally for the recognition of pharmacists as providers, believing “We [as pharmacists] can make a difference in the quality and costs of American healthcare.”18 The organization is continuously working to educate stakeholders about the transitioning roles of pharmacists and the benefits of pharmacists achieving provider status. FPA constantly features pharmacist who are currently providAUGUST 2015

|

13

Table 1: This table represents a compilation of each of the Likert scale-based survey questions and the respective numerical responses from the study participants, regardless of professional title.

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

1. There is a shortage of primary care physicians in the United States.

61

56

14

7

0

2. Pharmacists are capable of providing primary care services in conjunction with other health professionals.

65

44

15

11

4

3. Pharmacists should be able to provide counseling services directly to patients regarding questions about drug therapy.

99

36

3

1

0

4. Pharmacists can give adequate advice on the treatment of ailments or symptoms normally presented in an outpatient setting.

73

39

12

13

1

5. Pharmacists receive sufficient training to conduct patient assessments regarding demographics and history.

52

44

26

15

2

6. Pharmacists currently do not have the training to perform physical examinations of patients for the purpose of diagnosing disorders commonly encountered in a primary care setting (i.e., minor acute illness, chronic disease).

25

57

22

24

11

7. Pharmacists have enough time to provide non-dispensing services.

8

36

36

46

12

8. The direct involvement of a pharmacist in the primary care setting is beyond the profession’s scope of practice.

11

21

24

55

25

9. Pharmacists serving as an extension of medical doctors could relieve the shortage of primary care physicians.

45

51

22

17

4

10. Pharmacist assistance with patients in a capacity exceeding medication management will have a positive impact on patient outcomes.

61

53

14

9

2

11. I have a desire for pharmacists to play a more active role in providing patient care in an outpatient setting.

68

35

21

12

3

12. I would be comfortable with pharmacists overseeing chronic disease state management in an outpatient setting.

55

44

12

13

13

13. I would be comfortable with pharmacists treating minor acute complications in an outpatient setting.

42

58

20

13

6

14. If and when allowed by law, I am comfortable with pharmacist prescribing medications for patients.

52

43

22

12

10

15. The current pharmacy school curriculum prepares students to become primary care providers.

16

30

39

36

18

16. A residency in primary care will better equip pharmacist to assume the role as healthcare providers.

66

57

9

5

1

Survey Questions

14

17. Pharmacists or pharmacy students should complete an extra year of training or pharmacy school (total of five years) in relative diagnostic skills (i.e. labs, differentiation, etc.) to prepare for the role of a healthcare provider.

42

41

25

22

9

18. Patients will be comfortable with a pharmacist taking a more active role as a healthcare provider.

40

55

29

12

3

|

FLORIDA PHARMACY TODAY

ing clinical services to raise awareness of the healthcare services pharmacists can provide to patients. This study primarily surveyed various practitioners, future practitioners, pharmacists and student pharmacists from the state of Florida. Therefore, the results further support the views that pharmacists in this state can have a significant impact on the primary care shortage, and places even more importance on the support and dedication of the Florida Pharmacy Association’s goal to achieve provider status for pharmacists in the state of Florida.

The outcomes from expanding pharmacy services, as previously stated, resemble the impact of nurse practitioners and physician’s assistants who are compensated.2 Some concern arises that the inability of medical institutions to financially support additional clinical services would make it difficult to sustain these services and yield inconsistent patient benefits.19 Furthermore, most pharmacists are currently consumed with their normal day-to-day tasks, thus providing these additional services could, in fact, be tedious. Retail pharmacists, in particular, could potentially encounter a higher level of stress, due to most pharmacy chains only having one pharmacist on duty. If pharmacists gain recognition as healthcare providers, retail pharmacists would not only have to verify prescriptions, counsel patients and give immunizations, but also provide additional healthcare expertise. While time constraints could be obstructive in some settings, it is important to note that not every practice setting would be expected to provide primary care services. Based upon the precedent set by current CPAs and the terms of the current federal legislation, pharmacists would only be expected to provide expanded services in an ambulatory setting with an increased need for access to care.8 CONCLUSION With numerous changes erupting in the healthcare system, there will continue to be a surge of patients seeking access to quality care. Various current, former and future professionals in the healthcare field believe pharmacists

possess adequate clinical knowledge to help relieve the shortage of primary care physicians. In addition, pharmacists are now gaining state and national support for the transition into provider roles, with new legislation being proposed to amend the Social Security Act to recognize pharmacist services. While it is now being recognized that pharmacists are highly trained and readily accessible to tackle issues in drug regimens and provide disease state counseling, some additional training in the area of patient assessment and diagnosis of minor ailments may prove necessary to adequately fulfill the needs of patient care in an outpatient setting.

