IPA Journal Oct/Nov/Dec 2019

A Peer-Reviewed Journal | Vol. LXXV, No. 4 | OCT.NOV.DEC 2019

Technician Product Verification: is your pharmacy ready?

INSIDE: Committee Reports Flip the Pharmacy RAGBRAI Recap

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TABLE OF CONTENTS 8515Douglas DouglasAvenue, Avenue,Suite Suite16, 16,Des DesMoines, Moines,IAIA50322 50322 8515 Phone:515.270.0713 515.270.0713Fax: Fax:515.270.2979 515.270.2979 Phone: Email:ipa@iarx.org ipa@iarx.org| |www.iarx.org www.iarx.org Email:

PUBLICATION STAFF STAFF PUBLICATION

DavidSchaaf, Schaaf,Managing ManagingEditor Editor David KateGainer, Gainer,PharmD PharmD Kate AnthonyPudlo, Pudlo,PharmD, PharmD,MBA, MBA,BCACP BCACP Anthony LauraMiller Miller Laura CaseyFicek, Ficek,JD JD Casey Matthew PharmD, BCPS Amanda Pitlick, Abdulbaki, PharmD Amanda Abdulbaki, PharmD

Technician Product Verification

COVER STORY 2019 IPA Annual Meeting pg. 8 (TPV) pg. 8 Technician Product Verification

Seeallit all the policy, awards, leadership fromcan thisTPV year’s new-look Annual Get the-details - What is it, How it was and bornpies and -What do for both theIPA pharmacy Meeting. and pharmacist roles in your practice. technician Figure 1: TOC Pharmacist Services

OFFICERS OFFICERS Chairman

Inpatient chart review

CHAIRMAN Cheryl Clarke, EdD, RPh, FAPhA - Waukee Cheryl Clarke, PRESIDENT EdD, RPh, FAPhA - Waukee

• Review of admission medication reconciliation • Daily chart review to identify and intervene on drug therapy problems • Begin discharge planning including identifying barriers to access

PRESIDENT Connie Connolly, RPh, BCACP - DeWitt Connie Connolly, RPh, BCACP - DeWitt PRESIDENT-ELECT

Discharge time out

Diane Reist,PRESIDENT-ELECT PharmD, RPh - Cedar Rapids Diane Reist, PharmD, RPh - Cedar Rapids TREASURER

• Review discharge medication reconciliation to identify and intervene on drug therapy problems

TREASURER Tim Becker, RPh, FACP - Mason City Tim Becker, RPh, - Mason City SPEAKER OFFACP THE HOUSE SPEAKER OF THE HOUSE Ashley Dohrn, PharmD, BCGP - Le Claire Ashley Dohrn, PharmD, BCGPHOUSE - Le Claire VICE SPEAKER OF THE SPEAKER OF THE HOUSE Kristin Meyer, VICE PharmD, CGP, CACP, FASCP - Marshalltown Kristin Meyer, PharmD, CGP, CACP, FASCP - Marshalltown

TRUSTEES TRUSTEES REGION 1

REGION Sharon Cashman, RPh1 - Waverly Sharon Cashman, REGIONRPh 2 - Waverly REGION 2 - North Liberty Shane Madsen, PharmD, BCPS Shane Madsen, PharmD, REGIONBCPS 3 - North Liberty REGIONBCPS 3 - Norwalk Sally Haack, PharmD, Sally Haack, PharmD, - Norwalk REGION BCPS 4 REGION-4 Sioux City Gary Maly, PharmD Gary Maly,AT PharmD LARGE- Sioux City ATPharm LARGE- Iowa City Bill Baker, BS Bill Baker, Pharm - Iowa City Craig Clark,BS RPh - Cedar Rapids Clark, PhD, RPh -RPhCedar Rapids BillCraig Doucette, Iowa City Bill Doucette, PhD, RPhIowa City John Hamiel, PharmD - Waterloo JohnHONORARY Hamiel, PharmD - Waterloo PRESIDENT HONORARY PRESIDENT Tony Beraldi, RPh Council Bluffs Tony Beraldi, RPhTECHNICIAN - Council Bluffs PHARMACY PHARMACY TECHNICIAN Jessica Burge, CPhT - Des Moines Jessica Burge,PHARMACISTS CPhT - Des Moines STUDENT STUDENT Joshua Hart -PHARMACISTS Drake University Joshua Hart -- University Drake University Crissy Lawson of Iowa Crissy Lawson - University of Iowa TheJournal Journalofofthe theIowa IowaPharmacy PharmacyAssociation Associationisisaapeer peer The reviewedpublication. publication.Authors Authorsare areencouraged encouragedtotosubmit submit reviewed manuscriptstotobe beconsidered consideredfor forpublication publicationininthe theJournal.

Journal. manuscripts Forauthor authorguidelines, guidelines,see seewww.iarx.org. www.iarx.org.

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PharmacyAssociation.

Association.

Pharmacy

Discharge counseling

Legislative Session Recap Committee Reports What youpharmacy need to know this year’s See how fared infrom the 2019 Iowa IPA advisory committee Legislative Session. pg. 35 meetings. pg. 10

FEATURES FEATURES

Peer• Review: Development and RAGBRAI Recapping themedications IPA Face toRACAP: face counseling on new and changed Implementation a Transitions of Care Foundation’s sixthofyear of RAGBRAI. pg. 38 Transitions of care note Pharmacist Service. pg. 30 • Fax a note to the patient's preferred outpatient pharmacy noting the new, changed, and stopped medications

Follow-up phone call 2019 Annual 2018-2020 IPAMeeting StrategicRecap Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68 Speaker’s Address . . . . . .Product . . . . . . . Verification . . • . Patient . . . .contacted . . . . . .24-72 . . . . . . . 10 COVER STORY: Technician . . . . . .hours . . . . .post-discharge 8 to ensure they were able to obtain new medications and to review potential side effects PoliciesReports Adopted 13 Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Awards . . . . . . . .Expo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 16 2020 IPA Midwest Pharmacy CPESN Iowa . . . . .Into . . . .The . . . .Future! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 23 Flipping Our Way New EPAClass Regulations 27 Welcome of 2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Commencement 2019 .

28 Resident Spotlight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Peer Review . . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .38 30 RAGBRAI 2019 2019 Legislative Session Recap . . . . . . . . . . . . . . . . . . . . . . . . . . 35 CBD in the Pharmacy? Questions Answered . . . . . . . . . . . . . . 39

IN EVERY ISSUE IN EVERY President’sISSUE Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 CEO’s Column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75 Health Care Hot . Topics .

President’s PageNews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 . 6 Iowa Pharmacy Health Care Hot Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 19 Practice Advancement .

Iowa Pharmacy 20 Public Affairs . . . .News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 Practice Advancement 24 Technician Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 Public Affairs . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .34 36 IPA Foundation Technician Corner .

40 Members Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 IPAin Foundation 44 IPA Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 MembersofSection 48 Calendar Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46 IPA in Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47 51 Pharmacy Time . .Capsule .

Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Pharmacy Time Capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 MissionStatement Statement Mission

TheIowa IowaPharmacy PharmacyAssociation Associationempowers empowersthe thepharmacy pharmacyprofession professionto toimprove improvehealth healthoutcomes. outcomes.

The JUL.AUG.SEP2019 2019 || OCT.NOV.DEC

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President’s Page

advocacy Connie Connolly, RPh, BCACP DeWitt IPA President

A

dvocacy - it is a word we hear a lot. Do we really know what it means? The dictionary defines it as “public support for or recommendation of a particular cause or policy.” I define it as the act of speaking on behalf of or in support of another person, place or thing.

Advocacy happens year-round to build those relationships and understanding to pass meaningful policy in the legislature, but during this legislative season, advocacy becomes central to the activities of the Iowa Pharmacy Association.

Casey Ficek and our contract lobbyists do an impressive job of gathering information regarding our profession and passing it along to the key figures at the Capitol. They also are instrumental in helping our membership understand the current political issues and tell us where we can be the most effective in our efforts to advocate. We are fortunate to have their leadership and commitment.

“A commitment to cultivate a relationship with your state and/or national representation is all that is needed.”

Advocacy is an extension of storytelling. The stories being sent into IPA by pharmacists/residents and students are impassioned and effective. This level of understanding of the issues is what gets the

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attention of policymakers. Having a patient impact story is the best way to communicate to legislators and helps assure the message will be remembered when it comes time to vote. Feeling unsure about communicating with your elected leadership? Remember that they are your friends and neighbors and that you are the expert when it comes to pharmacy issues. They welcome your input as it allows them to become well versed on the topic in an efficient manner. Policymakers have an incredible amount of learning to do to keep up with the legislative session and if you can be their “cliff notes” source, you will be valuable to them.

If you would like more information about forming these relationships and how to advocate in an effective manner, check out this podcast by Josh Archambault on the Talk to Your Pharmacist Podcast: http://bit.ly/JoshArchambault.

health policy is being debated. I was heartened by the number of IPA members who have put themselves out there and declared themselves candidates for various offices around the state in their communities. If you have any desire to explore your options in running for any office, IPA staff and others would be happy to help you pursue this endeavor.

Champion Advocate opportunities still exist. It is not difficult to assume this role. A commitment to cultivate a relationship with your state and/ or national representation is all that is needed. As pharmacists, we are readily available to speak with members of our community and often we already know the candidate, or of them, when they decide to run for office. I encourage you to consider this important volunteer task. Time and time again it has been shown that grassroots efforts are most effective regarding these tasks.

Advocating for the profession in our day to day activities can also occur in a peer to peer fashion or to other healthcare providers. By showing that we are a valuable part of the team, we garner support for our priorities and for our inclusion on that team.

Running for an office is the ultimate way to advocate for the profession and your community. We are extremely fortunate to have two pharmacist legislators in Iowa; Senator Tom Greene and Representative John Forbes. It is immensely helpful to have this expertise close at hand when

Advocacy is also important in our day to day responsibilities as a pharmacist.

Advocating for and to your patients can be beneficial for both parties.

“When you advocate for a patient to others, they begin to see the value of having a personal pharmacist and this can be helpful in finding job satisfaction and in advancing practice initiatives.”

Whatever your comfort level, consider becoming an advocate for our profession and our patients. It is another way to show we care. ■

A continuous quality improvement program can be a lifesaver!

MA K E YOUR PATIENTS AND YOUR PHARMACY SAF ER .

FOR LESS THAN A DOLLAR A DAY ...

• • • •

Increase patient safety – learn from collected safety data and online resources Maintain compliance – meet accreditation, credentialing, PBM and state QA requirements Reduce costs – increase operations efficiency, reduce potential risk and cut down on “re-do” Rxs Safeguard your data – Patient Safety Organizations offer confidentiality and legal protection

Learn more at www.medicationsafety.org or call us at (866) 365-7472.

The Alliance of Medication Safety (APMS) is a federally listed Patient Safety Organization (PSO).

strategic plan

2018-2020 IPA STRategic plan

I

n the spring and summer of 2018, IPA engaged stakeholders in a strategic planning process designed to establish organizational priorities and goals, and develop a two year roadmap to achieve them. The rapid pace of change in healthcare required the Board of Trustees to review the document again in the summer of 2019, and ask, “Where do we want to go and how do we get there?”

This document sets forth Goals, Strategies, and Action steps, designed to move IPA forward and ensure the Association and our programs remain synonymous with excellence and innovation in three thematic areas: Strategic Growth, Practice Transformation, and Unified Voice.

Strategic Growth

To remain a vibrant and influential organization, IPA will focus its efforts in areas that promote growth in membership, resources, value, relevance, and engagement. IPA is most successful when our members are actively engaged in advancing our strategic goals, and the organization can grow and evolve to meet the diverse needs of our members.

• Increase membership recruitment, retention and engagement.

• Improve the wellbeing of pharmacy professionals in Iowa by focusing on professional resiliency and burnout.

• Expand reputation as a respected leader within the profession of pharmacy and among other healthcare organizations.

Practice Transformation

Across the country, Iowa is recognized and respected as a leader in innovative pharmacy practice. Along with innovation, IPA places a strategic

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emphasis on initiatives and resources that enable pharmacy practices to transform, allowing pharmacists and pharmacy technicians to practice at the highest level of patient care.

• Promote integration of pharmacists as valued members of the healthcare team.

• Assist pharmacists and pharmacy technicians with practice transformation to provide the highest level of patient care.

• Support career pathways for pharmacy technicians to advance technician roles in pharmacy practice settings.

Unified Voice

IPA is the unified voice representing pharmacy professionals in all practice settings across the continuum of care.

Our unified voice allows IPA to advocate for the pharmacy profession in Iowa to key stakeholders, including legislators, regulatory agencies, healthcare providers and the general public. IPA leverages its respected reputation, cultivates critical relationships and activates an engaged grassroots network to advance pharmacy practice, serve the profession and ultimately improve health outcomes.

• Continue to cultivate IPA’s strong grassroots advocacy in all pharmacy settings and active participation in legislative issues.

• Leverage the unique strength of IPA as the unified voice representing pharmacy in Iowa.

• Establish an advocacy agenda that increases access to pharmacist services, protects the public, and fosters practice advancement opportunities.

IPA’s Mission, Vision, and Values In addition to the new strategic plan, the IPA Board of Trustees approved a new vision statement, as outlined below with the IPA’s mission statement and values.

IPA Mission Statement

The Iowa Pharmacy Association empowers the pharmacy profession to improve health outcomes.

IPA Vision

The Iowa Pharmacy Association is the preeminent voice for all pharmacy professionals in Iowa and the leader in advancing pharmacy practice transformation.

IPA Values

Collaboration: Seek opportunities to partner with key stakeholders to achieve common goals and tackle healthcare challenges.

Advocacy: Promote the value of the pharmacy profession to payers, policy makers and patients and enable our members to do the same.

Innovation: Strive for excellence through actively pursuing “what’s next” for pharmacy practice.

Education: Provide high quality educational resources and opportunities to equip an engaged and innovative membership.

Engagement: Cultivate a culture that drives members to be actively engaged within their profession and provide them with opportunities to make an impactful contribution.

Leadership: Invest in the future of the pharmacy profession by nurturing those leaders and innovators who inspire others to transform the profession.

Positive Patient Outcomes: The health and safety of patients is at the core of everything the profession and this association does, guided by the principle of “if it’s right for the patient, it’s right for pharmacy.”

HealthCare Hot Topics

FDA Drug Shortages Task Force

In October 2019, the FDA released their task force report on chronic drug shortages. Among the report’s findings were that two-thirds of the 163 drugs affected by shortages in recent years were generally low-cost generics and had been on the market for a median of almost 35 years. Recommendations from the report included quality rankings for drug companies to attract higher prices and increased market share.

Rising Levels of Heart Failure in US

Deaths resulting from heart failure among U.S. seniors are reaching levels that could qualify it as an epidemic.

The lead author of a JAMA Cardiology study reported that approximately one in eight deaths from heart disease are the result of heart failure, and nine out of ten are in individuals that are older than 65. In 2017, more than 647,000 Americans died from heart failure, which is 51,000 more than in 2011.

