APhA2014
2014 Presidential address: The power of the pharmacy family Matthew C. Osterhaus
Delivered by Matthew C. Osterhaus, BSPharm, FASCP, FAPhA, incoming President of the American Pharmacists Association, at APhA2014, the Association’s Annual Meeting and Exposition, March 30, 2014, Orlando, FL. Good morning everybody! It is truly an honor to serve as the next APhA President. Being elected by one’s peers is special, and to lead such a wonderful, impactful organization is a remarkable opportunity. My father, Bob Osterhaus, served as APhA’s 137th president. We’re not the first father/son team, however. I will be the fourth son to be honored to follow in his father’s footsteps as APhA president, but the first in 77 years. Speaking of father and son, I’d like to introduce my family and our pharmacy family. First, a shout-out to Dale Yoder and the staff of Mercy Family Pharmacy who are running the practice back home in Iowa so my pharmacist staff could join us here. Tammy Bullock, Connie Connolly, Angie Spannagel, and Janis Rood—stand and take a bow! They make care happen! Joining them are my former residents. Next, my spiritual and legal advisers, Judges Phil and Nancy Tabor. Now, the 33 Osterhauses in attendance—10 of my nieces and cousins; 7 of my 9 siblings (Mark, John, Jane, Kate, Molly, Amy/John, and Betsy). We are missing my sister Meg in Australia and my brother Luke, whose enthusiastic spirit is with me every day. My four children, their spouses, and my six grandchildren: Andy, Joelle, Pieta and Everett; Maria, Bobby, Owen, Rya, Gibson, and Adia; Jack and Ashley; and our baby, Lau-
ra. My pharmacist wife and partner of 33 years, Marilyn. She is the real power and promise behind me and always by my side. And of course, my parents, Bob O and Ann, who have truly made all this possible. I would also invite all the members of the Iowa pharmacy family, including those from Pharmacists Mutual and Outcomes, and anyone else who wishes they were an Iowa pharmacist, to stand and accept my sincere thanks for what you have done for me and this profession. Obviously family is important to me, and the support they give me is a big part of my success. Twentyone years ago during his incoming speech as APhA president, my father spoke of the power of the pharmacy family. In reading his remarks again, I was struck by how the challenges and opportunities my father discussed are similar to those we face today. My Dad said, “I believe the pharmacy family will flourish, because I detect everyday an upselling of the sense pharmacists can—and are—controlling their destinies.” I believe the same is true today. Our profession is steeped in tradition, and we naturally often resist change. For example, in the Osterhaus home, we grew up listening to musicals. And like Tevye—where in Fiddler on the Roof he sings of “Tradition!”—there is comfort from routine and the status quo. But our traditions are crumbling. I dare say there are few comfortable pharmacists today as health care changes accelerate. Yesterday, Steve Simenson shared with you that the state of the Association is strong and there are new and exciting opportunities
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being placed before us. Steve provided great leadership in his presidential term and set the bar high for me. Thanks to his hard work, and the dedication of many others, our pharmacy family is gaining strength and recognition. We have come a long way. In 1992, my father was encouraging his peers to measure success by more than the number of prescriptions filled in a day. Let me tell you how things have changed since his speech in 1992. We have redesigned our workflow and our layout to maximize access to the pharmacist and privacy for the patient. We have ramped up our contribution to pharmacy education from summer interns to be a teaching site for six colleges of pharmacy and a premier community pharmacy residency site. We have been a pioneering partner in practice-based research, showing the value of pharmacists’ services. We have built the infrastructure and team to be top-notch caregivers; we are being handcuffed by pharmacy benefit management policies that pay us less than the cost of the drug product to dispense a prescription. We take pride in the fact that our counseling session with our patient C.A. prior to her vacation abroad armed her with an action plan if her asthma flared up; it did, and she followed the plan and avoided hospitalization on foreign soil. We make a difference by providing the medications our patients need, administering immunizations, guiding them through care transitions, coaching them to better diabetes control … and that’s before 10 a.m. on a Tuesday! The state of our pharmacy family is also strong because, like the families we all know and love, we take care of each other and work to ensure we meet our personal and profession-wide goals. I am so proud of how your volunteer-elected board and other leaders work with staff who come to work every day committed to serving the needs JU L/A U G 2014 | 54:4 |
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of America’s pharmacists, and you, our members in particular. That is what makes the APhA membership and the pharmacy family so unique. We help each other so we can all better help our patients. I promise we will keep doing so this year.