ACKNOWLEDGMENT At the time of writing, researchers were student pharmacists of Florida A & M University’s College of Pharmacy and Pharmaceutical Sciences under the supervision of Juan F. Mosley, Pharm.D. REFERENCES

1 U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis.

Projecting the Supply and Demand for Primary Care Practitioners Through 2020. Rockville, Maryland: U.S. Department of Health and Human Services, 2013. Available at: http:// bhpr.hrsa.gov/healthworkforce/ supplydemand/usworkforce/ primarycare/projectingprimarycare. pdf. Accessed September 15, 2014.

2 Peterson SM, Liaw WR, Phillips RL, et al. Projecting US primary care physician workforce needs: 20102025. Ann Fam Med. 10 (6); 503-509.

Available at: http://www.annfammed. org/content/10/6/503.abstract.

Accessed September 30, 2014.

3 Giberson S, Yoder S, Lee MP. Improving patient and health system outcomes through advanced pharmacy practice. A report to the U.S. surgeon general. Office of the Chief Pharmacist.

U.S. Public Health Service. Dec 2011.

Available at: http://www.usphs.gov/ corpslinks/pharmacy/documents/2 011advancedpharmacypracticereportt otheussg.pdf. Accessed November 13, 2014.

4 Webb CE, McGlew J. The PA PCC, H.R. 4190, and ACCP. Washington Report.

March 2014. Available at: http://www. accp.com/docs/govt/Washington_

Report-2014.pdf. Accessed February 4, 2015.

5 Rosenthal M. Provider Status Bill on Track for 2015. Pharmacist Practice News. December 2015. Available at: http://www.pharmacypracticenews. com/ViewArticle. aspx?d=Web%2BExclusives&d_ id=239&i=December+2014&i_ id=1130&a_id=28974. Accessed February 6, 2015.

6 Gutherie B.H.R.4190 - To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. March 11, 2014. Available at: https://www.congress.gov/bill/113thcongress/house-bill/4190/text?q=%7B %22search%22%3A%5B%224190%22% 5D%7D. Accessed February 4, 2014.

7 Accreditation Council for Pharmacy Education. Accreditation standards and key elements for professional program in pharmacy leading to the doctor of pharmacy degree. February 2014. Available at: https://www.acpeaccredit.org/pdf/ 8 Standards2016DRAFTv60FIRS TRELEASEVERSION.pdf. Accessed November 13, 2014.

9 Manolaskis P, Skelton J. Pharmacists’ Contributions to Primary Care in the United States Collaborating to Address Unmet Patient Care Needs: The Emerging Role for Pharmacists to Address the Shortage of Primary Care Providers. American Journal of Pharmaceutical Education. December 2011. Available at: http://www. ncbi.nlm.nih.gov/pmc/articles/ PMC3058447 10 Blazejewski L, Vaidya V, Pinto S, et al. Pharmacists’ perceived barriers providing non-dispensing services to underserved populations. J Community Health. 2013. 38:812–822.

Available at: www.ncbi.nlm.nih.gov/ pubmed/2519581.

11 American Academy of Family Physicians. Primary Care Definition.

2015; Avaliable at: http://www.aafp. org/about/policies/all/primary-care. html. Accessed January 30, 2015.

12 Dolovich L., Pottie K., Kaczorowski J., et al. Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics. Clinical Pharmacology & Therapeutics. June 2008. Available at: http://www.impactteam.info/ documents/CPT.pdf. Accessed January 31, 2015.

13 Weaver K. Provider status in the states. Pharmacy Times. December 2014. Available at: http://www. pharmacytimes.com/publications/

Directions-in-Pharmacy/2014/ December2014/Provider-Status-inthe-States#sthash.QhHARucU.dpuf.

Accessed February 7, 2015.