ACIP Updates PCV13 Recommendations

In 2014, the American Council on Immunization Practices (ACIP) recommended that adults 65 and older receive one dose of PCV13 followed by one dose of PPSV23 one year later.

For those who received PPSV23 before 65, they should still receive PCV13 once they turn 65 followed by PPSV23, however, the second dose of PPSV23 needs to be 5 years apart from the first dose.

In 2019, ACIP provided a new recommendation that adults 65 and older should still receive a single dose of PPSV23, however, shared clinical decision making is recommended for PCV13 vaccination for those who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant and who have not previously received PCV13.

In October 2019, the FDA released their task force report on chronic drug shortages.

CDC Addresses VapingAssociated Lung Damage

The CDC published interim guidance for health care providers of patients with suspected e-cigarette, or vaping product use associated lung injury (EVALI). The guidance comes as the number of cases of lung injury and deaths associated with e-cigarette or vaping products continually increases. Forty-nine states, the District of Columbia, and one U.S. territory have reported 1,299 cases of lung injury associated with the use of electronic cigarette (e-cigarette), or vaping, products. Twenty-six deaths have been reported from 21 states.

NDMA Found in Ranitidine

The FDA announced that it had found low levels of a nitrosamine impurity called N-nitrosodimethylamine (NDMA) in some ranitidine medicines.

NDMA is classified as a probable human carcinogen and is a known environmental contaminant and found in water and foods, including meats, dairy products, and vegetables. The

FDA is not calling for individuals to stop taking ranitidine at this time, however, the agency is requesting that consumers and health care professionals report any adverse reactions with ranitidine to the FDA’s MedWatch program.

Sen. Grassley, Senate Finance Committee Urge DIR Fee Reform

With strong bipartisan backing, the Senate Finance Committee, chaired

by Sen. Chuck Grassley (R-Iowa), sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma to “revive the pharmacy DIR reforms included in [CMS’] November 30, 2018 proposed rule, and finalize them for plan year 2021.”

Their letter concluded by stating, “These reforms, along with movement to a standardized set of pharmacy quality metrics, will enable pharmacies to best serve beneficiaries and bring more transparency and value to the Part D program.” ■

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feature

technician product verification

A

sk anyone in the pharmacy field “What exactly is TechCheck-Tech, or Technician Product Verification (TPV)?” and you’ll likely get a fairly standard answer: It’s a process in which technicians undergo an advanced training program, allowing them to perform the final verification step in the prescription filling process. In essence, the advanced training gives pharmacy technicians the competency to verify that the right product in the right amount was put in the right prescription bottle for the right patient.

But, ask “What will TPV do for both the technician and pharmacist roles in practice?” and you will likely get different answers based on who you talk to. A community pharmacist will likely tell you it reduces their monotonous load of busy-work and will free their time up to provide the advanced clinical services that

pharmacists are uniquely qualified to do. These services can include things like MTM, immunizations, OTC counseling, and inventory management. A hospital pharmacist may tell you their extra time can be devoted to medication reconciliation, antimicrobial and opioid stewardship, or discharge counseling. Technicians, however, will tell you it provides them with an opportunity to learn new skills and become a more integral part of the pharmacy team, which will lead to greater success for all involved. For the past 25 years, IPA has been leading the charge to get TPV approved in Iowa in an effort to further expand pharmacist roles and further the profession.

Following the initial 2011 spearhead at Spencer Hospital to prove its feasibility in Iowa, many states have started implementing their own TPV systems.

In 2014, the Iowa BOP authorized a

pilot to allow TPV (then called TechCheck-Tech) to be studied in a handful of Iowa community-based pharmacies.

Then, the 2018 article The Iowa new practice model: Advancing technician roles to increase pharmacists’ time to provide patient care services by Andreski, Myers, Gainer, and Pudlo was published showing the results. Technician Product Verification was implemented for 18 months at 7 pharmacies initially, and was finally expanded to include another 10. They found that during times when technician staffing allowed for TPV to occur that pharmacists’ time dispensing decreased by over 18% (67.3% vs.

49.06%, P = 0.005) and time in direct patient care (19.96% vs. 34.72%, P = 0.003), increased significantly.

Pharmacists were able to provide nearly twice as many total services per hour (2.88 vs. 5.16, P = 0.044), but reimbursable services per hour did not increase significantly (0.11 vs. 0.30, P = 0.129). This is attributed to the fact

TPV OVER THE YEARS

8

1990’s

2011

2014

2019

IPA House of Delegates supports TPV to expand tech and pharmacist roles

Spencer Hospital first to have an approved TPV program

BOP approves pilot to implement TPV in 7 community pharmacies which was expanded to 17

Iowa regulations adopted to allow TPV in all settings

1990’s

2007

2012-13

2018

IPA working to lead TPV efforts

Legislation allows BOP to certify TPV programs in hospital and LTC practice

Legislation allows pilot programs to research profession advancement

Results of TPV published in JAPhA

| The Journal of the Iowa Pharmacy Association

feature

that many of the services pharmacists provide are not currently reimbursed by most payers. Furthermore, data showed technicians are noninferior to pharmacists at performing the final verification on prescriptions. The overall error rate between pharmacist and technician product verification was insignificant (0.2729% vs. 0.5124%, P = 0.513). In fact, the majority of errors occurred over the first few months while technicians were getting used to the new program, and error rates were almost identical following that. Since technicians are so intimately familiar with the medications from filling them, it only makes sense that they should be able to verify fills. So, it only makes sense to consider using TPV whenever possible.

If your pharmacy is considering TPV, many new resources are becoming available. Several state pharmacy associations, including IPA, have

developed TPV Toolkits to not only help you assess its viability in your practice setting, but also to guide you through the implementation process. The IPA TPV Toolkit will aid you in deciding if TPV is right for your pharmacy, by assessing key areas such as personnel qualifications, adaptability to new workflow, and the enhanced services you may be able to offer. Timelines, checklists, and sample documents will help keep you on-track and moving toward launching your own TPV program, all while seamlessly integrating it into your everyday pharmacy practice.

With broader implementation of TPV throughout the U.S., the PTCB (Pharmacy Technician Certification Board) launched a new program in mid-October to help technicians earn a special TPV Certificate. In order to apply to take the $89 TPV Certification exam, the technician must be a CPhT

(Certified Pharmacy Technician, which is required in Iowa) who has completed a PTCB-Recognized Technician Product Verification Education / Training Program or a state board approved validation program. The CEImpact “Technician Product Verification Certificate Course for Pharmacy Technicians” is approved by PTCB, and is available at a discounted rate with purchase of IPA’s TPV toolkit. If a CPhT completes four of these certificate programs (which may include the TPV Certificate) and has three or more years of work experience, they would be eligible to earn their CPhT-Adv (Advanced CPhT Certificate).

Technician Product Verification provides an exciting launching pad to help you expand your current pharmacy offerings and allow your staff to truly practice at the top of their licenses. ■

www.iarx.org/TPV Is your Pharmacy Ready to implement Technician Product Verification?

Inside the TPV Toolkit, our Readiness Assessment will give you a gauge of your readiness to implement technician product verification to optimize patient care at your pharmacy practice.

The assessment should be completed individually at each unique pharmacy location with input from an owner/district supervisor/ pharmacy director, pharmacist-in-charge/pharmacy manager, and lead technician.

With the use of this assessment, you will know that it is likely a good time within your pharmacy to consider utilizing technician product verification to optimize patient care delivered by your pharmacists. This readiness assessment is just the first step as you begin the implementation process.

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committee reports

Education Advisory Committee

The IPA Education Advisory Committee convened via conference call on October 22, 2019. While the committee discussed key IPA educational events, they spent some time reviewing components of the current strategic plan and the current “Year of Storytelling” campaign.

The committee discussed details for planning of the 2020 Annual Meeting, including ideas for keynote speakers and networking events, as well as recommendations to build off of the learning sessions from pharmacy residents implemented in 2019. The committee provided insight for planning of IPA Goes Local for 2020 and future 2/2/2 webinar topics.

IPA ADVISORY COMMITTEE REPORTS IPA advisory committees provide guidance to the Board of Trustees and staff regarding specific practice areas.

Committees meet at least once a year at IPA headquarters in Des Moines, and may be asked to provide feedback by email or conference call throughout the year.

The committee discussed the development of a HealthSystem Leaders Forum that would target hospital pharmacy leadership. The committee reviewed the successes of hosting such events in Washington State and Wisconsin.

The committee also discussed the development of a new event for 4th year student pharmacists as they prepare for their NAPLEX and MPJE. This program would recreate programming that was once utilized during the Midwest Pharmacy Expo, but provide it around graduation time for students.

Other Committee Recommendations: • Provide resources for pharmacists who are interested in transitioning into different fields or roles in practice as a form of “career re-training.”

• Provide education programming on the statewide protocols, including how to apply to Iowa Medicaid as providers and bill for medications under the protocols.

The following pages feature recaps from this year’s fall committee meetings, including topics discussed and recommendations given.

Serving on a Committee

Serving on an IPA committee gives you the opportunity to influence the direction of the association and the advancement of pharmacy practice across the state. Each year, IPA’s president selects pharmacists, residents, pharmacy technicians and student pharmacists from a variety of practice settings and areas of the state to serve on committees.

See the list of committees at: www.iarx.org/committeestaskforces * = Chair, **=Vice-Chair IPA committees are formed in the late summer months.

If you are interested in serving on a committee, contact Anthony Pudlo at apudlo@iarx.org or 515-270-0713.

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| The Journal of the Iowa Pharmacy Association

Committee Members

Pamela Wiltfang*, Nancee Waterbury**, Emily Beckett, Dalton Fabian, Sally Haack, Shannon Hahn, Brianna Hostert, Ryan Jacobsen, Lynn Kassel, Tyson Ketelsen, Karla Knobbe, Carrie Koenigsfeld, Cindy Marek, Deanna McDanel, Alma Michelson, Wendy Mobley-Bukstein, Michael Parisi Mercado, Matt Pitlick, Amanda Rosmann, Susan Shields, Andrew Tenpas, Kate Waack, JP Webb, Sara Wiedenfeld, Matt Witry

committee reports

Health-System Liaison Board

Long Term Care & Senior Care Advisory Committee

The committee had invited guests to address the group, including: Matt Pitlick from the Iowa Healthcare Collaborative and Nancy Ruzicka from Ruzicka Healthcare Consulting. These individuals facilitated dialogue on topics of ambulatory care services, opioid stewardship, antimicrobial stewardship, and medical cannabis. The committee had active dialogue on the challenges and successes in dealing with each of these topics in their respective institutions.

The committee also reviewed new CMS requirements for antimicrobial stewardship in LTC, as well as barriers to providing vaccinations, opioid stewardship, and diversion of pain medications. The committee also discussed current research initiatives in Iowa focused on deprescribing, and the database of individualized protocols and procedures the research hopes to develop.

The IPA Health-System Liaison Board (HSLB) serves as an advisory committee to the IPA Board of Trustees to ensure that priority issues of hospital and health-system pharmacists in the state are discussed. The HSLB convened at IPA headquarters on November 5, 2019. The committee discussed multiple issues related to strategic growth of IPA, practice transformation across hospitals in Iowa, and continuing to be a unified voice for the profession.

The committee also used the opportunity to discuss upcoming regulatory and accreditation changes that are impacting their practices. The committee focused on areas to educate on USP 800, the 340B drug pricing program, technician product verification, and the e-prescribing mandate. The committee also discussed mechanisms to improve communication with health-system pharmacists, addressing current workforce trends, and providing input to ASHP.

IPA’s Long-Term Care & Senior Care Advisory Committee, chaired by Mark McMullen of Main Healthcare, convened for a live meeting on November 6, 2019. The committee opened its discussion on IPA’s current strategic plan, while also focusing on the statewide fall prevention strategies, how pharmacists can make an impact on decreasing antipsychotic medication use among elderly patients, and innovation in ACO partnerships through transitional care management.

Other Committee Recommendations: • Disseminate the universal PowerPoint on falls prevention for in-service and outreach education.

• Support IPA’s legislative agenda to expand CPA authority between pharmacists and other healthcare providers.

• Develop talking points and educate stakeholders on the value of pharmacists within ACO agreements to address patients in LTC and assisted living facilities.

Other Committee Recommendations: • Additional education on burnout to assist in facilitating conversations with upper management and leadership within institutions.

• Create ad-hoc committees to discuss issues and provide recommendations to IPA on biosimilar utilization and specialty pharmacy.

• Further review of the current/revised TPV regulations and offer recommendations to the Board of Pharmacy to clarify and update language to better encompass inpatient utilization of TPV.

Committee Members

Amanda Bushman*, Micaela Maeyaert**, Abby Beane, Eliza Dy-Boarman, Angie Fouts, Megan Hawkins, Geena Hopwood, Jeff Houseman, Candy Jordan, Namaro Kone, Celyna Koopman, Shane Madsen, Chris Medvec, Alex Mersch, Jen Morris, Emily Muehling, Briana Negaard, Melissa Nelson, Jessica Nesheim, Lauren Reist, Brian Seifert, Katy Stephens, Tim Welty, Jackie Whitman, Jonathan Wilson, Heidi Wood

Committee Members

Mark McMullen*, Jeff Reist**, Jen Alexander, Rocky Anderson, Mark Branum, David Brothersen, Connie Connolly, John Daniel, Megan Elsbury, Anisa Fornoff, Steve Hoyman, Kelsey Ihns, Nick Lund, Chelsea McIntire, Marcia McNulty, Kristin Meyer, Dick Michael, Nathan Mott, Rachel Otting, Kenzie Pfeffer, Justin Rash, David Scott, Kathy Stone, Jess Thompson, Brittany Traut, Joyce Wheeler, Michael Williams Jr

OCT.NOV.DEC 2019 |

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committee reports

Medicaid & Pharmacy Benefit Programs

IPA’s Advisory Committee on Medicaid and Pharmacy Benefit Programs is a professional advisory committee to IPA’s Board of Trustees related to the delivery of services to the Iowa Medicaid program and its recipients, administered

by DHS and the state’s fiscal intermediary. This committee has also been expanded to encompass Medicare Part D and issues pertaining to third party payors and pharmacy benefits managers. This committee convened for its live meeting on October 29, 2019, and focused its discussion on strategic growth of IPA, practice transformation in Iowa, and continuing to be a unified voice for the profession.

The committee invited Emily Rogers, the new pharmacy director at Iowa Total Care, to meet and discuss issues related to managed care services within Iowa Medicaid.

Rogers discussed leveraging existing studies and initiatives to demonstrate how pharmacists are able to impact patient health. The committee discussed the need for incentivizing pharmacists to be more actively involved in patient care. The committee encouraged Iowa Total Care to look into other Centene projects related to diabetes and prenatal care that utilized pharmacists across the spectrum of care.

The committee also discussed issues and initiatives related to Wellmark, CPESN Iowa, and the Board of Pharmacy regulations. The committee also discussed mechanisms to improve communication with IPA members and addressing current workforce trends.