The power of the pharmacy family: Internal Over 20 years ago, my father said, “In all families, the members hold in their hands the answer to whether or not the family will flourish. The same is true in the pharmacy family. All of us collectively impact whether pharmacy will flourish or whether we will decline in stature together.” Earlier I spoke of our natural resistance to change. But change is one of the few constants. We must embrace and lead if we are to reach the goals we have set. We are in the midst of a major disruption. There are external forces (the economy, Centers for Medicare & Medicaid Services) we cannot control that will force us to change. There are also some very positive agents of change surrounding you this morning. The pharmacist to your left and the one sitting to your right are part of that powerful force. It’s the individual pharmacist who says, “I can do better for my patients,” and then shares the idea with you. APhA is here to act as a conduit for sharing these innovations and best practices with you and your colleagues across the country. The Association is your doorway to education, resources, and opportunities for professional growth. The Association can amplify a single person’s voice and progress into something that will gain attention within and outside of the profession. Just like Steve, I am a community pharmacist who has been at the forefront in implementing patient care services that improve medication use and advance patient care, along with the other members of the health care team. It has not been an easy road; there are turf battles, financial barriers, and manpower 340 JAPhA | 5 4:4 | JUL /AUG 2 0 1 4
constraints. But we continue to maintain our focus on what our patients need. Our team at Osterhaus Pharmacy has worked to ensure accurate medication lists are exchanged on admission and discharge from our local hospital; we have met the needs of post-mastectomy patients, gaining referrals from a 40-mile radius due to our personal service; and we have enhanced the immunization rates of our patients with diabetes by collaborating with local physician clinics. Having “best practices” are not all we do to help the pharmacy family grow stronger. And what can we say about leadership? Through student and new practitioner programming, APhA has helped thousands of young pharmacists build a foundation for leadership positions within APhA and in their own practices as well. Regardless of experience, years since graduation and licensure, length of APhA membership, or participation in leadership academies, pharmacists can differentiate themselves through participation in their profession. An “It’s Mutual” membership campaign was launched in 2013 to convey that APhA shares every pharmacist’s desire for a successful and meaningful career. APhA is committed to being a responsible and available family member to its members. In 2013, APhA staff completed the first major phase to implement a new association management system, and in early 2014 we launched. The system will streamline the online transactions performed by members and non-members, while simultaneously helping the association better understand member interests and needs. To be more responsive and accessible to members, APhA also implemented a 24-hour call center support service, which allows members to speak directly and immediately with a member-support person rather than having to leave a teleja p h a.org
phone message. You’ll see continued improvements in the “member experience” in the coming months. Enhancing the value of your membership is a high priority at APhA!
The power of the pharmacy family: External In his presidential address, my father said, “Families need to have goals, and all members have a role to play in seeing those goals are met. In the pharmacy family, the mission statement for the profession of pharmacy is the foundation for the profession’s goals, and all members of the pharmacy family have a role to play in seeing that our mission to society is achieved.” My brothers and sisters remember well the question from Bob O, “What is your 5-year goal?” Today, we know our goal. Steve said yesterday the Association’s highest priority was committing “significant resources toward ensuring patients have access to your patient care services.” And that focus remains. With the Joint Commission of Pharmacy Practitioners (JCPP), we have an updated Vision Statement, and soon an Action Plan to meet it. The Vision Statement underscores another lesson of my father: “The patient is an adopted member of the family for whom we have a special responsibility.” It also provides a key message in our quest for provider status. The JCPP Vision Statement is: Patients achieve optimal health and medication outcomes with pharmacists as essential and accountable providers within patient-centered, team-based health care. Notice the patient comes first! As part of APhA’s provider status action plan, the government affairs team, along with collaborating pharmacy organizations, is aggressively pursuing advocacy activities that include educating and lobbying members of the key committees involved in health care policy and regulation. In December, there was an opportunity to educate Congress re-
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PRESIDENTIAL ADDRESS APhA2014