14 Maeseneer JD, Willems S, Sutter AD, et al. Primary Healthcare as a Strategy for Achieving Equitable Care: a literature review commissioned by the Health Systems Knowledge Network. 2007; Available at: www.who.int/social_ determinants/resources/csdh_media/ primary_health_care_2007_ en.pdf Accessed February 4, 2015.

15 American Society of Health-System Pharmacists. Statement on the Pharmacist’s Role in Primary Care.

Available at: http://www.ashp. org/DocLibrary/BestPractices/ SpecificStPrimary.aspx. Accessed January 9, 2015.

16 AACP Argus Commission. Call to Action: Expansion of Pharmacy Primary Care Services in a Reformed Health System. 2010; Avaliable at: http://www.aacp.org/governance/ COMMITTEES/argus/Documents/ ArgusCommission0 9_10final.pdf.

Accessed February 1, 2015.

17 United States. Cong. Senate. 113th Congress, 1st Session. HR 592, Pharmacy and Medically Underserved Areas Enhancement Act [introduced in the U.S. House of Representatives; 28 January 2015]. 113th Cong.,1st Sess.

Congressional Bills. Available at: https://www.congress.gov/bill/114thcongress/house-bill/592/text .

Accessed March 11, 2015.

18 United States. Cong. Senate. 113th Congress, 1st Session. S 312, Pharmacy and Medically Underserved Areas Enhancement Act [introduced in the U.S. Senate; 29 January 2015]. 113th Cong., 1st Sess. Congressional Bills. Available at: https://www.opencongress.org/ bill/s314-114/text . Accessed March 11, 2015.

19 Florida Pharmacy Association. The Mission Statement and Strategic Plan of the FPA “United to Advance Healthcare and Pharmacy Practice”.

Available at: http://www.pharmview. com/?page=StrategicPlan . Accessed March 11, 2015.

20 Cross MA. What the primary care physician shortage means for health plans. Managed Care.

June 2007. Available at: http:// www.managedcaremag.com/ archives/0706/0706.shortage.html.

AUGUST 2015

|

15

FROM THE 125TH FPA CONVENTION

Thank You

The Florida Pharmacy Association recognizes the importance of the support of all the sponsors and contributors to the 125th Annual Meeting and Convention. We would like to offer them a sincere thank you for helping to make our program a wonderful success.

2015 Convention Sponsors & Contributors

GOLD

SILVER

Tobacco Free Florida’s AHEC Tobacco Cessation Program

McKesson Pharmacists Mutual

SUPPORT SPONSORS Cardinal Health Chattem – A Sanofi Company CVS Health Brevard County Pharmacy Assn

Dade County Pharmacy Assn Empire Pharmacy Consultants Express Scripts Inc.

Interamerican Pharmacy Assn LexiComp / Wolters Kluwer Health Palm Beach County Pharmacy Assn

PRI Healthcare Solutions Rx Systems

Exhibitors American Associated Pharmacies AmerisourceBergen

LECOM School of Pharmacy

APCI

Medical Technology Associates

Cardinal Health

Merck

Amgen USA

Bloodworth Wholesale Drugs, Inc. Chattem - A Sanofi Company CVS Health

Empire Pharmacy Consultants

Medimmune / Astrazeneca Merck Vaccine Division

Minnesota Multistate Contracting Alliance for Pharmacy (MMCAP) National Apothecary Solutions

Florida Pharmacy Foundation

Nutramax Laboratories Consumer Care, Inc.

HD Smith Wholesale Drug Co.

PCCA

Novo Nordisk Inc.

Freedom Pharmaceuticals

PBA Health

H & H Wholesale Services Inc.

Pharmacists Mutual Companies (Silver Sponsor)

Heathcare Consultants Pharmacy Staffing & Consulting |

McKesson (Silver Sponsor)

Fagron Academy

Florida PDMP & Florida PDMP Foundation

16

Integral Solutions Group

FLORIDA PHARMACY TODAY

Pharmacy Technician Certification Board

PioneerRx

PPSC USA, LLC

Progressive Healthcare Solutions, LLC Publix Pharmacy QS/1

Relay Health

Rx Coop, LLC Sanofi

ScriptPro

Teva Respiratory

Tobacco Free Florida’s AHEC Tobacco Cessation Program (Gold Sponsor)

University of Florida College of Pharmacy U.S. Food and Drug Administration, Center for Drug Evaluation and Research Walmart/Sam’s Club Health and Wellness

FROM THE 125TH FPA CONVENTION

Find Your Pharmacy Passion!