Other Committee Recommendations: • Improve communication of when and how IPA resolves issues with the Medicaid MCOs, and soliciting input and issues regularly observed by the MCOs.

Pharmacy Technician Advisory Committee

On October 24, 2019, the Pharmacy Technician Advisory Committee met at IPA’s headquarters to discuss issues facing pharmacy technician practice in Iowa. The purpose of the meeting was to highlight areas where technicians are excelling in their roles, where they may be experiencing difficulties in practice, and to brainstorm ways IPA can help to improve the profession.

The committee spent much time discussing items within IPA’s strategic plan and efforts to increase active participation from technicians across all practice settings. The committee discussed specific initiatives that are advancing practice in Iowa, including technician product verification, medication history collection, and 340B inventory management.

The committee invited Ryan Burke from the Pharmacy Technician Certification Board (PTCB) to share updates to their certification process in 2020, as well as opportunities for advanced technician trainings that are available for those who wish to increase their responsibilities in caring for patients.

Other Committee Recommendations: • Add Pharmacy Support Person (PSP) on the IPA membership forms to provide clarity that PSPs can become members of IPA. • Spotlight medication history, 340B management, telepharmacy, and technician product verification as advanced roles during the networking breakfast at the 2020 Midwest Pharmacy Expo.

• Collaborate with PTCB to better understand advanced technician roles in Iowa compared to other states.

• Identify a point-person at each MCO for all concerns related to DME issues.

• Continue discussions with Wellmark and Medicaid regarding the value of Predictive Acquisition Cost (PAC) methodology.

• Evaluate opportunities for increased compensation for handling and dispensing of hazardous medications that have to follow USP 800 standards.

Committee Members

Jess Smith*, Bridget Jermeland**, Nancy Bell, Brent Bovy, Katarina Brown, Sharon Cashman, Abby Cate, Chelsea Cave, Mindi Chamberlain, Craig Clark, Jessica Frank, Dawn Grittmann, Tessa Heitkamp, Hannah Hemry, Dakota Hiner, Terry Jacobsen, Carson Klug, Nic Lehman, Emma McDonald, Randy McDonough, Emily Neddermeyer, Robert Nichols, Austin Oyen, Jamie Pitlick, Suzy Rolling, Marshall Sanders, Kim Spading, Aaron Stangel, Stevie Veach, Jarek Vetter, Aimee Wiedenman

Committee Members

Tammy Sharp-Becker*, Amanda West**, Jessica Burge Macey Calderwood, Theresa Dunkin, Meg Finn, Lori Foster, Michelle Garvin, Sonya Jones, Kaitlin Luett, Judy Mentzer, Angie Miller, Annie Pierce, Maggie Rice, Kelly Simon, Alyce Steig, Lindsay Stinson, Julia Strause, Daniel VandeVoort, Sharon Weber

OCT.NOV.DEC 2019 |

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REGISTER TODAY AT MidwestPharmacyExpo.com • 16.5 hrs of CPE for Pharmacists and 10 hrs of CPE for Technicians • Clinically Intensive Workshops (Friday) featuring high-level clinical programming • Keynote from Ryan Jenkins on leading and working within multi-generational teams • Build connections with pharmacists and pharmacy technicians from across 9 Midwestern states, plus hear from experts from across the country!

• 4 tracks including relevant programming for all practices: • Innovative Practice • Challenging Cases • Nutrition/Wellness

• Professional Roles and Skills

• Sunday Favorites:

• New Drugs with Joe Strain • Law: Drug Shortages with Erin Fox • Gamechangers with Geoff Wall

2020 Agenda Friday, February 7, 2020

Clinically Intensive Workshops 7:30 am

Registration

10:45 am

-Break-

8:30 am 8:45 am

11:00 am

2. Case Closed: Migraine Treatment Updates 3. What’s New in Nutrition? The Impact of Diet Fads and Label Changes on Patient Counseling t

Chronic Care Management: Focus on Diabetes Medication Misconceptions I Lunch & Networking (lunch provided)

3:45 pm

Medication Misconceptions II

3:15 pm

1. Unique Billing Opportunities for Your Practice

Welcome

12:15 pm

1:15 pm

Session 3

2:00 pm

6.5 hrs CPE for Pharmacists

4. Rural Pharmacy Practice: Partnering to Provide Interprofessional Care t 3:00 pm

Chronic Care Management: Focus on Anticoagulation

-Break-

Session 4

3:15 pm

1. HIV Pre-exposure Prophylaxis: An Overview 2. Geriatric Cases: Clinical Application of the 2019 Beers Criteria

-Break-

3. Self-Care=Healthcare: The Most Important Formula You Will Ever Learn t

5:00 pm Wrap-up and Adjourn

4. How Teamwork Impacts Joy in Work t

Saturday, February 8, 2020

4:15 pm

Midwest Pharmacy Expo

6.25 hrs CPE for Pharmacists & Pharmacy Technicians

6:30 am 7:00 am

8:15 am 8:30 am

9:30 am

9:45 am

Industry Symposium Breakfasts: • Advanced Technician Panel (Pharmacy Technicians only)

• Invokana-The First Therapy in 20 Years to Treat Diabetic Nephropathy in Patients with T2D (Open to all) Welcome

Keynote: “Lead & Work Across Generations: Strategies to Connect and Engage a Multi- Generational Team” by Ryan Jenkins t

-BreakSession 1 1. Drug Allergy Evaluation

2. On the Case: Updates in Respiratory Medicine

Session 2 1. Technician Product Verification: A Hands-on Exercise in Continuous Quality Improvement t t

4. Philosophy of Practice: Laying the Foundation for What We Do t Lunch and Exhibit Hall

5:30 pm

Adjourn

5:45 pm

Political Leadership Reception**

Sunday, February 9, 2020 Midwest Pharmacy Expo

4.0 hrs CPE for Pharmacists & Pharmacy Technicians

6:30 am

Registration Opens

9:30 am

-Break-

Industry Symposium Breakfasts New Drug Update t

8:00 am

-Break-

3. Recommending Supplements: Yes or No?

4. Why Did the Patient Do That? Understanding How Social Determinants of Health Influence Patient Decisions t

6:45 am

2. Case in Point: Critical Care Medicine

2. Okay, now what? Challenges in Internal Medicine

12:00 pm

1. Pharmacist to Pharmacist Collaboration 3. THC, CBD and Now Hemp Oil: Do they work? Are they safe? What’s available legally? t

4. You2: Being Intentional with Your Development t 11:00 am

Session 5

Registration Opens

3. Essential Oils: What Every Healthcare Professional Needs to Know t 10:45 am

-Break-

4:30 pm

9:45 am

Drug Shortages: Navigating the Challenge t

12:30 pm

Adjourn

10:45 am 11:00 am

-Break-

Gamechangers in Pharmacy t

Tracks:

1. Innovative Practice 2. Challenging Cases 3. Nutrition/Wellness 4. Professional Roles and Skills

CE accredited sessions in bold T - Accredited for both pharmacists & pharmacy technicians ** - Additional ticket purchase required

OCT.NOV.DEC 2019 |

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Iowa Pharmacy News

Falls Awareness

A Special Tribute to Chris Decker

On September 23, 2019, the first day of Fall, IPA members participated in the Falls Prevention Awareness Day event at the Wellmark YMCA in downtown Des Moines. APPE students from Drake, University of Iowa, and even St. Louis College of Pharmacy along with IPA’s Vice Speaker of the House, Dr. Kristin Meyer represented pharmacy at this multidisciplinary event. Student pharmacists performed blood pressure and bone density screenings as well as brown bag medication reviews to help identify risk of falls for attendees.

Attendees were provided with practical and evidence-based information on medications and medical conditions that could increase their risk of falls, and ways to reduce that risk.

IPA serves on the Iowa Falls Prevention Coalition, a group of stakeholders that meet quarterly to set and deliver on a Statewide Falls Prevention Strategy.

Pharmacy plays a critical role in falls prevention due to the impact of drugdrug and drug-disease interactions. The coalition has focused on expanding falls prevention awareness to all age groups, not only elderly patients as it can have adverse outcomes for anyone.

Pro-Vaccine Coalition Meets to Address Anti-Vaccine Movement

Due to growing concern about advocacy for the anti-vaccine movement, IPA participated in an initial meeting of stakeholders hosted by the Iowa Medical Society and Merck Vaccines on September 23, 2019. This coalition discussed potential anti-vaccination legislation in 2020 and strategies for stakeholders to take to address the issue moving forward. The group plans to reconvene throughout the next several months to build movement to counter concerns with anti-vaccination advocacy groups that have pushed legislation in other states.

Dedicating “The Deck” Chris Decker was the CEO of the Pharmacy Society of Wisconsin (PSW) for almost 30 years. He passed away on June 30, 2019 after a three year battle with glioblastoma, an aggressive brain cancer. His legacy of developing a Wisconsin Pharmacy culture of innovation, collaboration, and mutual respect supported pharmacy practice advancement in Wisconsin and beyond. We have all been touched by his story, his positivity, and his call to us to be “Difference Makers.”

In collaboration with Chris’ colleagues across the country, the Wisconsin Pharmacy Foundation facilitated over $123,000 in contributions in tribute to Chris – of which, IPA provided a $10,000 donation. In conjunction with this tribute, the PSW Board of Directors has resolved to dedicate a new patio space at the PSW office as “The Deck.” This networking and event space, conceived through Chris’ vision, now serves as a lasting place for the Wisconsin Pharmacy Family to come together, network, mentor, collaborate, and inspire one another.

The Wisconsin Pharmacy Foundation would like to thank “Team Deck” (Tom Temple, Ron Fitzwater, Steve Mullenix, Mark Pilkington, Rod Shafer, and Becky Snead; colleagues of Chris’ from across the country) and the Decker Family for their support in this special tribute to Chris Decker. ■

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| The Journal of the Iowa Pharmacy Association

PLATINUM BUSINESS PARTNER

Elevate the level of care you provide your patients.

www.iarx.org/platinum Platinum Business Partners receive all the benefits of a standard business partner plus access to higher level of services and resources from IPA. Here’s what some of our Platinum Business Partners have to say: “Although IPA is well positioned to address many of our hospital pharmacy concerns, one area we really needed their assistance was with getting a pharmacy residency program started. IPA customized our platinum business partner membership to meet our specific needs and created a detailed proposal for us that included planning for accreditation, staffing, and budget requirements for us to present to our executives for final approval. IPA’s help has been instrumental in providing us with insight and resources for us to foster innovation to across our pharmacy department and further drive the mission and vision of our institution.”

“Our company joined as a Platinum Business Partner with IPA approximately one year ago. Not only do we feel more connected to what’s going on in the industry, legislature, and within the organization, we also have a direct line of communication for any questions/concerns or help on matters that affect our business. One example is the help that we received from IPA in bridging some communication problems we were having with the MCO’s regarding DME billing. Thanks to the contacts they have established with members of those organizations, we were able to get the assistance we needed for billing claims. We gain a lot of information through our quarterly touch-base phone calls and also appreciate the discounts on various resources thanks to our PBP membership!”

– Doug Wetrich, Director of Pharmacy Mary Greely Medical Center

– Heather Storey, Pharmacy Manager, Clinical Consultant Lewis Drug

practice advancement of expertise. Six practice sites across overall goals of supporting clinicians, Iowa were selected to receive grant improve health outcomes, and funding for their patient care projects. reduce hospitalizations and over 40% In collaboration with Compass Practice These sites were located in Des Moines, included a cost savings focus. Over Transformation Network and the Iowa Chariton, Waterloo, Ida Grove, and 50% of participants reported being Healthcare Collaborative, IPA assisted Orange City. The projects included: able to capture meaningful data from with the Medication Management (1) pharmacist care coordination and their projects. Greater than 80% of Accelerator (MMA) grant initiative medication reconciliation for patients at participants were able to successfully from April 10, 2019 until August 30, their post-hospitalization clinic followintegrate pharmacists into the clinic 2019. The objective of the initiative up visit, (2) management of patients with practice. Most importantly, more than was to improve the management of hypertension and reviewing regimens 60% of participants plan to sustain patients’ medications by utilizing for appropriateness for patients taking their projects beyond the grant funding clinical pharmacists embedded in 10 or more medications, (3) diabetes period. These patient care projects clinics as well as building collaborative management for patients with A1C collectively allowed for pharmacistpractice agreements between clinics levels of 9% or greater, (4) improving delivered care and interventions to and pharmacies across Iowa. In depth diabetes management for patients impact numerous patients across these management of patients’ medications with A1C levels of 9% or greater with communities. will subsequently decrease unnecessary continuous glucose monitoring, (5) Inside IPA’s TPV Toolkit, ourand Readiness Assessment will give you a gauge of your readiness to implement technician utilization of the hospital assessing pain management medication In summary, pharmacists and clinic emergency department (ED), improve product verification to optimize patient care at your pharmacy The assessment should felt be that completed regimens for patientspractice. with chronic providers the MMAindividually project was patient outcomes, and produce totalwith input pain, at each unique pharmacy location from(6) antransitional owner/district supervisor/pharmacy director, pharmacist-in-charge/ a success and kickstarted their efforts of care management healthcare cost savings. adopting a collaborative practice model. for patients prior to discharge from pharmacy manager, and lead technician.

Although the relatively short project the hospital to improve medication Physician practices and pharmacies were timeline of less than 5 months was a adherence and resolve medication cost Withselected the use of this you will know that it is likely a good time within your pharmacy to consider utilizing to apply forassessment, funds to help with concern for participating pharmacists, issues for patients. their efforts in integrating pharmacists technician product verification to optimize patient care delivered by your pharmacists. almost This readiness assessment is just all were able to have meaningful in the healthcare team.

Each practice the first step as you begin the implementationResponses process.were received from patient encounters and make significant was able to choose a focus area for interventions to optimize medication MMA participants through a final their project that aligned with their survey. At least 50% of the individual adherence and health outcomes. ■ To learn more to purchase the TPV Toolkit, visit www.iarx.org/TPV. workflow, patientand population, and area practice site projects supported the

Medication Management Accelerator Project Concludes

Is your Pharmacy Ready to implement Technician Product Verification?

CPESN IOWA

CPESN IOWA - Flipping our way into the future!

I

n September, CPESN IOWA was awarded one of the Flip the Pharmacy practice transformation grants by the Community Pharmacy Foundation. The Community Pharmacy Foundation funded 20 Practice Transformation Teams across the country chosen to participate in the first cohort of the multi-year program.

Flip the Pharmacy aims to transform community-based pharmacies away from point-in-time, prescription-level care processes and business models to longitudinal patient-level care processes and business models through the use of hands on coaching and six different domains shown. This practice transformation work is not unfamiliar to many Iowa pharmacies who participated in the past with the Iowa Center for Pharmaceutical Care.

More than forty-five network pharmacies submitted applications to the Iowa Practice Transformation team and thirty pharmacies were selected to participate in Cohort 1.