garding the value of recognizing and including pharmacists’ patient care services. During Congress’ consideration of legislation to address Medicare’s sustainable growth rate, a potential amendment that would recognize pharmacists’ patient care services in affordable care organization (ACO) models was proposed. While the amendment was not ultimately introduced, it did place pharmacists’ patient care service recognition on various discussion tables and showed how quickly and successfully our pharmacy family engaged. Thank you to all that communicated with your Congress members. As evidenced by an increasing number of requests for input, APhA is consistently viewed as a balanced, reputable, and constructive resource on Capitol Hill when health care legislation is being considered. As announced earlier this month and discussed by Steve yesterday, APhA is a founding member of the Patient Access to Pharmacists’ Care Coalition, a multi-stakeholder initiative comprised of national pharmacy organizations and stakeholders to develop and help enact federal legislation supporting the federal recognition of pharmacists and pharmacists’ services. Specifically, this legislation will enable patient access to, and compensation for, pharmacist-provided patient care services under Medicare Part B. Our initial emphasis is to address an area of concern for the U.S. health care system by expanding access to pharmacy services for medically underserved patients in a manner consistent with state scope-of-practice laws. With already more than 20 pharmacy-related organizations part of the coalition, APhA is committed to work to expand that number, as well as include organizations representing patients and other health care providers. APhA will continue to explore and pursue all opportunities to advance “consumer access and coverage for p harmacists’ quality patient
care services.” APhA’s advocacy efforts directed toward pharmacist provider status are a multi-level campaign on the federal, state, and private sector. While I am extremely excited that pharmacy has legislation before Congress that recognizes the value of pharmacists and their patient care services in Medicare, our profession’s quest for recognition exceeds the pursuit of a single bill being drafted, introduced, and passed in Congress. Our strategy includes engagement by voters and decision makers. It also includes you! You will hear more about these efforts in the keynote presentations during this session. As within any successful family, lots of give and take is needed, and we don’t always get everything we want. Sometimes it takes baby steps to reach the ultimate goal. We cannot confuse the public or decision makers with varying terminology and “asks.” We build strength and influence when we act as one profession—one pharmacy family. During my presidential year, we will remain committed to “Advancing as One”—one health care team, one profession, and one patient care process. I viewed a YouTube video by Simon Sinek that summed up how we can make this happen. Our “ask” needs to be brought forward to the pharmacy family with an emphasis on the “why.” Every constituent, inside and outside the pharmacy family, needs to know why provider status is so important for our patients. We are driven by a purpose, a cause, a belief that we can impact our patients and the health care system by improving outcomes. Martin Luther King, Jr. did not inspire a generation to embrace change by saying, “I have a plan!” Rather, he was able to communicate a dream from his heart because he truly believed it. In November 2013, APhA submitted comments related to the U.S. Department of Health and Human Services’ (HHS) draft Strategic Plan for 2014–2018. The Association
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argued for provider status: “In order for pharmacists to fully realize their potential to improve patient care and outcomes and for HHS to achieve the objectives outlined in its Strategic Plan, certain barriers, including reimbursement issues and resource allocation, must be addressed.” APhA continued that the lack of federal provider status is often cited by state and private health plans as their reason for not covering beneficiaries or compensating pharmacists for their patient care services, as well as results in barriers to optimizing those services in emerging integrated care delivery models such as patient-centered medical homes or ACOs. We also included comments supporting the read/write access to electronic health records and making pharmacists eligible for the incentives to connect. We need to hold ourselves to higher standards. Inherent to any health innovation is the need to ensure standards of care are being met and can be measured. In 2013, APhA actively sought to ❚❚ Identify, highlight, and share innovative practices; ❚❚ Assess the current state of medication therapy management; ❚❚ Build consensus and momentum on provider status elements; ❚❚ Establish standards to accredit pharmacy practice; ❚❚ Help shape development of quality measures for medication use; and ❚❚ Evaluate new approaches to patient care and new payment models for pharmacists that align with evolving qualitybased and performance-driven reimbursement structures. Developing standardized measures and a consistent patient care approach by pharmacists is critical to meet the profession’s vision for pharmacy practice and the role of the pharmacist to provide specific, predictable, and measurable patient care services. To that end, clarifying JU L/A U G 2014 | 54:4 |
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and standardizing the pharmacist process of care was a high priority for APhA and collaborating pharmacy organizations in 2013. A well-defined process of care provides a framework for pharmacists to utilize tools and resources to take advantage of evolving opportunities in health care delivery. Additionally, a consistent process of care creates predictable expectations for pharmacist services utilizing standardized methods for collection, assessment, planning, implementation, evaluation and monitoring, and follow-up/transition activities related to patient medication use, safety, and outcomes. Once the pharmacists’ patient care process is finalized, APhA and other stakeholders will work to promote adoption and help you implement the process into your practice.
Conclusion We can all do more! As my father said 20 years ago, “As a family, each member has certain obligations to the other members of the family.” I need to do more because you want to do more. You need to do more because our patients deserve more. As a profession we need to do more so our country can thrive. When pharmacists from across the profession and country unite with a unified message, the results are powerful.