Florida Pharmacy Association’s 125th Annual Meeting and Convention June 24-28, 2015

Top: Former Former FPA presidents gather for their annual convention photo.

Bottom Left: FPA Speaker Jackie Donovan presents to the FPA House of Delegates in her former role as speaker-elect.

Bottom Right: Past FPA presidents Hamilton, Harris and Hobbs.

AUGUST 2015

|

17

FROM THE 125TH FPA CONVENTION

Convention Sc

2015 Award Recipients Each year the FLORIDA PHARMACY ASSOCIATION recognizes individuals who have shown their commitment to pharmacy in many exceptional ways. These award recipients continue to strive for excellence in their profession, meeting

The following awards were presented during the 125th Annual Meeting and Convention at the Renaissance at World Golf Village in St. Augustine.

challenges and opportunities while demonstrating their commitment to their respective communities.

Frank Toback/AZO Consultant Pharmacist Award presented by Jackie Donovan to Frank Trafficante.

18

|

FLORIDA PHARMACY TODAY

Frank Toback/AZO Consultant Pharmacist Award presented by Jackie Donovan to Frank Trafficante.

Jean Lamberti Mentorship Award presented by Alexander Pytlarz to Kathy Petsos.

DCPA Sidney Simkowitz Pharmacy Involvement Award presented by Carmen Aceves Gordon to Terry Gubbins.

R.Q. Richards Pharmacy Public Relations Award presented by Bob Parrado to Daniel Buffington.

NASPA/APhA Bowl of Hygeia presented to Carl “Fritz” Hayes by Boehringer Ingelheim representative Julie O’Malley.

Cardinal Health Generation Rx Champions Award presented to Bob Parrado by Cardinal Health representatives Debra Linaweaver and Jim Kilborn.

NASPA-Upsher Smith Excellence in Innovation Award presented by Preston McDonald to Kevin Sneed.

Alton Tower Philanthropy Award presented by Al Tower to Norman Tomaka.

Interamerican Pharmacist Association’s (IPA) Roman Maximo Corrons Inspiration & Motivation Award presented by Humberto Martinez to Angela Garcia.

Pharmacists Mutual Companies Distinguished Young Pharmacist Award presented to Luther Laite

by Pharmacist Mutual representative Sarrah Sheppard.

FROM THE 125TH FPA CONVENTION

crapbook

Photography courtesy of Carol Porter, Stu Ulrich and Michael Jackson

DCPA Sidney Simkowitz Pharmacy Involvement Award presented by Carmen Aceves Gordon to Terry Gubbins.

NASPA/APhA Bowl of Hygeia presented to Carl “Fritz” Hayes by Boehringer Ingelheim representative Julie O’Malley.

NASPA-Upsher Smith Excellence in Innovation Award presented by Preston McDonald to Kevin Sneed.

Poster Presentation Awards 1st Place - Kevin Klein-USF 2nd Place - Ashley Cubillos-LECOM 3rd Place - Ada Jalice-NOVA and Lacey Strickland-USF

Technician of the Year Award presented by Tim Rogers to Nicole Daw.

Presidential Award of Excellence presented by Suzanne Kelley to Preston McDonald.

James H. Beal “Pharmacist of the Year” Award presented by Suzanne Kelley to Angela Garcia.

National Alliance of State Pharmacy Association Nonprescriptions Medicines Academy Game Show 1st Place - LECOM School of Pharmacy (Sarah Stull, Anna Marsakova and Melissa Holehouse)

#1 Club New Member Certificate presented by Scott Tomerlin to David Mackarey.

Student Patient Counseling Competition 1st Place - Ashley Cubillos - LECOM 2nd Place - Sherice Newberry - FAMU 3rd Place - Jacqueline Walker - PBAU

Presidential Award of Excellence presented by Suzanne Kelley to Christina Laird.

Presidential Award of Excellence presented by Suzanne Kelley to Jeanette Connelly, Angela Garcia and Alexis Jurick.

AUGUST 2015

|

19

FROM THE 125TH FPA CONVENTION

125th Annual Meeting and Convention

Interamerican Pharmacist Association’s (IPA) Roman Maximo Corrons Inspiration & Motivation Award presented by Humberto Martinez to Angela Garcia.