These pharmacies committed to the Flip the Pharmacy Domains

two year Flip the Pharmacy practice transformation process; to review and complete Change Package assignments focused on workflow, technology, staffing, etc.; to meet with their assigned Practice Transformation Coach and submit at least 25 eCare plans for their patient encounters monthly. The CPESN Iowa Practice Transformation team is receiving generous in-kind support from Drake University College of Pharmacy, University of Iowa College of Pharmacy, Iowa Pharmacy Association, GRx Holdings, PrescribeWellness and some financial support from Cardinal Health and Pharmacists Mutual Foundation to support the grants initiatives.

The response from many of the participating pharmacies has been outstanding. One pharmacist stated, “We’ve been care-planning MedSync patients all day. It’s something we’ve been doing, but not documenting.

Very excited to improve the MedSync workflow in our pharmacy. This is such a neat program.” Another pharmacy noted that they began to more regularly

Lindsey Ludwig, RPh Executive Director CPESN Iowa

provide clinical MedSync since starting the Flip the Pharmacy initiative. They have retrained staff, overhauled their workflow and now have about 1/3 of their patients with 2+ maintenance medications actively on Sync. Their time has since been freed up and they are more able to complete all of their patient care initiatives and their STAR ratings have gone up a full point in the last few months. Iowa FtP Coaches have also noted that the energy and engagement among many of their assigned sites has been exciting to see.

Pharmacies are working together across the state to share ideas, best practices and experiences to help each other transform and engage in a new era of pharmacy practice.

From October 1 until mid-December 30 Iowa network pharmacies participating in the Flip the Pharmacy initiative have submitted over 5,000 care plans for patients. These same pharmacies have identified and addressed uncontrolled blood pressure in numerous patients and engaged in countless compliance issues while undergoing a practice transformation with their pharmacy and staff.

If you are interested in learning more about CPESN IOWA and the Flip the Pharmacy initiative, please plan to visit us at the MidWest Pharmacy Expo, visit www.cpesn.com or www. flipthepharmacy.com or contact Lindsey Ludwig at lludwig@cpesniowa.com for more information. ■

OCT.NOV.DEC 2019 |

19

welcome class of 2023

White Coat Ceremony Drake University College of Pharmacy and Health Sciences Jyoti Adhikari Emily Albers Brandon Ash Cameryn Baldwin Megan Barber Adrianne Bentzinger Leah Bishop Grace Brent Morgan Bump Ashlie Bunten Adam Butzler Autumn Campbell Reanna Campbell Benjamin Clemenson Sneha Cyriac Grace Dahlen Nguyen Dang Briana DiBenedetto Rachel Dietz Marie Fergot Jerime Gendron Noah Givant Ashley Grady Dillon Graf Megan Hartle Braeden Hartwig Eric Heung Ted Heying Ellie Hodapp Evan Jacobsen Allyson Klein Katherine Krusenstjerna Anna Laire Michael Larson James Lefevre

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Lindsay Lewis Joceline Lie Kailey McCollough McKenna McCreedy Jorin McGuire Jack McLoone Annika Meyers Hannah Mubark Molly Nelson Ken Nguyen Naomi Onyibe Lily Oram Lucille Palmquist Mahi Patel Nicole Pawlicki Brooke Pederson Haley Pertzborn Zachary Pogge David Ratsavong Jamie Rusan Brooklyn Sanderson Morgan Schrage Laura Schultz Komel Shahid Bailey Shie Ali Shishter Brandon Shulfer Michael Stiewe Darryle Stoltman Danira Suljic Jacob Tauke Adna Tokmic Madalyn Weaver Kim Welch Peyton Wood

Photos: Drake University College of Pharmacy and Health Sciences

| The Journal of the Iowa Pharmacy Association

welcome class of 2023

White Coat Ceremony University of Iowa College of Pharmacy Maisa A. AbuDagga Richarda Agyemang Tahani Abdallah Abdullah Alhumood Ashgan Alshawy Asmaa Alzhrani Jessica Anderson Jasmina Arnaut Keitasha Arnold Maddison Berstler Elyass Alsheikh Keirstin Broadway Lynn Bui Tiffany Bui Ellen Carlson Jordan Cervantes Elise Chang Alice Chang Paul Choeun Riley Clark Connor Clark Hannah Clausen Reumina Cufurovic Sydney Day Hoyt DeVolder Hejiazi Ding Lucas Dinh William Dunscombe Hanna Ebel Emma Erner Lucy Ernst Brock Fischer Kelsey Floerchinger Allison Folin Tyler Forer Caitlin Forrester Elena Foulke

Tanner Frey Emily Gajda Dylan Gao Nicholas Garza Molly Gavin Manar Awad Matt Hamilton Nicole Hanna Lakyn Hanson Sanya Hassan Michael Hickman Keaton Higgins Brandon Holdgrafer Claire Holtz Jasmine Howell Caitlyn Jerkins Travis Johnston Yury Kim Chan Woo Kim JeongAh Kim Leah Kinney Kelsey Kiwala Morgan Koenen Travis Larson Joshua Lechner Emily Leerar Mackenzie Male Brooklyn McCuddin Justin McKee Nathan Merten Benjamin Meyer Milagro MichelsCordao Madison Miller Thao Nguyen James Novak Kirstin Pacetti

Ashlyn Paillon Jalak Patel Nadia Phouphommakhith Catherine Ponto Ramya Ravi Taylor Roder Jose Rodriguez IV Anna Ruby-Trzeciak Kimberly Salazar Morales Komel Shahid Veronica Snow Esther Soh Kari Starbeck Emily Steimel Ayah Taha Audrey Tinkey Miah Thompson Annie Tram Hailey Tweden Alison Urbanski Hoang Van Emily VanOtterloo Kamyla Vargas Freytes Albert Vincent John Voller Tian Wang Serena Webb Alyssa Weber Ara Wiese Peirce Williams Rony Wright Allyssa Yahnke Amanda Zehnle Muris Zenelji

Photos: The University of Iowa Office of Strategic Communications\Justin Torner

OCT.NOV.DEC 2019 |

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Public Affairs

IPA WORKING FOR YOU to Address Your Iowa Medicaid & MCO Concerns Medicaid Provider Status

On November 18, 2019, Iowa Medicaid Enterprise (IME) released an informational letter describing the process for pharmacists to be recognized and listed as a new provider in Medicaid, effective July 1, 2020. This recognition is in direct response to legislation that passed in 2018 creating pharmacist statewide protocols for immunizations, naloxone, and nicotine replacement therapy.

DME Concerns

• Include a copy of the certificate from an organized course of study in a college or school of pharmacy or an ACPE-accredited continuing education program on vaccine administration, if applicable.

IPA continues to advocate on behalf of our members to Iowa Medicaid Enterprises (IME) and to the Managed Care Organizations (MCO) to ensure that claims for diabetes testing supplies, which have been moved to a durable medical equipment (DME) benefit since April 2019, are reimbursed fairly at the State rate. Numerous complaints on rejected claims, the complexity of the billing process, and low reimbursement have been fielded by IPA. In turn, IPA brought these issues to IME’s attention with a commitment from them to ensure that the MCO’s provide IPA members with direct points of contact for DME concerns. For a list of contacts for both Iowa Total Care and Amerigroup, please visit IPA’s Pharmacy Managed Care Organization Grid found on the www.iarx.org/iowamedicaid.

• Include a copy of current basic cardiac life support training certificate.

Amerigroup’s New PBM, IngenioRx

To enroll as a Medicaid Provider, a pharmacist will have to: • Complete the Iowa Medicaid Universal Provider Enrollment Application Form 470- 02546 (Section B).

• Include a copy of your Iowa Board of Pharmacy Pharmacist license.

• Include a copy of all applicable ACPEapproved continuing education certificates relative to vaccines, naloxone and nicotine replacement tobacco cessation products.

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IPA will continue to work with IME to ensure this is a smooth process for pharmacists. Stay tuned for additional information, updates, and education related to Medicaid provider status for pharmacists.

| The Journal of the Iowa Pharmacy Association

On October 1, 2019, Amerigroup changed their PBM to IngenioRx with CVS Caremark handling the point of sale claim adjudications. IPA worked closely with Amerigroup to ensure that all member pharmacies were contracted

with both IngenioRx and CVS Caremark before the go-live date to prevent any interruptions in patients’ therapies.

AAC Rate Review

IPA wants to keep you informed about the process to submit rate review requests to Iowa Medicaid (IME) and Myers & Stauffer.

First, a pharmacy should initially contact their claims processor to ensure the claim was billed correctly and verify the reimbursement methodology for that claim. In many cases, this will be through your pharmacy’s PSAO. Second, if reimbursement was below AAC, contact Myers & Stauffer through one of the multiple options listed on their communication plan, including online options.

This process has been in place since AAC was implemented. IPA encourages you to submit rate review requests to ensure that the current AAC calculated is accurate and appropriate. While AAC rates remain relatively stable, IME will make changes in published pricing based on these ongoing requests.

Public Affairs

IPA Action at the State Level

IPA spent the summer months laying the groundwork for the 2020 Iowa Legislative Session. A major part of that successful groundwork is working to ensure legislators visit IPA member’s practice sites.

It’s crucial that legislators see first-hand the innovative ways pharmacists and pharmacy technicians serve their patients.

Thank you to everyone who hosted or met with their legislator over the summer!

If you have not reached out to your legislators yet - it’s not too late! Now would be a perfect time to connect before session starts regarding pharmacy initiatives in 2020. Please contact IPA’s Director of Public Affairs, Casey Ficek, at cficek@iarx.org to get the ball rolling.

USP 800 Update

In September, United States Pharmacopeia (USP) postponed the official dates of Chapters <795>, <797>, and <825> due to concerns across the

profession. However, USP General Chapter <800>’s implementation date remained Dec. 1, 2019. The Iowa Board of Pharmacy met in October to further discuss the issue and how to proceed given the USP decision. The Board still expects all Iowa pharmacies to comply with USP <800> in its entirety, including facility design. The Board also expects Iowa pharmacies to reference which version of USP <795>, <797>, and <825> they are working to comply with within their standard operating procedures.

IPA reviewed various guidance documents available on the market.

IPA encourages pharmacies to consider an informational document available on IPA’s website at iarx.org/usp, which addresses identification of Hazardous Drugs, instructions on conducting an Assessment of Risk, and templates for all licensed pharmacies to develop Standard Operating Procedures (SOPs) addressed in USP<800>. This informational

material is for all licensed pharmacies including compounding pharmacies.

DHS Director Garcia Begins New Duties

On November 1, Kelly Garcia officially began her duties as the new director of the Iowa Department of Human Services (DHS). Garcia previously served as a deputy executive commissioner for the Texas Health and Human Services Commission, where she oversaw health, developmental and independence services for the state.

Director Garcia replaces Jerry Foxhoven, who resigned from the position in June.

IPA staff has held initial conversations with Director Garcia to help her understand the role of pharmacists across the state. She also stated she intends to continue reaching out to stakeholders who are impacted by DHS decisions and plans to focus on ensuring families who rely on DHS can serve independent and healthy lives. ■

Public Affairs

IPA Advocacy at the Federal Level Throughout 2019, IPA has done significant outreach and relationship building with Iowa’s Congressional delegation and their staff. Through attending congressional flyins, hosting pharmacy visits, and providing the expertise and knowledge of IPA members and staff when needed, IPA has been able to contribute in shaping the national policy discussion surrounding pharmacy.

Drug Pricing Roundtable

In June, IPA hosted a roundtable with Congresswoman Cindy Axne to discuss the issue of rising drug prices. Patients, pharmacists, and advocacy groups came together to tell their stories of how high drug prices are impacting Iowan’s daily lives. (left photo, above)

ASHP Legislative Day

In September, Director of Public Affairs Casey Ficek attended the ASHP Legislative Day in Washington DC as part of their Policy Week 2019. The group, including IPA members Jamie Sinclair and Alex Mersch and ASHP staff, met with Rep. Dave Loebsack, Senator Joni Ernst, and the offices of Senator Chuck Grassley, Rep. Cindy Axne, and Rep. Abby Finkenauer to discuss how issues like drug shortages, rising drug costs, and the opioid crisis affect patients. (center photo, above)

Addressing DIR Fees

Following CMS’s decision to not address direct and indirect renumeration (DIR) fees through rulemaking in the spring, IPA has also committed to ensuring that a legislative solution for DIR reform is included in any drug pricing package at the federal level. Below is a timeline of our grassroots efforts to ensure that this issue is top of mind for our Iowa lawmakers: 2019 IPA Action on DIR Fees – Timeline • January 2019 – Senator Grassley

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| The Journal of the Iowa Pharmacy Association

nominated to serve as Chairman of the Senate Finance Committee and immediately sets lowering health care/ prescription drug costs as a top priority.

• January 2019 – IPA submits letters to HHS Secretary Alex Azar and CMS Administrator Verma supporting finalization of proposed rule moving all pharmacy price concessions to the point of sale. Letters were also submitted by IPA to Iowa’s members of Congress encouraging them to sign on to letters in the Senate and House also supporting the proposed rule, with a majority doing so.

• April 2019 –Senator Grassley and the Finance Committee hold hearing to question major PBM executives. IPA collects and submits questions from members, as well as other states, to be shared with Senator Grassley for use during the hearing.

• April 2019 – IPA members and NCPA meet with Senator Grassley in Washington DC to highlight the impact of PBMs and excessive DIR fees on pharmacies.

• May 2019 – After receiving thousands of supportive comments from pharmacists, state associations, patient advocacy groups, and members of Congress (including IPA, IPA members, and Iowa’s congressional delegation), CMS fails to include DIR reform in proposed rule.

• June 2019 - IPA sends letters to Iowa congressional delegation encouraging support for a legislative solution on DIRs and to express their disappointment with the Administration’s decision to not finalize the proposed rule. Senator Joni Ernst and all four Iowa House

Representatives sign on to letters to HHS Secretary Azar expressing their disappointment as well. Sen. Ernst visited Hughes Pharmacy in Emmetsburg. (right photo, above) • June 2019 – IPA works with NACDS to help develop ad campaign to build public support for DIR reform. IPA member, Pamela Wiltfang, is recorded at an Iowa pharmacy as part of video ad campaign.

• June 2019 – IPA puts out grassroots call to action asking members to contact Senator Grassley’s office in support of DIR reform through the Senate Finance Committee drug pricing package. This call to action also encouraged members to contact their state legislators, asking them to reach out as well.

• July 2019 – IPA and nearly 60 co-signed Iowa pharmacy owners (representing 266 pharmacies) send letter to Senator Grassley urging DIR fee reform to be included in the Senate Finance Committee’s drug pricing legislation.

• August 2019 – IPA hosts exclusive member-only update/listening session with Senate Finance Committee Director of Health Policy Dr. Karen Summar regarding the prospect of Senate action on DIR fee reform.

• August 2019 – IPA membership is surveyed to provide Senator Grassley’s office with personal stories regarding the impact of DIR fees on pharmacies and patients.

• August 2019 – During the August congressional recess, IPA continues grassroots push by helping members attend Senator Grassley’s town hall meetings and submit letters to the editor/guest op-eds in support of his push to address DIR fees.

