The Coast Guard has undergone numerous changes since the attacks of September 11, 2001, most notably moving from the Department of Transportation to its new home at the Department of Homeland Security. Change within the Coast Guard has become an everyday occurrence as our mission dictates flexible maneuvering to meet the challenges of day-to-day operations. As one of the many operating divisions within the Coast Guard system, the Pharmacy Program also is experiencing a sea of change.
The Coast Guard’s Pharmacy Program operates under Rear Adm. Mark Tedesco, director of Health, Safety and Work-Life. The Coast Guard’s Pharmacy Program is small, compared with the operations of our sister services, serving approximately 43,000 active duty Coast Guard members and 8,000 reservists. U.S. Public Health Service officers are assigned to 15 Coast Guard pharmacy billets. These multi-disciplined individuals coordinate pharmacy activities in more than 150 shore-based ambulatory clinics and ashore/afloat sickbays, spanning from Puerto Rico to Alaska. Thirteen of the pharmacy billets are located in the field, and two are involved with program management.
The majority of Coast Guard pharmacy officers came to the Coast Guard with three to five years of pharmacist experience with the desire to use their practical experience and to take on new opportunities and challenges. Coast Guard pharmacy officer positions are unique, as they work directly with patients and medical and dental clinic personnel, while balancing considerable administrative responsibilities.
The restructuring of Coast Guard pharmacy operations began two years ago when the Coast Guard realigned operations under its modernization efforts. Pharmacy officers assumed pivotal positions as Regional Pharmacy Executives (RPEs), coordinating and standardizing operations for clinic pharmacies within their assigned group practices.
Opportunities for Coast Guard pharmacists continue to evolve. Following in the footsteps of the other services, the days of “lick, stick and pour” will become only a small part of our daily activities. Counseling the patient has been a mainstay for our pharmacists, providing an avenue of information channels and an opportunity to engage one-on-one with the patient. The Coast Guard Pharmacy Program will continue to move forward with incorporation of the emerging care model called “Patient Centered Medical Home” in which pharmacists will have a key role.Sea of Change: Coast Guard Pharmacy Cont.
Studies have shown that patient therapies and outcomes improve when pharmacists are engaged as part of the patient’s medical team by validating prescription and over-the-counter medication use and making timely recommendations. Smoking cessation and dietary supplements are other untapped areas in which Coast Guard pharmacists will become engaged as part of the patient’s overall health treatment plan. Although many details are still in the working stage for this more specialized counseling and monitoring, it is clear that Coast Guard pharmacists will be key partners in patient care.
The Coast Guard also is in the development stage of the patient’s Electronic Medical Record (EMR). The award-winning Epic EMR is known for being fast and physician-friendly, and Epic is working with the Coast Guard to develop this innovative product for use throughout our clinics and sickbays. Epic’s pharmacy ambulatory software, Willow, has been in use since January at non-military facilities. Creating the Coast Guard’s pharmacy package has presented some unexpected challenges that have required some modifications to the established software.
In addition, the Coast Guard’s software will include an inventory component that will assist in improved product management. Coast Guard providers will be able to access patient records, enter prescriptions, order laboratory tests and communicate with other providers and patients at the touch of a button. Information will be available in real time, providing the patient with mobile and immediately accessible comprehensive medical records. Although pharmacy personnel have enjoyed the benefits of collective prescription dispensing even under their current system, access to laboratory results and physician comments were unavailable unless an actual patient medical record was forwarded to the pharmacy for review.
The Coast Guard’s Pharmacy Program is moving forward to meet the needs of its patients with steady momentum. Coast Guard pharmacists are well trained to meet these changing requirements and are looking forward to the new horizons that will be met as change integrates into the Coast Guard’s healthcare system of the 21st century.
Capt. Thomson is Pharmacy Chief USCG and Pharmacy Program Coordinator/Consultant Chief, Quality and Performance Improvement Division
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