Jean Lamberti Mentorship Award presented by Alexander Pytlarz to Kathy Petsos.

Florida Rep. Cary Pigman interacts with FPA convention registrants at the political rally.

20

|

FLORIDA PHARMACY TODAY

R.Q. Richards Pharmacy Public Relations Award presented by Bob Parrado to Daniel Buffington.

Cardinal Health Generation Rx Champions Award presented to Bob Parrado by Cardinal Health representatives Debra Linaweaver and Jim Kilborn.

Endorsed* by:

Introducing Our Newest Florida Sales Team Member

Sarrah Sheppard

Pharmacists Mutual Insurance Company, THE national pharmacy leader in providing insurance and risk management solutions, is pleased to introduce our newest Florida sales team member – Sarrah Sheppard.

Sarrah joins Chuck Neyland in serving Florida pharmacists insurance needs.

Sarrah Sheppard Serves Central Florida

813.486.7427

sarrah.sheppard@phmic.com

Why insure with Pharmacists Mutual Companies: • Competitive rates • Dedicated to pharmacists and the pharmacy profession since 1909!

• Endorsed by over 40 state and national pharmacy associations* • Dividends paid annually for 105 years** • A (Excellent) rating by AM Best for over 75 years

Contact Sarrah or Chuck for a no obligation proposal for your insurance needs.

Chuck Neyland Serves the Florida Panhandle

251.656.7219

chuck.neyland@phmic.com *Compensated endorsement. ** Dividends cannot be guaranteed; however, they have been returned uninterrupted since 1909.

Find us on Social Media:

www.phmic.com 800.247.5930 Commercial Auto Professional Liability | Business Protection Umbrella Liability | Workers Compensation Not licensed to sell all products in all states.

AUGUST 2015

|

21

FROM THE 125TH FPA CONVENTION

125th Annual Meeting and Convention

U.S. Representative Buddy Carter (Ga.) provides the banquet keynote address at the 125th Annual Meeting and Convention.

FPA member David Mackarey receives his #1 Club jacket for membership recruiting.

Florida Department of Health Deputy Secretary Dr. Celeste Philip presents the keynote address at the 125th Annual Meeting and Convention.

Adopt-A-Student The Florida Pharmacy Association would like to thank the 2015 Mentor Sponsors of the Adopt-AStudent program:

There was lots of dancing during the banquet with music provided by Jacksonville’s KTG Entertainment.

22

|

FLORIDA PHARMACY TODAY

Alachua County Association of Pharmacists* Dade County Pharmacy Association* Eric Alvarez Paul Delisser Lisa Deziel Jackie Donovan*** Richard Finkel*** Terry Gubbins*** Ed Hamilton*** Betty Harris Michael Jackson Alexis Jurick Gary Koesten Keri Kratofil David Mackarey Preston McDonald

Thomas Munyer Bob Parrado Kathy Petsos* Robert Renna*** Melissa Ruble Theresa Tolle** Norman Tomaka*** Scott Tomerlin Alton Tower*** Karen Whalen Stuart Whiteman *Gold Sponsor **Silver Sponsor ***Bronze Sponsor

FROM THE 125TH FPA CONVENTION Participants getting ready for the 2015 Fun Run, as FPA and the Florida Department of Health team up to promote healthy living during the 125th Annual Meeting and Convention.

Pharmacists Mutual Companies Distinguished Young Pharmacist Award presented to Luther Laite by Pharmacist Mutual representative Sarrah Sheppard.

Presidential Award of Excellence presented by Suzanne Kelley to Christina Laird.

AUGUST 2015

|

23

FROM THE 125TH FPA CONVENTION

2 0 1 5 F PA 5 0 -Y E A R P H A R M A C I S T S 50-Year Pharmacists Honored

Those who have served our profession as pharmacists for a half-century were honored at the 125th Annual Meeting and Convention. We are grateful for these pioneers who have seen our profession evolve over five decades and have played such an important role in making pharmacy what it is today.

Julian R. Adams Jr. (Member since 1966) Charles Barger (Member since 1965) Robert B. Brown Jr. (Member since 2003) Joseph Duane (Member since 1984) Robert E. Duncan (Member since 2001 ) Mary Fumea (Member since 1984) Gerald Geist (Member since 1984) Roberta Jones (Member since 2007) TOP LEFT James H. Beal “Pharmacist of the Year” Award presented by Suzanne Kelley to Angela Garcia.

