With nearly 1,200 Commissioned Corps pharmacists and more than 400 civilian and tribally-hired pharmacists serving across 15 federal agencies and five departments, U.S. Public Health Service Pharmacy has harnessed a dedicated cadre of pharmacists with diverse expertise and skill sets. The range of experiences and history of innovation, coupled with unique practice environments, position us to facilitate collaboration, expand our roles and improve the nation’s health. For 2012 and beyond, PHS pharmacists are prepared to lead as commissioned officers, as public-health professionals and as healthcare providers. The following three areas have generated interest and fostered success in 2011 and demonstrate our capacity to lead in 2012:
- advancing the profession through partnerships and innovations
- building capacity in emergency and disaster response
- enhancing the nation’s health through prevention
Within each of these areas, numerous initiatives are under way that illustrate how PHS Pharmacy is addressing and responding to the dynamic landscape of challenges and opportunities.
Federal Partnerships and Innovations
There exists a recognized disparity between the demands of public health and provision of
|Rear Adm. Scott Giberson, RPh, MPH, USPHS Commissioned Corps Chief Professional Officer, Pharmacy|
healthcare with the fiscal and human resources available to alleviate the healthcare burden. Access to care, quality outcomes and cost-effectiveness, coupled with healthcare-provider shortages, provide a perfect medium for enhanced utilization of pharmacists in both the federal and non-federal sectors. Federal pharmacists have played a significant role in the federal healthcare system to bridge these gaps and improve public health, healthcare systems and consumer outcomes through expanded roles. Federal pharmacy practice environments and sustained inter-professional partnerships have given federal pharmacists the opportunity to facilitate the very changes that advance the profession. It is our shared responsibility to leverage these comparative advantages of our practice environment and work in partnership with key non-federal stakeholders to lead for the profession. Given this responsibility, federal-pharmacy leadership recently assessed and identified the need for a more uniform and formalized federal-pharmacist vision and scope of practice.
A 2010 call to action initiated the development of the Federal Pharmacist Vision. In April, 2010, the five federal-pharmacy chiefs from DoD, VA and PHS Pharmacy discussed the opportunity to further federal-pharmacist collaboration at the highest strategic level. In September 2010, we unanimously agreed to move forward with this initiative. Through numerous meetings, the federal-pharmacy chiefs, in consultation with many of our constituents, developed the first Federal Pharmacist Vision in January, 2011.
The consensus-built Federal Pharmacist Vision provides a platform to maximize the use of pharmacists, foster new paradigms of care and advance the profession to continue to improve the nation’s health.
The next steps in 2012 are to further define the scope of practice within this vision and implement initiatives where possible that sustain this vision.
As an example within PHS, HRSA established the Patient Safety and Clinical Pharmacy Services Collaborative (PSPC) — led by PHS pharmacists. PSPC integrates evidence-based clinical pharmacy services with a multidisciplinary team approach to improve patient safety and foster community partnerships in order to transform the nation’s healthcare delivery system. The PSPC expands the role of pharmacists and their provision of healthcare to high-risk, high-cost patients with multiple chronic conditions. More than 120 teams in 43 states are focused on delivering integrated care through patient-centered health homes, ultimately improving quality of care and patient safety.
Moving into its fourth year, the PSPC has partnered with the Centers for Medicare and Medicaid Services to enroll additional community teams in all 50 states. The PSPC is delivering critical, comprehensive patient-care services, as well as hard-wiring a new model of safer and better care into the nation’s healthcare-delivery system. The PSPC aims to meet its goal of integrating this model into 3,000 communities by 2015.
The IHS provides another tangible example of the capacity to lead within PHS Pharmacy, which has a 50-year history of clinical innovations. The IHS has partnered with the North Dakota Prescription Drug Monitoring Program (PDMP), the Bureau of Justice Assistance, the Alliance of States with Prescription Monitoring Programs and others to develop a controlled-substance prescription data-transmission solution. As a result of this partnership, IHS facilities in North Dakota, South Dakota and Minnesota have the capacity to share controlled-substance data with a state PDMP. This program will serve as a deterrent for prescription-drug abuse while promoting effective clinical care. The goal is to provide access to this data-sharing on controlled-substance prescriptions for all IHS, tribal and urban Indian programs.