This will require each of you to commit some of your time, talent, and treasure to your pharmacy family, and I encourage you to do so. We all must strike a balance with our own family and our practice, along with our profession. And this is not easy. I myself am not immune to this struggle, as several in the audience will agree. It came through in a very clear way when we were visiting the Milwaukee Zoo with our then 3-year-old son Andy. As we stood at the rail of the elephant compound, a young child next to us asked, “If that is the mommy elephant and that is the baby elephant, where is the daddy elephant?” Andy did not hesitate to reply, “He’s probably at a meeting.” Your pharmacy family needs you today. This is an all-hands-ondeck moment for our pharmacy family. We each need to learn to articulate the value we bring to patient care and boldly claim our place in the health care team environment. We need to deliver a clear message. People want to know “why.” Lead off your conversation with your dream of improving patient outcomes. Show your passion for enhancing access to your services. The Association is doing much work at the federal level, but we want to help you engage in your
states where so much of this evolution will take place. Health care reform has opened up many opportunities at the state level, but we need to be vigilant and get moving to embrace them. We will work with you, NASPA, and your state pharmacy association to create an unbeatable team! APhA needs to hear from and work closely with pharmacists in each state who are interfacing with patients directly, in order to take advantage of these opportunities. We also need to identify private payers and integrated care models such as ACOs that are already considering or very likely to integrate pharmacists as providers and pay for services. Your eyes and ears can help the entire pharmacy family. Please be proactive and keep us posted. Our pharmacy family is strong. We are a powerful force when working with each other, for our patients, and for our profession. That’s a good thing, because the country and our patients need a strong pharmacy family. We need to be ready to show our power and our passion if we want to be successful. Peter Marshall said, “A different world cannot be built by indifferent people.” If we believe in the positive impact pharmacists can have on the lives of our patients, then we need to be willing to invest our time, energy,
Matthew C. Osterhaus, BSPharm, FASCP, FAPhA A community and consultant pharmacist, Matthew C. Osterhaus, BSPharm, FASCP, FAPhA, co-owns and operates Osterhaus Pharmacy in Maquoketa, IA. He served previously as an APhA Trustee before his election to the APhA presidency, with membership on the Finance and Government Affairs Committees of the Board of Trustees. Osterhaus is a 1980 graduate of the University of Iowa College of Pharmacy. An adjunct faculty member of that college as well as Drake and Midwestern Universities, Osterhaus serves as preceptor for student pharmacists in pharmaceutical care. He has been the preceptor for an APhA/American Society of Health-System Pharmacists accredited community practice residency since 1997 and served as chairman of APhA’s Community Pharmacy Residency Advisory Panel. Osterhaus is a member of Outcomes Certified Pharmaceutical Care Network and works to advance community based research in Iowa. He has served on the Iowa Medicaid Drug Utilization Review Commission, the Iowa Board of Pharmacy Examiners, and the Iowa Medicaid Pharmacy and Therapeutics Committee. Osterhaus is active in his local and state pharmacy associations, having served as President of the Iowa Pharmacy Association. He is also on the Pharmacist Mutual Insurance Company’s Board of Directors and Outcomes Pharmaceutical Healthcare’s Board of Governors. Osterhaus received the APhA Good Government Pharmacist-of-the-Year Award in 2006 and the APhA–Academy of Pharmacy Practice and Management Distinguished Achievement Award in Community and Ambulatory Practice in 2005. He is an APhA Fellow.
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and dollars to win this battle. This is not the easy path but it is the right path, and together we will make it happen. We need to be ready to show our power and our passion if we want to be successful. Health care reform is on the move, but we need to keep up the effort as implementation continues. And we need to be ready for the next round of reform, because the cost of our system is unsustainable and the health of our patients is still in jeopardy.
I ask that you recharge your bond with pharmacy’s promise while discovering the latest innovations and resources for future growth. Use connections made and knowledge gained as a positive force in your own career, our profession, and for the greater good of your community and the health of our nation. Learn to articulate the value you bring to patient care and boldly claim your place in the teambased care environment. “Advanc-
ing as One” lets all commit to delivering on the “Power and Promise of Pharmacy.” Join me in being part of the powerful, positive change our profession can bring to our patients. I look forward to next year’s pharmacy family reunion to celebrate our successes. Thank you for joining me on this journey. doi 10.1331/JAPhA.2014.14521
Call for Volunteers:
Editorial Advisory Board, JAPhA The publisher and editors of the Journal of the American Pharmacists Association invite interested APhA members from pharmacy practice, research, education, industry, and related fields to apply for 10 available positions on the JAPhA Editorial Advisory Board (EAB). The term of service is 3 years, beginning at APhA2015 in San Diego. Responsibilities of EAB members are to: ❚❚ Act as a core group of peer reviewers for submitted manuscripts. ❚❚ Serve as consultants to the editors about proposed changes or new directions in journal content and format or in the processes (e.g., peer review) and policies associated with journal production. ❚❚ Participate on ad hoc subcommittees to examine specific questions and suggest solutions. ❚❚ Provide feedback and suggestions on journal contents and policies as required or requested. Current EAB members are not eligible for reappointment until the year after completion of their terms (e.g., an EAB member whose term expires in 2015 would be eligible for appointment to a new term in 2016). Interested individuals should complete the application form at www.surveymonkey.com/s/FT82XPP and send a current curriculum vitae to Executive Editor L. Michael Posey at [email protected] by October 31, 2014.