TOP RIGHT Past presidents of FPA Women in Pharmacy pause for a group photo.

BOTTOM LEFT Exhibitor of the Year Award winners: 1st Place, Chattem–A Sanofi Company (L) and 3rd Place, Sanofi (C& R)

David Kazarian (Member since 2001) Nancy Kazarian (Member since 1999) Robert Merada (Member since 1966) Robert Moulton (Member since 2002) James Mullins (Member since 1965) Cecil Phillips (Member since 1991) Arnold Rosenbleeth (Member since 2002) Les Slesnick (Member since 1981) Frank Trafficante (Member since 1999) Daniel Witty (Member since 2005)

24

|

FLORIDA PHARMACY TODAY

FROM THE 125TH FPA CONVENTION

Poster presentation: Ashley Cubillos

Poster presentation: Heather Strouse

FPA RECOGNIZES THOSE WE LOST IN 2014-15

Poster presentation: Cameron Durlacher

During the 125th Annual Meeting and Convention at the Renaissance at World Golf Village in St. Augustine, the Florida Pharmacy Association recognized the passing of the following FPA members. We are grateful for their contributions and remember them with fondness and respect.

IN MEMORIAM* Robert Ansbacher – Pembroke Pines William Connors – Dade City Joan 0. Koivisto – Jacksonville Cindy Maggio – Nassau Eric Rothouse – Plantation Mark Scheffler – Naples Sharon Elaine Smith – Tallahassee Maita P. Singer – Tallahassee Charles Stidham – Lake Placid *This list is believed to be accurate as of the convention. If any names were omitted, please contact the FPA office.

Poster presentation: Ngoc Chau and Deandra Romero AUGUST 2015

|

25

FROM THE 125TH FPA CONVENTION Presidential Award of Excellence presented by Suzanne Kelley to Jeanette Connelly, Angela Garcia and Alexis Jurick.

Alton Tower Philanthropy Award presented by Al Tower to Norman Tomaka.

26

|

FLORIDA PHARMACY TODAY

Technician of the Year Award presented by Tim Rogers to Nicole Daw.

#1 Club New Member Certificate presented by Scott Tomerlin to David Mackarey.

Social Media Healthcare: To Post or Not to Post Jeana Pearce (Fourth Year UF Pharmacy Student) Carol Motycka, Pharm.D. BCACP What did you do in the 60 seconds before opening this journal?

Every 60 seconds, 293,0 0 0 stat uses are updated, 136,0 0 0 pho tos are uploaded and 510 comments are posted on Facebook.1 With social media use skyrocketing in the past five years, it is becoming increasingly popular for companies to get in on the action. As of January 2015, there were 1.393 billion monthly active users on Facebook and 280 million monthly active users on Twitter.2 This leads us to a very important question: What is the role of social media in healthcare?

Social media is well known for its personal use including updating statuses, posting photos and following friends. However, it is becoming increasingly common for people to use social media as a means to find healthrelated information. A recent statistic showed that 28 percent of health-related conversations on Facebook are supporting health-related causes, followed by 27 percent of people commenting about health experiences or updates.3 Many say this is a step in the right direction, since it shows people being pro-active about their health. Forty percent of consumers say information found via social media affects the way they deal with their health and 90 percent of respondents 18-24 years old said they would trust medical information shared by others on their social media network.3

It is not uncommon today for healthcare providers to utilize social media as a means to deliver health-related information. With 26 percent of all hospitals in the U.S. participating in social media3 and 60 percent of physicians stating their most popular activities on social media are following what colleagues are sharing and discussing,3 it appears as though social media can improve healthcare, but how are patients responding to this? A recent statistic showed 54 percent of patients are very comfortable with their provider seeking advice from online communities to better treat their conditions and 60 percent of doctors say social media improves the quality of care delivered to patients.3 This shows that social media can greatly benefit individuals looking for an alternative way to receive

It is not uncommon today for healthcare providers to utilize social media as a means to deliver healthrelated information.

health-related information and that many providers in healthcare are already utilizing this alternative method.

