Overview of Community, Retail, and Ambulatory Care Pharmacy PDF

(PPT NO. 2 – PROFESSOR KRINSKY) Overview of Community, Retail, and Ambulatory Care Pharmacy 1. What is ambulatory care pharmacy? A: A branch of pharmacy providing integrated, accessible healthcare services for ambulatory patients transitioning from hospital to home or other care facilities. 2. W...

(PPT NO. 2 – PROFESSOR KRINSKY) Overview of Community, Retail, and Ambulatory Care Pharmacy 1. What is ambulatory care pharmacy? A: A branch of pharmacy providing integrated, accessible healthcare services for ambulatory patients transitioning from hospital to home or other care facilities. 2. Which organizations collaborated on defining ambulatory care pharmacy practice? A: The American College of Clinical Pharmacy (ACCP), American Society of Health-System Pharmacists (ASHP), and American Pharmacists Association (APhA). 3. Where do ambulatory care pharmacists typically work? A: Accountable care organizations, community clinics, federally qualified health centers, VA medical centers, and outpatient clinics. 4. Name at least three services ambulatory care pharmacists provide. A: Chronic disease management, medication reconciliation, and immunizations. 5. What is a Collaborative Practice Agreement (CPA)? A: A formal agreement allowing pharmacists to perform specific patient care functions under the supervision of a licensed provider. 6. What is comprehensive medication management? A: A service by ambulatory care pharmacists to optimize drug therapy and improve therapeutic outcomes. 7. What is required to become an ambulatory care pharmacist? A: Typically, a PGY-1 or PGY-2 residency, board certification, and continuing education. 8. What is the BCACP certification? A: Board Certified Ambulatory Care Pharmacist certification from the Board of Pharmacy Specialties. 9. What other certifications are relevant to ambulatory care pharmacists? A: Certified Diabetes Educator (CDE), Clinical Lipid Specialist (CLS), and Certified Asthma Educator (CAE). 10. What are some technical considerations when establishing ambulatory care services? A: Documentation, billing, payer mix, staffing, and space. 11. What billing codes can ambulatory care pharmacists use? A: Incident-to codes, Diabetes Self-Management Training, Chronic Care Management, and Transitional Care Management. 12. Name a barrier to ambulatory care pharmacy services. A: Defining the pharmacist’s role within the clinic and compensation for time. 13. What is the future outlook for ambulatory care pharmacy? A: Positive, with expanded roles due to shortages of primary care providers and more states approving provider status. 14. What is the historical role of community pharmacists? A: Providing compounded medicines and being a respected health advisor in the community. 15. What are the types of community pharmacies? A: Independent, chain, supermarket, internet, and mail order pharmacies. 16. What has changed in community pharmacy since the 1900s? A: Shift from compounding to retail, chain expansion, and increased role of third-party payers. 17. What is the primary goal of operating a community pharmacy? A: Patient care and improving patient outcomes alongside profitability. 18. Name three patient care services offered in community pharmacies. A: Medication Therapy Management (MTM), immunizations, and wellness screenings. 19. What is a DIR fee? A: A fee associated with Medicare Part D plans, often reclaimed by insurers after audits. 20. How has technology impacted community pharmacy practice? A: Enhanced prescription processing, medication ordering, and patient data management. 21. What is the impact of third-party payers in community pharmacy? A: They cover over 80% of prescriptions, affecting pharmacy revenues and reimbursement rates. 22. Describe the difference between retail and community pharmacy. A: Community pharmacy focuses on patient-centered services, while retail pharmacy is more product-oriented. 23. How does managing “things” affect community pharmacy operations? A: It involves inventory control, financials, legal compliance, and marketing. 24. Name key inventory items managed in a community pharmacy. A: Medications, OTC products, compounding materials, and equipment. 25. What are perpetual and periodic inventory systems? A: Perpetual tracks inventory continuously, while periodic counts are done at set intervals. 26. What is the role of the DEA in community pharmacies? A: Overseeing controlled substances and ensuring pharmacies have proper licenses. 27. What type of documentation must community pharmacies keep? A: Prescription records, immunization logs, and controlled substance forms. 28. Name a technology commonly used in community pharmacies. A: Pharmacy dispensing software systems and automated counting machines. 29. What is the significance of the 222 form in community pharmacies? A: It’s used for ordering Schedule II controlled substances. 30. Name a cost associated with community pharmacy operations. A: Inventory management, employee wages, and third-party billing services. 31. How can community pharmacies generate revenue? A: Through prescription sales, OTC products, durable medical equipment, and clinical services. 32. What legal and regulatory aspects must community pharmacies follow? A: Licensing, compliance with HIPAA, OBRA-90, and state-specific laws. 33. How do pharmacies handle marketing and advertising? A: Through billboards, in-store signage, social media, and community involvement. 34. What does managing “people” in a community pharmacy entail? A: Overseeing staff roles, customer interactions, and partnerships with healthcare providers. 35. What is the traditional workflow in a community pharmacy? A: Prescription intake, data entry, dispensing, pharmacist check, counseling, and checkout. 36. Why are wellness screenings important in community pharmacies? A: They help identify health risks and engage patients in preventive care. 37. Name a challenge community pharmacies face today. A: Increasing workload, DIR fees, and reimbursement challenges from PBMs. 38. What role do PBMs play in community pharmacy? A: Managing prescription drug plans, often affecting pharmacy profits. 