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Register Today APhA’s Annual Meeting & Exposition is the premier event in pharmacy. Join your colleagues in San Diego from March 27–30, 2015, and experience comprehensive programming, captivating speakers, and professional networking opportunities. Visit aphameeting.org for more information
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2014 Presidential address: The power of the pharmacy family Matthew C. Osterhaus
Delivered by Matthew C. Osterhaus, BSPharm, FASCP, FAPhA, incoming President of the American Pharmacists Association, at APhA2014, the Association’s Annual Meeting and Exposition, March 30, 2014, Orlando, FL. Good morning everybody! It is truly an honor to serve as the next APhA President. Being elected by one’s peers is special, and to lead such a wonderful, impactful organization is a remarkable opportunity. My father, Bob Osterhaus, served as APhA’s 137th president. We’re not the first father/son team, however. I will be the fourth son to be honored to follow in his father’s footsteps as APhA president, but the first in 77 years. Speaking of father and son, I’d like to introduce my family and our pharmacy family. First, a shout-out to Dale Yoder and the staff of Mercy Family Pharmacy who are running the practice back home in Iowa so my pharmacist staff could join us here. Tammy Bullock, Connie Connolly, Angie Spannagel, and Janis Rood—stand and take a bow! They make care happen! Joining them are my former residents. Next, my spiritual and legal advisers, Judges Phil and Nancy Tabor. Now, the 33 Osterhauses in attendance—10 of my nieces and cousins; 7 of my 9 siblings (Mark, John, Jane, Kate, Molly, Amy/John, and Betsy). We are missing my sister Meg in Australia and my brother Luke, whose enthusiastic spirit is with me every day. My four children, their spouses, and my six grandchildren: Andy, Joelle, Pieta and Everett; Maria, Bobby, Owen, Rya, Gibson, and Adia; Jack and Ashley; and our baby, Lau-
ra. My pharmacist wife and partner of 33 years, Marilyn. She is the real power and promise behind me and always by my side. And of course, my parents, Bob O and Ann, who have truly made all this possible. I would also invite all the members of the Iowa pharmacy family, including those from Pharmacists Mutual and Outcomes, and anyone else who wishes they were an Iowa pharmacist, to stand and accept my sincere thanks for what you have done for me and this profession. Obviously family is important to me, and the support they give me is a big part of my success. Twentyone years ago during his incoming speech as APhA president, my father spoke of the power of the pharmacy family. In reading his remarks again, I was struck by how the challenges and opportunities my father discussed are similar to those we face today. My Dad said, “I believe the pharmacy family will flourish, because I detect everyday an upselling of the sense pharmacists can—and are—controlling their destinies.” I believe the same is true today. Our profession is steeped in tradition, and we naturally often resist change. For example, in the Osterhaus home, we grew up listening to musicals. And like Tevye—where in Fiddler on the Roof he sings of “Tradition!”—there is comfort from routine and the status quo. But our traditions are crumbling. I dare say there are few comfortable pharmacists today as health care changes accelerate. Yesterday, Steve Simenson shared with you that the state of the Association is strong and there are new and exciting opportunities
Journal of the American Pharmacists Association
j apha.org
being placed before us. Steve provided great leadership in his presidential term and set the bar high for me. Thanks to his hard work, and the dedication of many others, our pharmacy family is gaining strength and recognition. We have come a long way. In 1992, my father was encouraging his peers to measure success by more than the number of prescriptions filled in a day. Let me tell you how things have changed since his speech in 1992. We have redesigned our workflow and our layout to maximize access to the pharmacist and privacy for the patient. We have ramped up our contribution to pharmacy education from summer interns to be a teaching site for six colleges of pharmacy and a premier community pharmacy residency site. We have been a pioneering partner in practice-based research, showing the value of pharmacists’ services. We have built the infrastructure and team to be top-notch caregivers; we are being handcuffed by pharmacy benefit management policies that pay us less than the cost of the drug product to dispense a prescription. We take pride in the fact that our counseling session with our patient C.A. prior to her vacation abroad armed her with an action plan if her asthma flared up; it did, and she followed the plan and avoided hospitalization on foreign soil. We make a difference by providing the medications our patients need, administering immunizations, guiding them through care transitions, coaching them to better diabetes control … and that’s before 10 a.m. on a Tuesday! The state of our pharmacy family is also strong because, like the families we all know and love, we take care of each other and work to ensure we meet our personal and profession-wide goals. I am so proud of how your volunteer-elected board and other leaders work with staff who come to work every day committed to serving the needs JU L/A U G 2014 | 54:4 |
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of America’s pharmacists, and you, our members in particular. That is what makes the APhA membership and the pharmacy family so unique. We help each other so we can all better help our patients. I promise we will keep doing so this year.