As of March 2015, 464,085 people were following the CDC on Facebook, and Drugs.com, a health and wellness website that provides “independent data on more than 24,000 prescription drugs, over-the-counter medicines and natural products,� had 459,274 Facebook followers.4 Individuals are also utilizing social media for support for chronic conditions such as The Congestive Heart Failure Support Group, a social support network for individuals coping with heart failure. nt independent, objective, comprehensive and up-to-date information in a clear and concise format for both consumers and healthcare professionals.

Along with the many benefits of utilizing social media in the healthcare industry come many risks. With many avenues in social media that patients are using to receive health-related information, how are we ensuring that the information posted is accurate, comprehendible and protective of AUGUST 2015

|

27

private health information? Currently, only 31 percent of healthcare organizations have specific social media guidelines in writing and 23 percent of drug companies have not addressed security and privacy in terms of social media.3 It seems as though there is a huge gap between people utilizing social media for healthcare and how that information is being monitored for accuracy and security.

sued a statement on its website regarding pharmacists’ use of social media.7 ASHP recommends that pharmacists use social media because these tools can help educate the public about the best uses of medication and disseminate information rapidly. However, professional standards concerning medical advice must be maintained and pharmacists must understand the limits of the new form of media. ASHP

“Social media can be a great tool that can be used to inform the public on pharmacy issues, provided that the message is crafted carefully and has an element of entertainment applied to it.”

Another major concern for many companies utilizing social media for healthcare is professionalism. In a 2013 article titled: “Innovations in Pharmacy, Social Media and Unprofessional Pharmacists Conduct: A Cross-Sectional Survey of Boards of Pharmacy,” pharmacists’ utilization of social media was analyzed. The purpose was “to determine how often boards of pharmacy receive complaints related to licensee’s online behavior and what types of online behaviors may prompt an investigation of a licensee.”6 There was a moderate consensus (50-75 percent) regarding further board investigation for an individual placing a photo of a patient receiving vaccine therapy on the Internet without consent, depiction of alcohol use in the workplace without intoxication on a Facebook post and depiction of alcohol use outside of the workplace with intoxication on a Myspace page. If a Board of Pharmacy is having difficulty coming to a consensus regarding individual professionalism on social media, then there are also implications and difficulties regarding companies, specifically hospitals, utilizing social media. This is particularly troubling when we know that less than half have written guidelines in place to ensure security and privacy.

The American Society of HealthSystem Pharmacists (ASHP) has is28

|

FLORIDA PHARMACY TODAY

strongly warns against violation of patient privacy and against disparagement of patients, even in anonymous terms. ASHP states “Medical advice offered through social media should be

provided in accordance with the professional standards of pharmacy practice. For example, pharmacy professionals should provide medical advice only with a complete understanding of the patient’s medical conditions and only if they accept the associated liabilities, especially those regarding privacy and the requirements of pharmacy practice. Pharmacy professionals should be aware that providing medical advice may create a pharmacist–patient relationship, which incorporates all of its obligations and liabilities. All online relationships should conform to the ethical boundaries of an appropriate pharmacist–patient relationship.”7 When Michael Jackson, Florida Pharmacy Association’s Executive Vice President and CEO, was asked his thoughts regarding social media and usage by pharmacists, he said: “It is unbelievable how social media has grown in the 10 short years since its creation. For hundreds of years the public received its information on what was talked about in community gatherings,

“It is important, however, that your message is correct, relevant and timely and has a positive spin that has meaning to the general public. “ in news print and, beginning in the late 1920s, what was broadcast on television and radio.

“In any case, the public had to either go to these gatherings, seek out printed news or have devices to receive television or radio broadcasts.

“Social media has changed dramatically how people receive information and is becoming the standard for learning about new and emerging things in the marketplace or social environment. This is fueled by the acceptance that nearly everyone has an information portal attached to their belts, in their personal handbags or within easy reach.

“Social media can be a great tool that can be used to inform the public on pharmacy issues, provided that the message is crafted carefully and has an element of entertainment applied to it.

Each of us may have a Facebook page or Twitter account that receives posts almost every other minute. We may hand sweep through posts that have no interest but tap into those messages that have relevance to our lives.

“To get the best views by the public, the message has to drive home a need for it to be opened. Messages such as ‘How to live a healthy life simply by knowing your pharmacist,’ ‘What your pharmacist can do to save you money,’ or ‘Knowing your pharmacist can help improve the quality of your senior years,’ are topics of discussion that may cause consumers to press down on a smart phone touch screen. If the message is profound enough then it is shared, which is how social media works best. You reach beyond just your immediate network of connections.