Public Affairs

Board of Pharmacy: REGULATORY UPDATE The Iowa Board of Pharmacy convened for open session on September 10, 2019 to discuss multiple requests, reports and informational items, as well as several proposed rules.

Executive Director’s Report

Several changes related to the Board of Pharmacy staff were discussed by Andrew Funk. Melanie Givens was hired for the clerk specialist position for registering pharmacy interns, pharmacy support persons, and licensing of pharmacists. Jennifer Tiffany, who formerly served in the role of Associate Director of the PMP, has transitioned back into her compliance officer role.

Vote of Adoption on New Regulations Authorized Dispensers of Pseudoephedrine Products The Board approved adoption of rules that identify all registered pharmacy employees as authorized dispensers of pseudoephedrine products, including pharmacy support persons. These changes became effective on November 13.

Proposed Notice of Intended Action Expedited Partner Therapy The Board approved the proposed notice of intended action that will allow a pharmacist to fill a non-patient specific prescription when issued pursuant to Iowa Code section 139A.41 for the purpose of expedited partner therapy to treat sexually transmitted chlamydia or gonorrhea infection in an unnamed partner or partners. Iowa Code section 139A.41 allows a physician, physician assistant, or advanced registered nurse practitioner who diagnoses a sexually transmitted chlamydia or gonorrhea infection in an individual patient to prescribe prescription oral antibiotic drugs to that patient’s sexual partner or partners without examination of that patient’s partner or partners.

Prescription Transfers The Board also approved a proposed notice of intended action that would allow one pharmacy to provide prescription drug order information to another pharmacy for a non-controlled substance prescription for the purpose of providing a patient with a three-day supply of continuing medication. This process would not constitute a transfer of prescription. ■

Tune-in to IPA’s BOP: What, Why & How podcast following each Iowa Board of Pharmacy meeting to recap the board’s actions and earn pharmacy law CE! Each episode will focus on WHAT actions were taken by the Board of Pharmacy, WHY the BOP took the actions it did, and HOW BOP action will impact practice in Iowa.

www.iarx.org/BOP_Podcast

OCT.NOV.DEC 2019 |

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Advance IPA’s Legislative Agenda by Becoming a Champion Advocate Are you interested in becoming an important partner in helping IPA advance its legislative and regulatory agenda throughout the year? IPA is looking for Champion Advocates across Iowa to build relationships with their elected officials. Help us achieve our goal of having a Champion Advocate in every House and Senate district!

Our goal is to have pharmacists establish trust and familiarity with their legislators to keep them aware of the key issues facing pharmacy. As you work to educate our representatives and senators, we can help build their understanding of our concerns regarding patient care and the role of the pharmacist.

By volunteering as a Champion Advocate, you would be kept up to date on the latest information relating to IPA’s advocacy agenda and would be ready to answer the call when IPA needs to make a grassroots push with legislators.

Responsibilities would include:

• Building relationships outside of the legislative session by hosting pharmacy visits with legislators and delivering PAC contributions when needed • Contact legislators during session to explain how pending legislation would affect your pharmacy practice • Relaying your personal experiences to help legislators understand the important role that today’s pharmacists play in enhancing the health care of Iowans • Stay informed with bill tracking/ IPA legislative priorities and participate in bi-weekly update calls

If you are interested in becoming a Champion Advocate or have any questions, contact Casey Ficek, IPA’s director of public affairs, at cficek@ iarx.org or 515-270-0713. Casey can help you identify your senator and representative and get started with setting up a pharmacy visit.

Technician Corner

Technician Members!

To receive the Tech Tidbits newsletter each month, be sure that your email is up-to-date in your member profile on IPA’s website www.iarx.org.

PTCB Launches AssessmentBased Certificate Programs

As part of their ongoing efforts to support the vital role of pharmacy technicians in patient care, the Pharmacy Technician Certification Board (PTCB) recently launched Assessment-Based Certificate Programs for pharmacy technicians to demonstrate their knowledge and underscore their passion for pharmacy.

Technician Product Verification (TPV) Earning a Technician Product Verification (TPV) Certificate offers an opportunity for technicians to demonstrate and be recognized for their competency in completing final verification duties, checking medications dispensed by others or by automated systems for accuracy, and managing detail-oriented work and administrative tasks.

Medication History The Medication History Certificate indicates pharmacy technicians have the knowledge to collect accurate in-depth medication histories, identify potential medication errors, and complete related administrative duties to advance patient safety and care.

Coming Soon: Hazardous Drug Management Pharmacy technicians who earn the PTCB Hazardous Drug Management Certificate demonstrate their knowledge of defined guidelines and requirements for managing hazardous drugs and are prepared to play a vital role in helping ensure the safety of the facility.

These new programs are an important step toward earning the new Advanced CPhT credential (CPhT-Adv) from PTCB as early as mid-2020. With advanced knowledge, pharmacy technicians are able to take on further responsibilities and contribute to

a safer, more efficient pharmacy. To learn more about PTCB’s Credential Index, visit www.ptcb.org/credentials.

Medication Recalls

(From IPA’s September 2019 Tech Tidbits newsletter) A drug recall is an effective way to protect the public from faulty or potentially harmful products. A medication recall may be conducted voluntarily by a pharmaceutical company or as required

by FDA request - as the role of the FDA is to oversee the strategy, assess adequacy of the recall and determine classification of drug recall. Drug recall classification consists of 3 classes including: • Class I: A dangerous or defective product that could cause serious health problems or death. Examples: food found to contain botulinum toxin, food with undeclared allergens, a label mixup on a lifesaving drug, or a defective artificial heart valve.

• Class II: A product that might cause a temporary health problem or pose slight threat of serious nature. Example: a drug that is under-strength but that is not used to treat life-threatening situations.

• Class III: A product that is unlikely to cause any adverse health reaction but violates FDA labeling or manufacturing laws. Examples: a minor container defect and lack of English labeling in a retail food.

Resources for Pertinent Safety Information There are resources available to help you stay up to date with safety alerts and drug recalls. The FDA provides weekly Enforcement Reports, which reports all products that have been recalled and classified by the FDA, the link to subscribe to the Enforcement Report mailing list can be found here: https:// www.fda.gov/safety/recalls-marketwithdrawals-safety-alerts/enforcementreports#howsubscribe.

Medwatch, a FDA safety information and adverse event reporting program provides up to date safety information and has an

email subscription available at https:// www.fda.gov/safety/medwatch-fdasafety-information-and-adverse-eventreporting-program.

Recent Medication Recalls The FDA has learned that certain ranitidine medicines, including some products commonly known as the brandname drug Zantac, contain a nitrosamine impurity, N-nitrosodimethylamine (NDMA), that was also found in blood pressure medications like valsartan and losartan/hydrochlorothiazide earlier this year. The FDA isn’t calling for individuals to stop taking ranitidine at this time; however, patients taking prescription ranitidine who wish to discontinue use should talk to their health care professional about other treatment options. People taking OTC ranitidine could consider using other OTC medicines approved for their condition. There are multiple drugs on the market that are approved for the same or similar uses as ranitidine.

Steps to Follow for a Medication Recall 1. Become informed. In the event of a medication recall, make sure to follow any specific guidance from your pharmacy or hospital. Using resources such as the FDA weekly enforcement reports and subscribing to MedWatch email list serve will help you stay up to date and informed.

2. Identify the lot numbers of the medications in question. One can find the lot numbers affected by the recall either through the medications manufacturers or FDA website at https://www.fda.gov/drugs/drugsafety-and-availability/drug-recalls.

After lot numbers have been identified, ensure none of your medications belong to the recalled lots.

3. Safely dispose of the recalled medications. Safely disposing of recalled medications reduces the chances of accidently dispensing the medications and prevents environmental contamination. Some medications come with specific disposal instructions or need to be taken to an authorized takeback site. If instructions are not given the FDA’s website provides instructions OCT.NOV.DEC 2019 |

27

TECHNICIAN CORNER

on how to dispose of medications.

4. Contact the patient and their doctor.

If possible, identify which patients have already received the recalled medication and provide instructions on how they can dispose of the medications and education to contact their doctor ASAP if they experience any unusual symptoms.

References 1) https://www.fda.gov 2) https://www.goodrx.com/blog/drug-recallsrecalled-medication-what-to-do/

Technician Product Verification

(From IPA’s November 2019 Tech Tidbits newsletter) Iowa recently finalized a complete revision of Chapter 40 of the Board of Pharmacy regulations relating to Technician Product Verification (TPV) programs, formerly known as “Tech-Check-Tech”. This change allows certified pharmacy technicians,

that meet the training and education requirements set forth by the Board of Pharmacy, to verify prescriptions in hospitals, long-term care, and community pharmacy settings. The Board rules became effective on June 26, 2019.

Great progress has been made for pharmacy technicians to practice in more advanced roles. However, fulfilling the requirements to be eligible to perform TPV can be challenging, time-consuming, and difficult to ensure that you and your pharmacy are meeting all rules and requirements. This is exactly why IPA has created the Technician Product Verification Toolkit and collaborated with CEImpact to offer the Technician Product Verification certificate training program to give you and your pharmacy everything you need to get trained, meet board requirements, and start verifying prescriptions.

Technician Product Verification (TPV) toolkit: This toolkit includes: six essential

Newly Certified Iowa Technicians July 1 - Sept. 30, 2019 Congratulations to the following pharmacy technicians on becoming PTCB-certified!

Jordan Abbott Jessica Anderson Taylor Baker Megan Barloon Esmee Belzer Hana Berry Brittany Bolerjack Anna Britton Mary Brown Regine Buenaobra Kayla Chau Josie Christof Ann Cody Anna Coffin Laura Coon Jonathan Corrigan Emily Dieter Terry Do Celeste Dolter Lauren Duncalf William Dunscombe Megan Earles Steve Etheredge Gabriella Fedewa Grace Fehlhafer Ginger Fisher Anna Fox Tyler Fugate

Andrea Garcia Ferre Taylor Gau Ava Glass Katelyn Goergen Adela Hadziric Erinn Hall Collin Havel Dawn Havey Denise Heagy Kelsey Hill Sarah Hou Tobias Huffman Xi Jin Nicole Johannsen Kylie Juenger Joseph Klosowski Dylan Kruger Lacie Lerch Julienne Audrey Lieb Seth Loock Kimberly Ly Jessica Lynn McPherson Lisa McTaggart Casey Mills Elizabeth Miner Megan Mitchell Michelle Morey Jessica Marie Muhlenbruch

Viviana Munoz Henry Nguyen Alexandria Nigg Sarah Noga Angela O’Connor Kaitlin Palmersheim Kalpana Patel Amy Peterson Thuy Phillips Stefanie Quinn Autumn Ralston Veronica Ramirez Melinda Rogers Shelby Ross Gracie Schnell Michael Sehl Madison Sharp Kaylee Shearer Nicole Smith Stefanie Trout Esther Van Der Brink Morgan VanZante Jessica Wagner Machaley Ward Kayla Ward Cassidee Wolter Maosong Ye

training modules that fulfill requirements by the Iowa Board of Pharmacy and templates for initial proposal to the Iowa Board of Pharmacy to implement TPV; guidance for quality improvement reporting and data collection; implementation timelines for pharmacists, technicians, and management.

Technician Product Verification (TPV) certificate training: This certificate training program will meet the requirements of the Iowa board of pharmacy for technician product verification programs. Pricing $250 (discount available with purchase of the TPV Toolkit). Certificate program available now!

If you would like to take advantage of this great opportunity to expand your role as a technician, please visit www.iarx.org/TPV for more information on how to get started with the TPV toolkit and Training!

CPhT Recertification CPE for FREE! Join IPA for your FREE Subscription to CEI’s Technician Catalog!

CEI’s Technician Catalog is a web-based subscription that contains accessible and convenient continuing education courses for technicians to recertify and advance their career path.

Members: Login at www.iarx.org/ cei_libraries to take advantage of this new benefit for members and spread the word to your colleagues.

Specializing in certifying pharmacy technicians because patient safety matters.

Choose PTCB. Choose Excellence.

ptcb.org OCT.NOV.DEC 2019 |

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resident spotlight

meet the 2019-2020 iowa pharmacy residents IPA would like to introduce the 55 pharmacy residents and fellows practicing in Iowa in 2019-2020.

Take a minute to see who they are and where they are practicing this year.

Amanda Abdulbaki

Abigail Caslow

Meredith Frey

Lynn Aung

Tiffany Cheng

Jillian Ginger

Jessica Berei

Austin Cook

Amanda Hoerres

Win Brand

Brock Dantuma

Krystal Holmes

University of Iowa Hospitals & Clinics PGY1 HealthSystem Administration Graduate of Wisconsin Sciences

University of Iowa Hospitals & Clinics PGY1 Pharmacy Practice Graduate of Michigan

Kathryn Bress

Tess Dyson

Olivia Hopton

Katarina Brown

Brittany Faley

Brianna Hostert

Lorin Fisher

Anthony Hunt

Iowa Pharmacy Association Association Fellowship Graduate of Mercer University

Mercy Medical Center – Cedar Rapids PGY1 Pharmacy Practice Graduate of University

Des Moines VA Health Care System PGY1 Ambulatory Care Graduate of Drake University

MercyOne – Waterloo PGY1 Pharmacy Practice Graduate of North Kakota Sciences

MercyOne - Des Moines PGY2 Emergency Medicine Graduate of University of Pittsburgh

North Liberty Pharmacy PGY1 Community Practice Graduate of University of Iowa

Elisabeth Carrol

University of Iowa Hospitals & Clinics PGY2 Emergency Medicine Graduate of Colorado Sciences

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MercyOne – Des Moines PGY1 Pharmacy Practice Graduate of Drake University

MercyOne - North Iowa PGY1 Pharmacy Practice Graduate of Creighton University

University of Iowa Hospitals & Clinics PGY2 HealthSystem Administration Graduate of Auburn

Iowa City VA Health Care System PGY1 Pharmacy Practice Graduate of University of Iowa

UnityPoint Health/Allen PGY1 Pharmacy Practice Graduate of University of Iowa

University of Iowa Hospitals & Clinics PGY2 Ambulatory Care Graduate of University of Iowa Sciences

University of Iowa Hospitals & Clinics PGY1 Ambulatory Care Graduate of Wisconsin

UnityPoint Health – Des Moines PGY1 Pharmacy Practice Graduate of University of Iowa

Vanadro Industry Fellowship Graduate of Drake University

Iowa City VA Health Care System PGY1 Pharmacy Practice Graduate of Drake University

Greenwood Drug PGY1 Community Practice Graduate of Drake University

University of Iowa Hospitals & Clinics PGY1 Pharmacy Practice Graduate of University of Iowa Sciences

resident spotlight

Morgan Jacks

Kevin Martin

University of Iowa Hospitals & Clinics PGY2 HealthSystem Administration Graduate of Florida

Whitni Patterson

UnityPoint Health/Allen PGY1 Pharmacy Practice Graduate of University of Iowa University