The power of the pharmacy family: Internal Over 20 years ago, my father said, “In all families, the members hold in their hands the answer to whether or not the family will flourish. The same is true in the pharmacy family. All of us collectively impact whether pharmacy will flourish or whether we will decline in stature together.” Earlier I spoke of our natural resistance to change. But change is one of the few constants. We must embrace and lead if we are to reach the goals we have set. We are in the midst of a major disruption. There are external forces (the economy, Centers for Medicare & Medicaid Services) we cannot control that will force us to change. There are also some very positive agents of change surrounding you this morning. The pharmacist to your left and the one sitting to your right are part of that powerful force. It’s the individual pharmacist who says, “I can do better for my patients,” and then shares the idea with you. APhA is here to act as a conduit for sharing these innovations and best practices with you and your colleagues across the country. The Association is your doorway to education, resources, and opportunities for professional growth. The Association can amplify a single person’s voice and progress into something that will gain attention within and outside of the profession. Just like Steve, I am a community pharmacist who has been at the forefront in implementing patient care services that improve medication use and advance patient care, along with the other members of the health care team. It has not been an easy road; there are turf battles, financial barriers, and manpower 340 JAPhA | 5 4:4 | JUL /AUG 2 0 1 4
constraints. But we continue to maintain our focus on what our patients need. Our team at Osterhaus Pharmacy has worked to ensure accurate medication lists are exchanged on admission and discharge from our local hospital; we have met the needs of post-mastectomy patients, gaining referrals from a 40-mile radius due to our personal service; and we have enhanced the immunization rates of our patients with diabetes by collaborating with local physician clinics. Having “best practices” are not all we do to help the pharmacy family grow stronger. And what can we say about leadership? Through student and new practitioner programming, APhA has helped thousands of young pharmacists build a foundation for leadership positions within APhA and in their own practices as well. Regardless of experience, years since graduation and licensure, length of APhA membership, or participation in leadership academies, pharmacists can differentiate themselves through participation in their profession. An “It’s Mutual” membership campaign was launched in 2013 to convey that APhA shares every pharmacist’s desire for a successful and meaningful career. APhA is committed to being a responsible and available family member to its members. In 2013, APhA staff completed the first major phase to implement a new association management system, and in early 2014 we launched. The system will streamline the online transactions performed by members and non-members, while simultaneously helping the association better understand member interests and needs. To be more responsive and accessible to members, APhA also implemented a 24-hour call center support service, which allows members to speak directly and immediately with a member-support person rather than having to leave a teleja p h a.org
phone message. You’ll see continued improvements in the “member experience” in the coming months. Enhancing the value of your membership is a high priority at APhA!
The power of the pharmacy family: External In his presidential address, my father said, “Families need to have goals, and all members have a role to play in seeing those goals are met. In the pharmacy family, the mission statement for the profession of pharmacy is the foundation for the profession’s goals, and all members of the pharmacy family have a role to play in seeing that our mission to society is achieved.” My brothers and sisters remember well the question from Bob O, “What is your 5-year goal?” Today, we know our goal. Steve said yesterday the Association’s highest priority was committing “significant resources toward ensuring patients have access to your patient care services.” And that focus remains. With the Joint Commission of Pharmacy Practitioners (JCPP), we have an updated Vision Statement, and soon an Action Plan to meet it. The Vision Statement underscores another lesson of my father: “The patient is an adopted member of the family for whom we have a special responsibility.” It also provides a key message in our quest for provider status. The JCPP Vision Statement is: Patients achieve optimal health and medication outcomes with pharmacists as essential and accountable providers within patient-centered, team-based health care. Notice the patient comes first! As part of APhA’s provider status action plan, the government affairs team, along with collaborating pharmacy organizations, is aggressively pursuing advocacy activities that include educating and lobbying members of the key committees involved in health care policy and regulation. In December, there was an opportunity to educate Congress re-
Journal of the American Pharmacists Association