“It is important, however, that your message is correct, relevant and timely and has a positive spin that has meaning to the general public. A message that talks about pharmacist clini-

cal training may go well for those of us within our industry but may not be interesting to a consumer. Video social messaging, showing pharmacists’ empathic and caring relationships with consumers, can go a long way toward delivering a positive presence in today’s society.”

There is an enormous amount of information related to healthcare on the Internet. Unfortunately, this information is not always accurate or from a reputable source (i.e. medical doctor or pharmacist). However, with more reputable sources joining the forces, we can help make social media a more accurate and secure venue for our patients to access healthcare information and take charge of their health. This should not replace other methods of receiving healthcare, such as medical journals and face-to-face interaction, but rather be a supplement. Patients are already utilizing social media and we should consider it on of our duties to help ensure that the information is accurate and keeps patient safety at the forefront.

If you are interested in incorporating social media into your company, whether by creating a company page on a social media website or utilizing iPADs in the pharmacy for patient consultation via internet, here are a few things to keep in mind: ■■ Implement written guidelines with specifics on accuracy and patient safetyInformation should be informative and in lay language, so that the general public can understand and not misinterpret ■■ Keep personal and professional social media accounts separate ■■ Always have another individual review before posting to check for errors/syntax ■■ Never include patient-specific information (HIPAA)

■■

Let us embrace social media as a venue to reach a large number of individuals to increase patient awareness/health, ensure patient safety and continue to keep pharmacy and pharmacists as a pillar in the community.

REFERENCES

Zephoria Internet Marketing Solutions.

The Top 20 Valuable Facebook Statistics – Updated May 2015. https://zephoria. com/top-15-valuable-facebookstatistics/. Accessed June 3, 2015.

DMR Directory of Social Network, App and Digital Stats. Facebook Stats and Facts. http://expandedramblings. com/index.php/businessdirectory/19745/facebook/. Accessed March 5, 2015.

Infographics Archive. 24 Outstanding Statistics on How Social Media has impacted Healthcare. https:// getreferralmd.com/2013/09/ healthcare-social-media-statistics/.

Accessed March 5, 2015.

Get Referral MD. 24 Outstanding Statistics on How Social Media has impacted Healthcare. https://getreferralmd. com/2013/09/healthcare-social-mediastatistics/. Accessed March 5, 2015.

Drugs.com Know more. Be sure. http:// www.drugs.com/. Accessed March 6, 2015 Skelley J, Hughes P, Elmore L. (2013).

Social Media and Unprofessional Pharmacist Conduct: A Cross-Sectional Survey of Boards of Pharmacy.

Innovations in pharmacy. 4(3) http://www.pharmacy.umn.edu/ innovations/prod/groups/cop/@ pub/@cop/@innov/documents/ article/cop_article_457084.pdf.

Accessed June 3, 2015 ASHP Statement on Use of Social Media

by Pharmacy Professionals. American Society of Health-System Pharmacists Inc. Automation and Information Technology-Statements 2012. http:// www.ashp.org/DocLibrary/ BestPractices/AutoITStSocialMedia. aspx. Accessed June 3, 2015

AUGUST 2015

|

29

florida BUYER’S GUIDE PHARMACY TODAY

ADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.

PHARMACY RESOURCES Abbott Diabetes Care Hernan Castellon (305) 220-0414 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

LEGAL ASSISTANCE Kahan ◆ Heimberg, PLC Brian A. Kahan, R.Ph., Attorney at Law (561) 392-9000 Fried Law Office, P.A. Dennis A. Fried, M.D., J.D. (407) 476-1427 The Health Law Firm George F. Indest III, J.D., M.P.A., LL.M. (407) 331-6620

PHARMACEUTICAL WHOLESALER

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Bob Miller, BPharm, CPH (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029

TEMPORARY PHARMACISTS – STAFFING HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029 Rx Relief (800) RXRELIEF

McKesson Drug Company Jim Springer (800) 804-4590 FAX: (863) 616-2953

Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt.

30

|

FLORIDA PHARMACY TODAY

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm DRUG INFORMATION CENTER Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK (800) 222-1222 www.fpicn.org NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 (703) 683-8200 (703) 683-3619 fax info@ncpanet.org RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”