Jazmin Lee

Becky Matzek

Iowa City VA Health Care System PGY1 Pharmacy Practice Graduate of University Nebraska Medical Center COP

MercyOne – Waterloo PGY1 Pharmacy Practice Graduate of South Dakota

Rachel Purdy

Jonathan Lochner

Chelsea McIntire

Nicole Rasmussen

Sarah Lothspeich

Erin Moore

Sydney Rechtenbaugh

James Lowery

Briana Negaard

Allison Sekula

University of Iowa Hospitals & Clinics PGY2 Oncology Graduate of University of Iowa University

Mercy Medical Center PGY1 Pharmacy Practice Graduate of University of Iowa

Iowa City VA Health Care System PGY1 Pharmacy Practice Graduate of Mercer University

Zach Lynch

University of Iowa Hospitals & Clinics PGY2 Ambulatory Care Graduate of University of Iowa

OutcomesMTM PGY1 Managed Care Graduate of University of Mississippi

University of Iowa Hospitals & Clinics PGY1 Pharmacy Practice Graduate of University of Iowa

Theodore Nguyen

University of Iowa Hospitals & Clinics PGY1 HealthSystem Administration Graduate of University of Iowa

MercyOne - North Iowa PGY1 Pharmacy Practice Graduate of Drake University

UnityPoint Health PGY1 Pharmacy Practice Graduate of South Dakota State

UnityPoint Health PGY1 Pharmacy Practice Graduate of South Dakota State University MercyOne Pharmacy PGY1 Community Practice Graduate of Drake University

University of Iowa Hospitals & Clinics PGY2 Pain and Palliative Care Graduate of University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences

Lauryn Smelser

Jenna Manatrey-Lancaster

Meghan O’Donnell

Taylor Smith

Anna Marceau

Austin Oyen

Katy Stephens

Kylie Markovich

Chandni Patel

Jessica Streit

UnityPoint Health/Allen PGY1 Pharmacy Practice Graduate of University of Iowa

UnityPoint Health – Des Moines PGY1 Pharmacy Practice Graduate of Drake University

Des Moines VA Health Care System PGY1 Ambulatory Care Graduate of Drake University

UnityPoint Health – Des Moines PGY1 Pharmacy Practice Graduate of Drake University

MercyOne – Des Moines PGY1 Pharmacy Practice Graduate of University of Wyoming

Towncrest Pharmacy PGY1 Community Practice Graduate of South Dakota State University

University of Iowa Hospitals & Clinics PGY2 Pediatrics Graduate of Wayne State

University of Iowa Hospitals & Clinics PGY2 Pediatrics Graduate of Mississippi

University of Iowa Hospitals & Clinics PGY1 Ambulatory Care Graduate of Kansas

University of Iowa Hospitals & Clinics PGY1 Pharmacy Practice Graduate of Oklahoma University

University of Iowa Hospitals & Clinics PGY1 Pharmacy Practice Graduate of University of Iowa

OCT.NOV.DEC 2019 |

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STUDENT LOAN REFINANCING

Pay off student debt sooner.

Save thousands.

IPA and SoFi have teamed up to help you take down student debt—with student loan benefits, exclusively for IPA members, family and friends.

Why refinance student loans with SoFi?

Refinance student loans or Parent PLUS loans at sofi.com/IPA to receive a $1001 welcome bonus.

Serious savings.

Low rates.

Federal and private.

No extra fees.

Membership perks.

Members save

Low variable and fixed

You can consolidate and

No application/origination

Exclusive networking

thousands when they

rate options may reduce

refinance both federal and

fees or prepayment

events, financial

refinance.

your interest rate.

private loans.

penalties—ever.

workshops, and more.

How to apply: 1

Find your rate at sofi.com/IPA.

2

If approved, select your rate and term.

3

Upload identity, income, and loan information.

Claim your 1001 toward your student loans at sofi.com/IPA. Checking your rate will not affect your credit score.2 Terms and Conditions Apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. To qualify, a borrower must be a U.S. citizen or permanent resident in an eligible state and meet SoFi’s underwriting requirements. See SoFi.com/elgibility for details.

SoFi refinance loans are private loans and do not have the same repayment options that the federal loan program offers such as Income Based Repayment or Income Contingent Repayment or PAYE. Licensed by the Department of Business Oversight under the California Financing Law License No. 6054612. SoFi loans are originated by SoFi Lending Corp., NMLS # 1121636. Information as of July 2018.

1 Additional terms and conditions apply. Offer is subject to lender approval. To receive the offer, you must: (1) register and/or apply through the referral link you were given; (2) complete a loan application with SoFi; (3) have and provide a valid US bank account to receive bonus; (4) and meet SoFi’s underwriting criteria. Once conditions are met and the loan has been disbursed, you will receive your welcome bonus via automated clearing house (ACH) into your checking account within 30 calendar days. Bonuses that are not redeemed within 180 calendar days of the date they were made available to the recipient may be subject to forfeit. Bonus amounts of $600 or greater in a single calendar year may be reported to the Internal Revenue Service (IRS) as miscellaneous income to the recipient on Form 1099-MISC in the year received as required by applicable law. Recipient is responsible for any applicable federal, state or local taxes associated with receiving the bonus offer; consult your tax advisor to determine applicable tax consequences. SoFi reserves the right to change or terminate the offer at any time with or without notice.

2 To check the rates and terms you may qualify for, SoFi conducts a soft credit pull that will not affect your credit score. A hard credit pull, which may impact your credit score, is required if you apply for a SoFi product after being pre-qualified.

4

Celebrate your savings.

resident spotlight

Alyssa Sykuta

Andrew Tenpas

Jaelyn Westfield

Jacqueline Whitman

Samuel Williams

Kelsey Zenti

University of Iowa Hospitals & Clinics PGY1 Pharmacy Practice Graduate of Drake University

University of Iowa Hospitals & Clinics PGY1 Pharmacy Practice Graduate of University of Iowa

Osterhaus Pharmacy PGY1 Community Practice Graduate of University of Iowa

UnityPoint Health - Allen Hospital PGY1 Community Practice Graduate of University of Wisconsin

Jess Thompson

Hy-Vee Drug Store PGY1 Community Practice Graduate of Drake University

NE IA Medical Education Facility & Waverly Health Center PGY1 Ambulatory Care Graduate of Drake University

Iowa City VA Health Care System PGY1 Pharmacy Practice Graduate of University of Iowa

Annual Resident’s Meeting Expanded in 2019 On September 24, 2019, fifty-three pharmacy residents from across Iowa met in Iowa City for the 2019 Annual Resident’s Meeting. In addition, 26 residency program directors and residency preceptors joined the meeting along with their residents.

This year’s meeting featured IPA’s elected presidential officers sharing their stories and leadership journeys in a panel discussion.

IPA President Connie Connolly then provided an overview of IPA’s leadership agenda, which included initiatives she has been involved in during her time in office.

At this year’s event, IPA convened two separate programming tracks – one for residents, and one for RPDs and preceptors.

Residents participated in roundtable discussions led by IPA leadership, staff and PGY2 residents. The topics included managing a research project, professional involvement, leadership in advocacy, and transitioning from their roles as students to new

practitioners and preceptors to pharmacy students. Additionally, RPDs and preceptors had special programming for CPE credit on Adjusting Learning to Your Learner (Nancee Waterbury, PharmD, BCACP), Developing Great Learning Experiences (Diane Reist, PharmD, RPh), and Integrating Leadership Training with Your Residents (Emily Muehling, PharmD, BCPS).

IPA hosts the Resident’s Meeting each year to bring together all of Iowa’s pharmacy residents for a day of professional development and networking with their peers and IPA leadership.

OCT.NOV.DEC 2019 |

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IPA FOUNDATION

The 2019 Eggleston-Granberg Golf Classic was held on a beautiful day at the Legacy Golf Club in Norwalk, Iowa on September 6th. Thanks to the generosity of 72 golfers, the IPA Foundation raised $12,400 toward their initiatives to support student pharmacists at Drake University and the University of Iowa. Since the Golf Classic is a friendly competition, there were a few winners.

Longest Drive Mens – Paul Van Heukelom Longest Drive Womens – Christina Kunz Longest Putt Mens – JP Webb Longest Putt Womens – Beth Bird Closest to Pin Mens – Mark Ploehn Closest to Pin Womens – CoraLynn Trewet

Championship Flight

1st: Nate Peterson, JP Webb, Matt Fleshner, Tom Troung 2nd: Andy Ploehn, Andrew Ploehn, Mark Ploehn, Dustin DeMuth 3rd: Tom Temple, Bill Wimmer, Bri Bakken, Kayla Sanders

First Flight

1st: Brett Faine, Andrew Nugent, Paul Van Heukelom, Kellen Ludvigson 2nd: CoraLynn Trewet, Jim Hoehns, Matthew Busalacchi, Colby Dunn 3rd: Rich Riesberg, Drew Riesberg, Robert Schroeder, Nevin Radechel

Second Flight

1st: Jay Currie, Al Shepley, Cheryl Clarke, Denny Jorgensen 2nd: Jamie Pitlick, Matt Pitlick, Sally Haack, Jeremy Haack 3rd: Bill Baker, Beth Bird, Cambridge Hampsher, Chris Fox

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| The Journal of the Iowa Pharmacy Association

Thank You Golf Classic Sponsors!

The IPA Foundation would like to extend a special thank you to these sponsors. This event would not be possible without their support.

Cart Sponsor

NuCara Pharmacies

Beverage Cart Sponsor Greenwood Drug

Hole Sponsors

Bill Baker Chris Connolly/Wells Fargo Advisors Jay & Ann Currie Sarah Derr & Paul Roczinak Drake University College of Pharmacy & Health Sciences Dubuque Area Pharmacy Association IPA Foundation Johnson County Pharmacy Association

Manning Pharmacy North Iowa Pharmacy Inc Osterhaus Pharmacy Pharmacists Mutual Group PharmServ Staffing Chuck & Janalyn Phillips Quad Cities Area Pharmacy Association Smith Drug Towncrest Pharmacy The University of Iowa College of Pharmacy

Student Sponsors

Sarah Derr Bill Doucette Denny Jorgensen Julie Kuhle Erik Maki Steven Martens Lisa Ploehn Anthony Pudlo Doug Schara Susan Shields Bob Stessman Wayne County Hospital Retail Pharmacy

Bill Baker Carl Chalstrom Connie Connolly

OCT.NOV.DEC 2019 |

35

IPA FOUNDATION

Another Great Weekend in Galena

The Leadership Pharmacy Conference was held on August 8-10, 2019, in Galena, IL, bringing together ten Iowa pharmacists and ten Wisconsin pharmacists along with IPA and Pharmacy Society of Wisconsin leadership and staff. As with the 30 previous conferences, participants enjoyed strong leadership training and a focus on the issues impacting the profession.

Lauri Freking from Wixted & Company presented on communication strategies, difficult Q&A sessions, and practicing your communication during the first full day.

Similar programming occurred the rest of the weekend as Steve Rough of the University of Wisconsin Hospital and Clinics and Mike Brownlee of the University of Iowa Hospitals and Clinics presented on effectively implementing change with an interactive “Shark Tank” activity.

Any IPA pharmacist member residing and/or practicing in Iowa or Wisconsin within their first three (3) to fifteen (15) years of practice is eligible to apply for participation in Leadership Pharmacy. Nominate a colleague (due Feb. 1, 2020) or apply today (due Feb. 15, 2020) at www.iarx. org/LeadershipPharmacy.

2019 Iowa Participants:

Michael Daly, PharmD – Drake University/The Iowa Clinic Matthew Farley, PharmD - Fresenius Kabi Brian Glenn, PharmD – Clarke County Public Hospital Alex Mersch, PharmD – University of Iowa Hospitals and Clinics Michael Schnackenberg, PharmD – Hy-Vee Pharmacy, Des Moines Adam Weinkauf, PharmD – UnityPoint Health – St. Luke’s Hospital Terry Wiedenfeld, PharmD – Mercy Medical Center, Sioux City Pamela Wong Wiltfang, PharmD – NuCara Pharmacy Matthew Witry, PharmD, PhD – University of Iowa College of Pharmacy Heidi Wood, PharmD – University of Iowa Hospitals and Clinics

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| The Journal of the Iowa Pharmacy Association

Bill Burke Student Leadership Conference

IPA hosted 30 student leaders from Drake University College of Pharmacy & Health Sciences and The University of Iowa College of Pharmacy for the 24th annual Bill Burke Student Pharmacist Leadership Conference on September 20-22, 2019. For the first time, the conference was spread over three days and was held at the Wildwood Hills Ranch in St. Charles, Iowa.

The conference began on Friday afternoon with an inspirational welcome from Renae Chesnut, dean of Drake University College of Pharmacy and Health Sciences, who encouraged the students to stay involved both on and off campus as they continue to grow as leaders and future practitioners.

After that, the students heard from Mike Pursel, director of medical health relations at Sanofi Biosurgery. Mike shared his insights on how leadership opportunities, along with barriers, surface throughout a career in pharmacy.

On Saturday, Sara Ennis, founder and president of SparkPoint Inc., led the students through a series of interactive discussions on communication skills.

This session helped the students develop skills around building relationships and engaging with customers and other staff members, recognize when and how to conduct a difficult conversation, and how to empower themselves and others to meet diverse needs, including their own. After lunch, the students completed a challenging High Ropes course which required application of the communication skills they learned that morning. The course was designed for groups to navigate obstacles together.

On Sunday, the conference attendees discussed how to apply everything they learned to their careers in pharmacy. Students worked together to identify what issues they as pharmacists will face in their careers, what the impact of those issues would be, and what they as leaders and soon-to-be new practitioners could do to address these issues. Overall, the student leaders had a blast during this interactive, leadership development and team-building conference.

Held every fall, the conference is made possible through a partnership between IPA, Drake University, the University of Iowa, and grant support from Main at Locust Pharmacy in Davenport, Iowa.

2019 Participants:

Drake University: Andrew Bjorlin, Beau Blake, Layne Davis, Christopher Karch, Riley Karpen, Dinka Miljkovic, Areeb Nagamiyan, Phuong Ngo, Andrew Olson, Robert Schroeder, Rachel Wedermeyer, Brittani Weichman, Olivia Welter, Verent Yee, Lauren Zimmerman University of Iowa: Cole Borchardt, Guadalupe Chavez, Raemi Chavez, Sarah Cinquepalmi, Michelle Jakaitis, Anna Kane, Helena Kobuzi, Catherine Kruse, Meredith Lumberg, Jacquelyn Mareau, Lauren Reist, Bibiana Ruiz Granado, Abbey Schwery, Matt Stahl, Matthew Yeates

IPA FOUNDATION

It’s not what you know – it’s who you know.

B

efore I became the Executive Intern at IPA, I didn’t think this quote was all that relevant to my life. My professional connections were isolated to the students and faculty of Drake University’s pharmacy program and I felt like that was enough. However, I quickly realized that the saying “pharmacy is a small world” is actually true; that’s when I decided that the quote “it’s not what you know – it’s who you know” is something every pharmacy professional should live by.