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garding the value of recognizing and including pharmacists’ patient care services. During Congress’ consideration of legislation to address Medicare’s sustainable growth rate, a potential amendment that would recognize pharmacists’ patient care services in affordable care organization (ACO) models was proposed. While the amendment was not ultimately introduced, it did place pharmacists’ patient care service recognition on various discussion tables and showed how quickly and successfully our pharmacy family engaged. Thank you to all that communicated with your Congress members. As evidenced by an increasing number of requests for input, APhA is consistently viewed as a balanced, reputable, and constructive resource on Capitol Hill when health care legislation is being considered. As announced earlier this month and discussed by Steve yesterday, APhA is a founding member of the Patient Access to Pharmacists’ Care Coalition, a multi-stakeholder initiative comprised of national pharmacy organizations and stakeholders to develop and help enact federal legislation supporting the federal recognition of pharmacists and pharmacists’ services. Specifically, this legislation will enable patient access to, and compensation for, pharmacist-provided patient care services under Medicare Part B. Our initial emphasis is to address an area of concern for the U.S. health care system by expanding access to pharmacy services for medically underserved patients in a manner consistent with state scope-of-practice laws. With already more than 20 pharmacy-related organizations part of the coalition, APhA is committed to work to expand that number, as well as include organizations representing patients and other health care providers. APhA will continue to explore and pursue all opportunities to advance “consumer access and coverage for p harmacists’ quality patient
care services.” APhA’s advocacy efforts directed toward pharmacist provider status are a multi-level campaign on the federal, state, and private sector. While I am extremely excited that pharmacy has legislation before Congress that recognizes the value of pharmacists and their patient care services in Medicare, our profession’s quest for recognition exceeds the pursuit of a single bill being drafted, introduced, and passed in Congress. Our strategy includes engagement by voters and decision makers. It also includes you! You will hear more about these efforts in the keynote presentations during this session. As within any successful family, lots of give and take is needed, and we don’t always get everything we want. Sometimes it takes baby steps to reach the ultimate goal. We cannot confuse the public or decision makers with varying terminology and “asks.” We build strength and influence when we act as one profession—one pharmacy family. During my presidential year, we will remain committed to “Advancing as One”—one health care team, one profession, and one patient care process. I viewed a YouTube video by Simon Sinek that summed up how we can make this happen. Our “ask” needs to be brought forward to the pharmacy family with an emphasis on the “why.” Every constituent, inside and outside the pharmacy family, needs to know why provider status is so important for our patients. We are driven by a purpose, a cause, a belief that we can impact our patients and the health care system by improving outcomes. Martin Luther King, Jr. did not inspire a generation to embrace change by saying, “I have a plan!” Rather, he was able to communicate a dream from his heart because he truly believed it. In November 2013, APhA submitted comments related to the U.S. Department of Health and Human Services’ (HHS) draft Strategic Plan for 2014–2018. The Association
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argued for provider status: “In order for pharmacists to fully realize their potential to improve patient care and outcomes and for HHS to achieve the objectives outlined in its Strategic Plan, certain barriers, including reimbursement issues and resource allocation, must be addressed.” APhA continued that the lack of federal provider status is often cited by state and private health plans as their reason for not covering beneficiaries or compensating pharmacists for their patient care services, as well as results in barriers to optimizing those services in emerging integrated care delivery models such as patient-centered medical homes or ACOs. We also included comments supporting the read/write access to electronic health records and making pharmacists eligible for the incentives to connect. We need to hold ourselves to higher standards. Inherent to any health innovation is the need to ensure standards of care are being met and can be measured. In 2013, APhA actively sought to ❚❚ Identify, highlight, and share innovative practices; ❚❚ Assess the current state of medication therapy management; ❚❚ Build consensus and momentum on provider status elements; ❚❚ Establish standards to accredit pharmacy practice; ❚❚ Help shape development of quality measures for medication use; and ❚❚ Evaluate new approaches to patient care and new payment models for pharmacists that align with evolving qualitybased and performance-driven reimbursement structures. Developing standardized measures and a consistent patient care approach by pharmacists is critical to meet the profession’s vision for pharmacy practice and the role of the pharmacist to provide specific, predictable, and measurable patient care services. To that end, clarifying JU L/A U G 2014 | 54:4 |
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and standardizing the pharmacist process of care was a high priority for APhA and collaborating pharmacy organizations in 2013. A well-defined process of care provides a framework for pharmacists to utilize tools and resources to take advantage of evolving opportunities in health care delivery. Additionally, a consistent process of care creates predictable expectations for pharmacist services utilizing standardized methods for collection, assessment, planning, implementation, evaluation and monitoring, and follow-up/transition activities related to patient medication use, safety, and outcomes. Once the pharmacists’ patient care process is finalized, APhA and other stakeholders will work to promote adoption and help you implement the process into your practice.
Conclusion We can all do more! As my father said 20 years ago, “As a family, each member has certain obligations to the other members of the family.” I need to do more because you want to do more. You need to do more because our patients deserve more. As a profession we need to do more so our country can thrive. When pharmacists from across the profession and country unite with a unified message, the results are powerful.