The IHS and the VA pharmacy programs have partnered on the VA Consolidated Mail Outpatient Pharmacy (CMOP) medication mail-out program. Through this partnership, the IHS utilizes the VA’s capacity to fill prescriptions at their CMOP prescription-filling factories to meet the IHS need for prescription dispensing and distribution. This will advance the IHS clinical-pharmacy practice by shifting some of the pharmacist’s time from the traditional role of dispensing to more clinical (and direct) patient care.USPHS Pharmacy Prepared to Lead Cont.
Emergency and Disaster Response
As a key component to protecting the nation’s health, PHS pharmacists also serve in critical roles in the national-response network, establishing the foundation to advance disaster response. PHS pharmacists collaborate with response partners and serve in leadership roles across the national response network and thus are well- positioned to further mission capabilities. From holding command positions in planning and operations to the management of the strategic national stockpile, PHS pharmacists are answering the 2011 CPO call to action by expanding upon their traditional roles. Critical positions held by PHS pharmacists include serving as regional health administrators and command of HHS Distribution Logistics and Rapid Deployment Forces.
Significant accomplishments are achieved through collaboration with federal, state and local responders in disaster missions. In recent years, during domestic deployments, PHS pharmacists have provided care to thousands of patients during Hurricanes Katrina, Gustav and Ike. With a history of service in missions inclusive of the 9/11 World Trade Center and anthrax attacks and multiple hurricanes, PHS pharmacists possess an expansive array of experiences in emergency response. During Operation Lone Star, PHS pharmacists collaborated recently with the state and local partners to provide free healthcare services for thousands of patients from underserved populations in rural areas of southern Texas. This provides additional and innovative ways to serve vulnerable and medically underserved populations. As customary, PHS also has the capacity and experience to continue to partner with DoD on disasters when such needs arise. Past examples include hurricane-ravaged Haiti, ship-based missions with the U.S. Navy and collaborations formed with the Iraq and Afghanistan ministries of health. This information has been chronicled in multiple publications and can be found at the following websites: http://www.usphs.gov/corpslinks and http://www.usphs.gov.
|Lt. Yiying Tsai counsels a patient on medications after Hurricane Ike. — USPHS photo|
On June 16, 2011, the 18th U.S. Surgeon General, Vice Adm. Regina Benjamin, released the nation’s first National Prevention Strategy. The National Prevention Strategy (NPS) is a shift from a focus on sickness and disease to one based on prevention and wellness. To further implement and amplify priorities of the NPS, PHS Pharmacy has developed a PHS Pharmacy Prevention Strategy.
The PHS Pharmacy Prevention Strategy outlines many of the activities that PHS pharmacists perform to enhance prevention and wellness. Pharmacists can contribute substantially to national prevention efforts by improving access to preventive care and wellness, increasing the quality and quantity of services and enhancing public health and health information technology infrastructures. In federal health systems, PHS pharmacists regularly serve as healthcare providers in disease prevention and implement prevention services in areas, including the prevention of prescription drug abuse, medical errors, obesity, diabetes, cardiovascular disease and others. PHS pharmacists also provide smoking-cessation services, reproductive and sexual health education and pharmacy-based immunization delivery. According to the American Pharmacists Association in 2011, more than 150,000 pharmacists in the U.S. have been trained in immunization delivery. CDC estimated that pharmacists across the nation administered approximately 20% of the influenza vaccinations, about 25 million doses, during the 2010-2011 flu season.
Although prevention begins with the availability of information and access to the healthcare system through communities, colleagues and friends, Americans will need additional access to the healthcare system. Our most-accessible healthcare professionals — pharmacists — should contribute significantly to the development of a more comprehensive preventive paradigm.
The PHS Pharmacy Prevention Strategy demonstrates how PHS pharmacists and the pharmacy profession are able to: 1) increase access to quality care and preventive services; 2) shift from treatment-focused to prevention-focused care; and 3) coordinate national prevention efforts within the profession. The strategy illustrates that PHS pharmacists are directly engaged in national prevention efforts with our U.S. Surgeon General and are prepared to lead in preventive efforts.
Our health system is changing, offering the pharmacy profession unprecedented opportunity. Pharmacists must be prepared to recognize and seize the opportunities afforded to us. We must be proactive and take steps to continue to build capacity, expand our scope and set our goals for national health impact. As demonstrated through our innovative initiatives, collaborative provision of healthcare, emergency response and capacity, and development of preventive strategies, PHS Pharmacy will continue to lead with our federal-pharmacist colleagues to advance pharmacy practice and the profession.
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