Throughout my time with IPA, I was able to attend meetings in a variety of settings and had the opportunity to meet many different people. After I met someone for the first time, I almost always heard their name come up in a separate conversation. I found it intriguing that everybody in the pharmacy world knew each other not only professionally, but also personally.

These relationships are important to form in order to keep up with what others are doing in their practice areas, and they become especially important during career transitions. In today’s pharmacy climate, it is becoming more and more common to see pharmacist layoffs seemingly out of nowhere; having a professional connection with somebody in a different career setting can prove to be extremely beneficial for pharmacists finding themselves in these situations. Often, pharmacists may hear about job openings before the jobs are even posted, which gives those candidates a leg up on the competition. This in itself points to the value of creating and maintaining positive professional relationships.

As a student pharmacist, future employment is something that is always on my mind. For me, the development of connections harbors a distinct value that cannot be found in simply knowing information.

Since I have a year and a half left until graduation, there are still many unopened doors in front of me that are waiting to be explored; some of these doors may be unlocked, welcoming all who wish to pass through, but others may require a key in order to get through. Relationships can act as these keys, and student pharmacists

“The development of connections harbors a distinct value that cannot be found in simply knowing information.”

Olivia Welter Student Pharmacist Drake University

patient care-based rotations. The trick for me has been not to look for specific patient care areas, such as cardiology, to preference, but instead to look at who the preceptor is and consider what can be learned from that person and their team. I am grateful for each and every person I encountered over the summer and will encounter throughout the next year while on rotations, especially because the caliber of pharmacists in Iowa is unmatched.

Thank you to everyone for making my time as the Executive Intern so valuable! ■

should look for every opportunity to collect them. I will soon be going on rotations and, since I am considering taking more of an alternative route with my pharmacy career, I’ve been finding it difficult to look forward to the blocks that will be heavily focused on patient care. Thanks to my time as the IPA Executive Intern this summer, however, I’ve learned how I can strategically cater my experiences towards my own professional goals. Learning the importance of networking taught me how to make the most out of situations where it might be difficult to find value, such as

OCT.NOV.DEC 2019 |

37

RAGBRAI 2019

RAGBRAI 2019 Each July, the Des Moines Register holds the Registerâ&#x20AC;&#x2122;s Annual Great Bicycle Ride Across Iowa (RAGBRAI) and the IPA Foundation sponsored its sixth team for the weeklong trek through the state in 2019. As ambassadors for the association and our profession, the IPA Foundation RAGBRAI team connects with Iowa pharmacists and pharmacies along the route, serves fellow riders with first aid and OTC treatments, and educates Iowans on the important role of the profession.

This yearâ&#x20AC;&#x2122;s ride was a southern route covering more than 440 miles and over 15,000 feet of climb. The profession was able to track the IPA Foundation team on social media throughout the week using #RollinRx. In 2019, Pharmacy Times once again provided in-depth coverage of our RAGBRAI team broadcasting to a larger audience about the adventure on two wheels from river to river.

RAGBRAI 2019

Saturday, July 20: Council Bluffs

Team members arrived at the IPA offices at noon to pack their bikes and supplies for the week in the team shuttle and trailer. It didn’t take long until they were on their way to the home of their gracious host in Council Bluffs, Leslie Noty. Only a few years out of pharmacy school at University of Iowa, Leslie is already the pharmacist in charge at the Hy-Vee in Council Bluffs. After settling in, team members had the opportunity to pick up OTC donations and meet Traci Lindley and her staff at Walgreens, as well as visit with IPA Honorary President, Tony Beraldi at Oard Ross Drug, owned by his family and serving the community for more than a century.

Overnight Hosts: Leslie Noty, PharmD Pharmacies Visited:

Oard Ross Drug, Council Bluffs : Anthony Beraldi, RPh PIC Walgreens #5306, Council Bluffs: Traci Lindley, PharmD PIC

Sunday, July 21: Council Bluffs to Atlantic

Distance: 57 mi. - Climb: 2577 ft. (75.2 mi. – 3657 ft. w/gravel loop) Day one began early with a few team members heading to the Missouri River to dip their tires as an official launch of the ride.

This first day found team members improvising with garbage bag “rain gear” as they started out but thankfully the rain subsided quickly. While most pharmacies were closed by the time the team arrived in Atlantic later that day, Josh Borer was excited to offer the team a tour of his new Rex Pharmacy location, which was still under construction. Afterwards they were warmly welcomed into the home of retired pharmacist, Allen Fann and his wife, Marianne for the evening. While the team couldn’t convince the Fann’s to join the group for the Hairball concert in downtown, the team greatly appreciated the delicious morning meal as they got ready for the road ahead.

Overnight Hosts: Allen (RPh, retired) & Marianne Fann Pharmacy Visited:

Rex Pharmacy, Atlantic: Josh Borer, PharmD

Monday, July 22: Atlantic to Winterset Distance: 68.1 mi. – Climb: 2044 ft.

Day two saw several additional riders joining the team, including IPA’s own Kate Gainer. Today’s route provided the opportunity to visit four pharmacies in four different communities along the way. Pharmacist and IPA member, DeeAnn Wedemyer-Oleson, also offered the team a late morning “refuel and fun” stop as they headed into Adair. Later that day they arrived in Winterset and

were able to meet the staff of a couple of additional pharmacies before heading to their hosts for the evening. Scott and Brenda Clouse, along with daughter and student pharmacist, Alexis, provided the team with an amazing overnight stay in a beautiful country home just outside of Winterset, complete with bonfire and s’mores.

Overnight Hosts: Alexis (University of Iowa PharmD candidate 2022), Scott & Brenda Clouse

Pharmacies Visited:

Rex Pharmacy, Anita: Kelly Bump, RPh Fay Pharmacy, Adair: Peter Fay, RPh Wright Pharmacy, Stuart: Kirsten Meacham, PharmD and staff Montross Pharmacy, Earlham: Mark Jobst, RPh; Susan Smith, CPhT Medicap Pharmacy, Winterset: Kailey DeVries, PharmD; Suzanne Jensen, RPh; Linda Oglesbee, CPhT; and Kathy Livingston, CPhT

Tuesday, July 23: Winterset to Indianola Distance 39.9 mi. – Climb: 1573 ft.

Our shortest ride (coincidentally?) also saw our team growing to its largest for the week. Sixteen riders took off on day three from Winterset to enjoy the beautiful ride to Indianola. Pat Wilsbacher of Pharmacists Mutual Insurance also joined the team to take his turn at driving our supply van for the day. Before leaving town, the team made stops at Montross Pharmacy and HyVee Pharmacy and then made their way to Medicap Pharmacy in Norwalk. An earlier arrival in Indianola meant that they were able to make stops at all of the Indianola pharmacies that afternoon before arriving at the home of Steve and Rhonda Sayler for a great overnight rest.

Overnight Hosts: Steve (RPh) & Rhonda Sayler (parents of Morgan Herring, PharmD, U of I faculty)

Pharmacies Visited:

Montross Pharmacy, Winterset: Jeff Olsen, RPh Hy-Vee Pharmacy, Winterset: John Ellis, PharmD Medicap Pharmacy, Norwalk: Stephanie Fenster, PharmD; Sarah Andreeson, PharmD; Katie Plagge, PharmD Medicap Pharmacy, Indianola: Ryan Lister, PharmD; Shelby Johnson, CPhT; Savannah Coulthard, CPhT; Natalie Phillips, PSP Hy-Vee Pharmacy, Indianola: Steve Sayler, RPh Walgreens Pharmacy, Indianola: Sarah Jurgens, PharmD Walmart Pharmacy, Indianola: Karen Bui, PharmD

OCT.NOV.DEC 2019 |

39

RAGBRAI 2019

Wednesday, July 24: Indianola to Centerville

Distance: 84.3 mi. – Climb: 3252 ft. (116.6 mi./4562 ft. w/Karras loop) The team was thankfully well rested at the start of day four and two team members even started early enough to successfully complete the full “century” ride today. Indianola to Centerville was not only the longest day but also the hilliest! They stopped to rest halfway in Chariton and were able to visit both pharmacies in that community before traveling on to Centerville. Our hosts for the evening, retired pharmacist Rollie Reznicek and his wife, Lucy, had a full house but graciously offered camping space for the team. They were able to visit son, Frank Reznicek at the family owned Owl Pharmacy, as well as make a stop to meet the staff at Walmart that evening.

Overnight Hosts: Rollie (RPh, retired) & Lucy Reznicek Pharmacies Visited:

Hy-Vee Pharmacy, Chariton: Melissa Burbridge, RPh; technicians: Tiffany, Ali, Ashley, and Meagan Lucas County Health Center Pharmacy, Chariton: Ann Moon, RPh; Bill Baer, RPh Owl Pharmacy, Centerville: Frank Reznicek, RPh Walmart Pharmacy, Centerville: Julie Spowart, RPh

Thursday, July 25: Centerville to Fairfield Distance: 65.9 miles – Climb: 2328 ft.

While the team may have been running on fumes as they rolled into Centerville, the energy spiked on day five of the ride. The innovation displayed by Iowa pharmacists was on full display with visits at two hospitals as well as a new independently owned pharmacy. Recent graduate Mylo Wells welcomed the team into his new pharmacy, Wells Hometown Drug, in Bloomfield and showcased what he had done to open an independent pharmacy in his hometown after the closure of the Shopko.

Outside of these pharmacy visits, the team found itself in great need by fellow RAGBRAI riders and was able to offer more than enough assistance with OTC items throughout the day.

Overnight Hosts: Carri (PharmD) & Stephen Pumphrey Pharmacies Visited:

Wells Hometown Drug, Bloomfield: Mylo Wells, PharmD; Lila Thompson, CPhT; Mary Lawson, Tech in Training Hy-Vee Clinic Pharmacy, Bloomfield: Kim Burton, RPh Davis County Hospital Pharmacy, Bloomfield: Wendi Barker, PharmD NuCara Pharmacy, Fairfield: Murphye Zane, PharmD Jefferson County Health Center Pharmacy, Fairfield: Katie Mitchell, PharmD; Carri Pumphrey, PharmD

RAGBRAI 2019

Friday, July 26: Fairfield to Burlington Distance: 69.3 mi. – Climb: 1713 ft.

As a RAGBRAI-first, the day six overnight was held in a Mississippi River town – Burlington. The team never quite made it to the river though as they had several visits at nearby pharmacies as well as a gracious host in Audrey and Jeff Housel.

The team was fortunate enough to enjoy a filling dinner at a favorite Mexican restaurant of Audrey and Jeff. While it was wonderful to sit down for a great meal, it was even better celebrating with Audrey and Jeff as they celebrated 11 years of marriage that day! To help burn a few more calories that evening, some of the team was challenged to a dance off by Audrey and Jeff ’s little girls and their neighborhood friends.

Overnight Hosts: Audrey (PharmD) & Jeff Housel Pharmacies Visited:

Walgreens Pharmacy, Burlington: Andrea Perez, PharmD; Jen Davis, PharmD; technicians Carrie, Gabbi, Kristine, and Sara Hy-Vee Pharmacy, Burlington: Gail Wideman, PharmD; BreyAnna Blair, CPhT Heritage Park Pharmacy, West Burlington: Brian Anderson, RPh; Amy Morrett, RPh; Sara Johnson, PharmD; Piper Williamson, CPhT; Cortney Barron, CPhT Great River Medical Center Pharmacy, West Burlington: Tracey King, RPh; Dan Marshall, PharmD; Elizabeth Wallerich, CPhT Walmart Pharmacy, West Burlington: Katie Linnenbrink, PharmD; Erin Cavanaugh, student pharmacist

Saturday, July 27: Burlington to Keokuk Distance: 62.8 mi. – Climb: 1736 ft.

The team finished strong for its sixth year of riding RAGBRAI! While there were no pharmacies along the route, the team was able to connect with pharmacists who were volunteering in their hometowns that were along the route. With beautiful weather and a picturesque ride along the Mississippi River into Keokuk, the team was all smiles for their chance to dip their front tires in the river.

THANK YOU! The IPA Foundation would like to thank each of the riders, gracious hosts and generous sponsors that comprised this year’s RAGBRAI team. We would also like to thank all of the pharmacists and pharmacies that welcomes the team each day and everyone we met along the way!

Week-Long Riders Bryan Bailey Sharon Cashman Kevin Moores Anthony Pudlo Jeffrey Reist Troy Trygstad Ben Urick

Drivers

Pat Wilsbacher Bill Cashman Anthony Pudlo Ben Urick Troy Trygstad

OTC Donations

Save the Date for RAGBRAI XLVIII July 19-25, 2020

Bloomfield Clinic Pharmacy-Bloomfield NuCara Health Solutions-Coralville & Brooklyn Walgreens-Council Bluffs

Daily Riders

Bill Cashman Ben Fox Christopher Fox Kate Gainer Levi Gates Manda Johnson Don Letendre Heather Ourth Douglas Schara Pam Schweitzer

Sponsors

Pharmacy Times Independent Pharmacy Cooperative Pharmacists Mutual Companies Medicap PharmacyNorwalk Medicap PharmacyIndianola Medicap PharmacyWinterset

OCT.NOV.DEC 2019 |

41

MEMBERS Section

IPA Member Spotlight:

Emma Kraayenbrink, PharmD Clinical Pharmacist, Envision Pharmacy Consulting

Written by:

Tessa Heitkamp 2020 PharmD Candidate Drake University

E

very day, Dr. Emma Kraayenbrink, lives the pharmacist’s dream of practicing at the top of her license. As a clinical pharmacist with Envision Pharmacy Consulting, she provides clinical pharmacy services at Crescent Community Health Center in Dubuque, Iowa. Seeing patients on the clinical pharmacy schedule, Dr. Kraayenbrink has collaborative practice agreements with the physicians in the clinic that allows her to manage patient medication therapy for a handful of chronic disease states. However, the value of her abilities and knowledge as a pharmacist wasn’t always recognized.

“When I first starting working in clinic, I wasn’t sure what the role of a pharmacist was [at the clinic] or where we fit into the workflow.” It wasn’t until Dr. Kraayenbrink and her colleagues started to gather patient quality metrics that other healthcare providers saw the positive impact a pharmacist can have on patient care.

After graduating from University of Iowa in 2012, Dr. Kraayenbrink decided to pursue a community pharmacy residency. Dr. Kraayenbrink mentioned how she knew she always wanted to do a

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residency, but wasn’t necessarily looking for an ambulatory care focused site until she completed her residency interviews. She matched with The University of Iowa College of Pharmacy PGY-1 Community Pharmacy site in Dubuque, Mercy Family Pharmacy. After finishing her residency Dr. Kraayenbrink decided to stay on in Dubuque and became a fulltime pharmacist. “I had put so much hard work into that year of education and built meaningful relationships with co-workers, patients, and other providers that I didn’t want to leave.”

Once Dr. Kraayenbrink started her full-time position after residency, she noticed the pharmacists didn’t have a set role in the clinic’s workflow.