This will require each of you to commit some of your time, talent, and treasure to your pharmacy family, and I encourage you to do so. We all must strike a balance with our own family and our practice, along with our profession. And this is not easy. I myself am not immune to this struggle, as several in the audience will agree. It came through in a very clear way when we were visiting the Milwaukee Zoo with our then 3-year-old son Andy. As we stood at the rail of the elephant compound, a young child next to us asked, “If that is the mommy elephant and that is the baby elephant, where is the daddy elephant?” Andy did not hesitate to reply, “He’s probably at a meeting.” Your pharmacy family needs you today. This is an all-hands-ondeck moment for our pharmacy family. We each need to learn to articulate the value we bring to patient care and boldly claim our place in the health care team environment. We need to deliver a clear message. People want to know “why.” Lead off your conversation with your dream of improving patient outcomes. Show your passion for enhancing access to your services. The Association is doing much work at the federal level, but we want to help you engage in your
states where so much of this evolution will take place. Health care reform has opened up many opportunities at the state level, but we need to be vigilant and get moving to embrace them. We will work with you, NASPA, and your state pharmacy association to create an unbeatable team! APhA needs to hear from and work closely with pharmacists in each state who are interfacing with patients directly, in order to take advantage of these opportunities. We also need to identify private payers and integrated care models such as ACOs that are already considering or very likely to integrate pharmacists as providers and pay for services. Your eyes and ears can help the entire pharmacy family. Please be proactive and keep us posted. Our pharmacy family is strong. We are a powerful force when working with each other, for our patients, and for our profession. That’s a good thing, because the country and our patients need a strong pharmacy family. We need to be ready to show our power and our passion if we want to be successful. Peter Marshall said, “A different world cannot be built by indifferent people.” If we believe in the positive impact pharmacists can have on the lives of our patients, then we need to be willing to invest our time, energy,
Matthew C. Osterhaus, BSPharm, FASCP, FAPhA A community and consultant pharmacist, Matthew C. Osterhaus, BSPharm, FASCP, FAPhA, co-owns and operates Osterhaus Pharmacy in Maquoketa, IA. He served previously as an APhA Trustee before his election to the APhA presidency, with membership on the Finance and Government Affairs Committees of the Board of Trustees. Osterhaus is a 1980 graduate of the University of Iowa College of Pharmacy. An adjunct faculty member of that college as well as Drake and Midwestern Universities, Osterhaus serves as preceptor for student pharmacists in pharmaceutical care. He has been the preceptor for an APhA/American Society of Health-System Pharmacists accredited community practice residency since 1997 and served as chairman of APhA’s Community Pharmacy Residency Advisory Panel. Osterhaus is a member of Outcomes Certified Pharmaceutical Care Network and works to advance community based research in Iowa. He has served on the Iowa Medicaid Drug Utilization Review Commission, the Iowa Board of Pharmacy Examiners, and the Iowa Medicaid Pharmacy and Therapeutics Committee. Osterhaus is active in his local and state pharmacy associations, having served as President of the Iowa Pharmacy Association. He is also on the Pharmacist Mutual Insurance Company’s Board of Directors and Outcomes Pharmaceutical Healthcare’s Board of Governors. Osterhaus received the APhA Good Government Pharmacist-of-the-Year Award in 2006 and the APhA–Academy of Pharmacy Practice and Management Distinguished Achievement Award in Community and Ambulatory Practice in 2005. He is an APhA Fellow.
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and dollars to win this battle. This is not the easy path but it is the right path, and together we will make it happen. We need to be ready to show our power and our passion if we want to be successful. Health care reform is on the move, but we need to keep up the effort as implementation continues. And we need to be ready for the next round of reform, because the cost of our system is unsustainable and the health of our patients is still in jeopardy.
I ask that you recharge your bond with pharmacy’s promise while discovering the latest innovations and resources for future growth. Use connections made and knowledge gained as a positive force in your own career, our profession, and for the greater good of your community and the health of our nation. Learn to articulate the value you bring to patient care and boldly claim your place in the teambased care environment. “Advanc-
ing as One” lets all commit to delivering on the “Power and Promise of Pharmacy.” Join me in being part of the powerful, positive change our profession can bring to our patients. I look forward to next year’s pharmacy family reunion to celebrate our successes. Thank you for joining me on this journey. doi 10.1331/JAPhA.2014.14521
Call for Volunteers:
Editorial Advisory Board, JAPhA The publisher and editors of the Journal of the American Pharmacists Association invite interested APhA members from pharmacy practice, research, education, industry, and related fields to apply for 10 available positions on the JAPhA Editorial Advisory Board (EAB). The term of service is 3 years, beginning at APhA2015 in San Diego. Responsibilities of EAB members are to: ❚❚ Act as a core group of peer reviewers for submitted manuscripts. ❚❚ Serve as consultants to the editors about proposed changes or new directions in journal content and format or in the processes (e.g., peer review) and policies associated with journal production. ❚❚ Participate on ad hoc subcommittees to examine specific questions and suggest solutions. ❚❚ Provide feedback and suggestions on journal contents and policies as required or requested. Current EAB members are not eligible for reappointment until the year after completion of their terms (e.g., an EAB member whose term expires in 2015 would be eligible for appointment to a new term in 2016). Interested individuals should complete the application form at www.surveymonkey.com/s/FT82XPP and send a current curriculum vitae to Executive Editor L. Michael Posey at [email protected] by October 31, 2014.
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Register Today APhA’s Annual Meeting & Exposition is the premier event in pharmacy. Join your colleagues in San Diego from March 27–30, 2015, and experience comprehensive programming, captivating speakers, and professional networking opportunities. Visit aphameeting.org for more information
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