Dr. Kraayenbrink noted her great relationships with other healthcare providers, but involving a pharmacist in clinical decision making was almost an uncharted area in her clinic. Dr. Kraayenbrink reflected on how hard it was to define her role within patient care and so she and her pharmacist colleagues decided to start collecting data on the impact pharmacists were having on patient outcomes. “Data never lies. Once other healthcare providers started to see the value pharmacists bring to patient outcomes, we were able to access more resources and become more involved in the patient care process.” Dr. Kraayenbrink also mentioned that it took a while for her position to evolve into what it is today. “I always tried to be accessible to patients and providers. I took every opportunity I could to show my expertise and clinical knowledge.

And I definitely didn’t do it alone. I work with a great team which works together to achieve positive outcomes.”

As Dr. Kraayenbrink’s patient outcomes continued to improve, her

responsibilities expanded. She talked about her experiences running the anti-coagulation and hypertension clinics in her practice site, along with working with patients to optimize their drug therapies. Dr. Kraayenbrink described the most rewarding aspect of her job is being able to increase access to healthcare for patients without insurance who can’t afford to see a physician for medication adjustments.

“Pharmacists have always had the reputation of accessibility and I see this expanding.” Dr. Kraayenbrink is able to work one-on-one with patients to improve medications therapies by adding or discontinuing medications, titrating medication doses, and changing medications when needed all through collaborative practice agreements with physicians at the Community Health Center.

Dr. Kraayenbrink is also a preceptor to P4 students on rotations. She encourages students to start building professional relationships with other pharmacists and healthcare providers early in their careers. Dr. Kraayenbrink also advises students to actively pursue areas of interest by asking to job shadow, attending conferences, and questioning professionals about their careers. “As soon as you can be exposed to your career interests, the sooner you can start to build relationships with professionals in that field and potential future employers. A good preceptor or mentor is invaluable. Thankfully, I have one who helped open doors to try new things and improve patient care.” Dr. Kraayenbrink stated the ever so popular phrase of “Pharmacy is a small world,” and tries to instill the importance of networking and building professional relationships in each of her students.

MEMBERS SECTION

The mission of the Iowa Pharmacy Association is to empower the pharmacy profession to improve health outcomes. Dr. Kraayenbrink lives this mission every day as she strives to create a positive impact on her patients and practice site.

“This is what we went to school for, to become medications experts.

We need to continue to participate in patient clinical decisions and show the value of having a pharmacist manage an individual’s medication regimen.” ■

Welcome NEW IPA MEMBERS! JULY 1 - SEPT 30, 2019: Emily Albers Joseph Anderson Brandon Ash Cameryn Baldwin Megan Barber Adrianne Bentzinger Winfield Brand Grace Brent Kathryn Bress Ashlie Bunten Adam Butzler Autumn Campbell Abigail Caslow Grace Dahlen Briana DiBenedetto

Rachel Dietz Meredith Frey Ashley Grady Dillon Graf Charles Hartig Braeden Hartwig Eric Heung Ted Heying Ellie Hodapp Lisa Kriegel Katie Krusenstjerna Anna Laire Mike Larson James LeFevre Lindsay Lewis Miriam Loewen

Phillip Masters Kailey McCollough McKenna McCreedy Jorin McGuire Hannah Mubark Molly Nelson Meghan Odonnell Naomi Onyibe Austin Oyen Lucille Palmquist Mahi Patel Nicole Pawlicki Brooke Pederson Zachary Pogge Nevin Radechel

David Ratsavong Jamie Rusan Morgan Schrage Laura Schultz Brandon Shulfer Alissa Smith Jonathan Smith Michael Stiewe Danira Suljic JT Tauke Adna Tokmic Kelly Walvatne Kayla Weirup Kim Welch Boone Whiting Peyton Wood

IPA MEMBER BENEFIT Have You Accessed Your FREE Continuing Education Benefits Yet? WWW.IARX.ORG/ACCESSCPE

IPA members receive a FREE subscription to CEI’s web-based Pharmacist or Pharmacy Technician Course Catalog, which include all required CPE for pharmacist relicensure and pharmacy technician recertification, for FREE. In addition, you also receive FREE continuing education credit for IPA’s BOP: What, Why & How podcast series and select 2/2/2 webinar recordings!

OCT.NOV.DEC 2019 |

43

IPA in ACTION ADVERTISER IPA Attends APhA Board of Trustees Meeting

As an opportunity for state associations to work collaboratively with national association leadership, IPA EVP/CEO, Kate Gainer, attended the September 15-16 Board of Trustees meeting of the American Pharmacists Association (APhA) in Washington DC. This was an opportunity for APhA leadership to also learn about successes and challenges at the state level to advance provider status legislation to help further guide national efforts. In addition, this was a chance for the profession to discuss efforts to address professional burnout, the opioid crisis, as well as hear directly from new Executive Director Jan Engle of ACPE to discuss the increase of pharmacy schools and graduating pharmacists.

IPA Shares MHFA Trainings in Nebraska

In an effort to share the experience that comes from conducting Mental Health First Aid (MHFA) trainings across Iowa, IPA offered a MHFA to over 25 pharmacists in Nebraska prior to the start of the Annual Meeting of the Nebraska Pharmacists Association (NPA) on July 18, 2019 in Lincoln, NE. The group was engaged throughout the 8-hour training program, and offered great insight to NPA leadership about the need to offer similar training across the state of Nebraska.

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As part ofPlace this visit to NPA’s Annual Meeting, IPA us. was All invited your ad/classified ad with to attend aads, special dinner with the NPA keynote speaker, contracts, payments, reproductionpast RADM Scott Giberson, and discuss the role of the pharmacist in material and all other related mental health care services.

communication should be addressed to David Schaaf at dschaaf@iarx.org or NACDS Total Store Expo Convenes in Boston callTotal the Store IPA office The NACDS Expo isat the515.270.0713 industry’s largestfor gathering information. of its mostmore influential leaders. On August 23-26, the event

provided regional and national pharmacy chain management and leadership a unique opportunity to gain new insights into today’s evolving marketplace and set their course for the future.

From the large exhibit hall to engaging programming, IPA members were available to network with key leaders across the country and look for new ways to offer services and programs in Iowa. With much focus on finding resolution to troublesome DIR fees and moving towards value-based payment models, the NACDS conference was valuable to all those in attendance.

Save-the-date for 2020 Total Store Expo - August 8-10 in San Diego!

PBA Health & PPOk Unify in Overland Park, KS

In the first conference since the merger, PBA Health and Pharmacy Providers of Oklahoma (PPOk) hosted its all-inone Unify Conference on July 12-14 in Overland Park, Kansas.

As a valued partner, IPA attended the event to showcase our association to pharmacy owners from across the country. In addition to participating in the exhibit hall, IPA was part of panel of other state associations to demonstrate the importance of advocacy at the state level to address the many pressures facing independent pharmacy ownership.

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| The Journal of the Iowa Pharmacy Association

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45

DECEMBER 2019

IPA IN ACTION38-12

IPA Goes Local Burnout and Resiliency - Ames, IA

CALENDAR

7-8

Iowa Governor’s Conference on Public Health Des Moines, IA

23

CEImpact Immunization Training - Des Moines, IA

Find additional details to these events and more at www .iarx

ASHP Midyear - Las Vegas, NV

NOVEMBER 2019

CALENDAR OF EVENTS

3-6

PharmSci 360 - San Antonio, TX

Find additional details to these events and more at www.iarx.org. Click on the “Calender of Events” link under the Events tab.

5

IPA Goes Local Burnout and Resiliency - Iowa City, IA

5-6

Iowa Board of Pharmacy Meeting - Des Moines, IA

7-10

ASCP Annual Meeting - Grapevine, TX

January

12-13 Leading without Leading to Burnout - Cedar Rapids, IA

29

IPA

2/2/2 is IPA’s free monthly webinar series that keeps you engaged and informed on the hot the pharmacy profession.

Legislative issues Day -impacting Des Moines, IA When is it?

2nd Tuesday of every month at 2:00 p.m.

February 7-9

IPAMidwest LEGISLATIVE DAY legislative daySafety and Health 13-14 ipa 2019 Rural Agricultural January 29, 2020 2020 IA January 29, Conference - Marshalltown, www iarx org/IPALegDay www.iarx.org/IPALegDay 15 NAMI Iowa Annual Conference

JOIN US ON: Midwest Pharmacy Expo12, - Des IA November 2019:Moines, E-prescribing

DECEMBER 2019

11 2/2/2 Webinar:December Role of Pharmacists 10, 2019: TBDin STD Prevention January 14, 2019: TBD

March 10

2/2/2 Webinar

Register for these upcoming webinars and view previous ones at www.iarx.org/222.

3

IPA Goes Local Burnout and Resiliency - Ames, IA

8-12

ASHP Midyear - Las Vegas, NV

Feb 7-9, 2020 Hilton Des Moines Downtown

MidwestPharmacyExpo com

Topics subject to change

20-23 APhA Annual Meeting - Washington, D.C.

ApriL

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| The Journal of the Iowa Pharmacy Association

7-8

Iowa Governor’s Conference on Public Health - Des Moines, IA

14

2/2/2 Webinar

23

CEImpact Immunization Training - Des Moines, IA

25-28 NACDS Annual Meeting - Scottsdale, AZ 25

APhA’s Pharmacy-Based Immunization Delivery Certificate Program - Kansas City, MO

MAY 12

2/2/2 Webinar

12

MPJE/NAPLEX Review Course - Grinnell, IA

14-16 NABP Annual Meeting - Baltimore, MD

2/2/2isisIPA’s IPA’sfree free monthly webinar series 2/2/2 monthly webinar series thatthat keeps you engaged and informed on the keeps you engaged and informed on the hot hot issues issues impacting the pharmacy profession. impacting the pharmacy profession.

2/2/2 is on the 2nd Tuesday of every month at 2:00 p.m.

When is it?

2nd Tuesday of every month at 2:00 p.m.

Join US NEXT: •

February 11, 2020: Role of Pharmacists in STD

Prevention JOIN US ON:

• November March 10, TBD 12,2020: 2019:Topic E-prescribing

JUNE 6-10 ASHP Summer Meetings - Seattle, WA 9

2/2/2 Webinar

17

Eggleston-Granberg Golf Classic - Pleasant Hill, IA

18-19 2020 IPA Annual Meeting - Des Moines, IA

December 2019: TBD GET Past10, topics:

• Iowa Poison Control Center - Here to Answer the Call 14, 2019: • January LicenseTrak - Your TBD Partner with License Renewals • E-Prescribing Mandate - What, Why & How

Register for these upcoming webinars and

Register for these upcoming webinars and view view previous ones at www.iarx.org/222. previous ones at www.iarx.org/222.

Topics subject to change

46

52 | The Journal of the Iowa Pharmacy Association

| The Journal of the Iowa Pharmacy Association

Pharmacy TIME Time CAPSULE Capsule PHARMACY

19 99 86

Issues Issues&&events eventsthat thathave haveshaped shapedIowa Iowa pharmacy pharmacy(or (orare arefun funto toremember!) remember!)

JANUARY:

The Iowa Board of Pharmacy announces “secret shoppers” program to enforce patient counseling and pro-DUR regulations .

January:

First edition of the Iowa Law andorganization Information for Manual rolledinoffIowa the occurred . On January 1st, Iowa Society The formal establishment of thePharmacy new professional pharmacy press; the price was $40. of Health-System Pharmacists and the Iowa Pharmacy Association were unified to represent all pharmacists, pharmacy students, and pharmacy technicians in Iowa .

february:

The Healthy and Well Kids inremodeled.

Iowa (HAWK-I) program began on January 1st which provided coverage for children age 18 and IPA headquarters were The remodeling included an enlarged younger who did not qualify for Medicaid but were at 185% of the federal poverty level . reception area, an increase in work and storage spaces, an enlarged board room, a library, a restroom to accommodate the handicapped, and more functional office space for the executive director and other members of the staff.

MARCH: IPA Head quaBanker . rters Jordan Cohen began as the new dean of the University of Iowa College of Pharmacy on March 1st succeeding Gilbert Cohen was previously dean of the University of Kentucky College of Pharmacy .

May:

Drake University’s APhA student chapter wins the first place Chapter Governor Tom Vilsack was the keynote speaker at IPA Legislative Day on March 3rd . His speech focused on the importance of Achievement Award from APhA for their professional events and projects quality health care to attract future Iowans . undertaken over the last year.

The Remington Medal was awarded to Carl Franklin Emswiller, Jr . of Leesburg, Virginia during APhA annual meeting in San Antonio, Texas on March 7th . june: Phil Weider installed as IPA’s 108th President. Phil graduated from Drake Representative Iowa Pharmacist, RobertofOsterhaus, receivedin theDes Hubert H . Humphrey Award from APhA on March 8th Universityand in 1950, and was president Forker Pharmacy Moines. which recognizes a pharmacist for distinguished public service as an elected or appointment government official .

August

APRIL: The House of Delegates approved a Professional Competency In Pharmacy

IPhA held its 93rd annual convention . This convention hosted several speakers who spoke on topics ranging from “Better statement at the Annual Meeting. This statement outlined the professional Pharmacy Communication” between chain and independent pharmacy to “Legal and Public HealthPhil Aspects of Rx Price Weider requirements of the pharmacy profession and highlighted ways the practice was Posting and Discount Advertising Practices” . changing in Iowa.

MAY:

September Certification in Geriatric Pharmacy established by CCGP A new member joined the IPA crew; Rex, the IBM System/36 computer system!

He had a whoppingfor 90Iowa megabytes of storage withSystem 5 terminal outlets.Directors In today’sto discuss issues facing practitioners and IPA hosted a conference Hospital and Health Pharmacy standards, Rex could hold 18 songs before running out of storage. consequently develop ways to advance pharmacy practice .

The FDA added “pharmacist” to Over-the-Counter Medication labeling as in “Ask your doctor or pharmacist .”

October

DHS begins reimbursing pharmacies based on actual acquisition cost (AAC), On November 10, a from pharmacy postage stamp was(AWP). issued in Cincinnati, Ohio to honor the 120th anniversary of the American moving away average wholesale price This meant a lower Pharmaceutical Association .

The stamp pictured a Bowl of Hygeia, that was associated with the American Pharmaceutical reimbursement for pharmacies, as AAC is normally less than AWP. However, Association, and a Mortar and Pestle, associated with the National Association ofpaid Retail Druggists .

IPA amended the appropriation bill to increase the professional service fee to pharmacies to compensate for the decreased drug cost payment.

Rex

The Iowa Pharmacy Association Foundation is committed to the preservation of the rich heritage of The Iowa Pharmacy Association Foundation is committed to the preservation of the rich heritage of pharmacy practice in Iowa. By honoring and remembering the past, we are reminded of the strong tradition pharmacy practice in Iowa . By honoring and remembering the past, we are reminded of the strong tradition we have to build upon for a prosperous future for the profession. we have to build upon for a prosperous future for the profession .

OCT.NOV.DEC 2019 | JUL.AUG.SEP 2019 |

47 53

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