39. What are the key components of patient counseling in pharmacies? A: Medication instructions, side effects, and adherence tips. 40. What is Medication Therapy Management (MTM)? A: A service where pharmacists optimize patient medications to improve outcomes. 41. How do PBMs influence medication prices? A: Through rebates, discounts, and contract negotiations. 42. What is the purpose of callback programs in pharmacies? A: To check patient adherence and response to medications. 43. What challenges do pharmacies face with third-party reimbursement? A: Complex billing procedures and delayed or reduced payments. 44. How have community pharmacies evolved in the past century? A: From compounding-focused practices to retail models with expanded services. 45. What is the role of a district manager in chain pharmacies? A: Overseeing multiple pharmacy locations and ensuring operational consistency. 46. Name a professional service that generates income in pharmacies. A: Immunization clinics. 47. What does “integrated care” mean in the context of ambulatory care? A: Providing coordinated services with other healthcare providers. 48. Why is patient education crucial in community pharmacy? A: It improves medication adherence and health outcomes. 49. How has Medicare Part D impacted pharmacy revenue? A: It increased third-party coverage, affecting the reimbursement landscape. 50. What are “incident-to” codes used for in ambulatory care pharmacy? A: Billing for services provided as part of a physician’s treatment plan. 51. Name a common barrier to establishing new pharmacy services. A: Securing stakeholder support and physician collaboration. 52. What is the significance of HIPAA in pharmacies? A: It mandates the protection of patient health information. 53. How do community pharmacies support chronic disease management? A: Through medication adjustments, monitoring, and patient follow-ups. 54. What role does the State Board of Pharmacy play in community pharmacies? A: Regulating licensure and compliance with state pharmacy laws. 55. What is the primary role of a pharmacy technician? A: Assisting with prescription processing, inventory, and customer service. 56. Why are PBMs involved in prescription drug pricing? A: They negotiate drug prices with manufacturers and determine reimbursement rates. 57. What is the purpose of immunization records in pharmacies? A: Documenting vaccinations for compliance and patient history. 58. Why is technology integration important in pharmacy practice? A: It improves efficiency in prescription processing and data management. 59. What are DIR fees in Medicare Part D? A: Fees pharmacies pay to PBMs, often post-transaction, affecting profits. 60. How does CLIA certification impact pharmacies? A: It allows pharmacies to perform certain lab tests for patient care. 61. What does “workflow optimization” involve in pharmacy settings? A: Streamlining processes to enhance efficiency and patient service. 62. Why is customer service training essential in community pharmacy? A: To ensure a positive patient experience and build customer loyalty. 63. How does the pharmacist’s role in ambulatory care differ from community pharmacy? A: It involves more direct patient care and coordination with other providers. 64. What are accountable care organizations (ACOs)? A: Groups of healthcare providers working together to improve patient outcomes. 65. Why are third-party payers significant in the pharmacy industry? A: They cover most prescriptions, influencing pricing and reimbursement. 66. How does marketing help community pharmacies? A: By attracting new customers and promoting pharmacy services. 67. What is a challenge of the pharmacist’s role in ambulatory care? A: Time management to balance patient care and administrative tasks. 68. Why are continuing education programs important for pharmacists? A: To stay updated on new practices, medications, and regulations. 69. What are the benefits of ambulatory care for patients with chronic conditions? A: Improved medication management and ongoing support between doctor visits. 70. How does MTM benefit patients in community pharmacies? A: It provides personalized medication management to improve adherence. 71. What is a Certified Diabetes Educator (CDE)? A: A healthcare professional certified to educate patients on diabetes management. 72. Name a certification relevant to community pharmacists. A: Certified Anticoagulation Care Provider (CACP). 73. Why is revenue generation important in community pharmacies? A: To sustain the business and continue providing patient services. 74. What is the main goal of patient counseling in pharmacy practice? A: To educate patients on proper medication use and adherence. 75. How do pharmacies help with medication adherence? A: Through counseling, follow-ups, and adherence packaging. 76. What are “prescription checkbacks” in pharmacy services? A: Follow-up calls to assess patient response to new medications. 77. What role does the Veterans Affairs (VA) play in ambulatory care? A: It provides care for veterans, often allowing pharmacists to have prescribing authority. 78. What are medication therapy management services (MTMS)? A: Programs aimed at optimizing therapeutic outcomes for patients. 79. Why is an accurate medication history important? A: To prevent drug interactions and ensure safe prescribing. 80. How does the integration of EHRs impact pharmacy services? A: It enables better coordination of care with other healthcare providers. 81. What are some ways pharmacies contribute to preventive care? A: Providing immunizations, health screenings, and wellness education. 82. How has pharmacy practice changed with Medicare Part D? A: It introduced more third-party coverage, impacting pharmacy revenues. 83. Why is the pharmacist’s role in public health growing? A: Due to their accessibility and ability to provide preventive services. 84. What is a durable medical equipment (DME) provider in pharmacy? A: Pharmacies that supply medical equipment like braces, canes, and support stockings. 85. How do community pharmacies address medication costs for patients? A: Through medication audits and cost-effective alternatives. 86. What is a common regulatory requirement for pharmacies? A: Adhering to state laws and guidelines for controlled substances. 87. How do pharmacies manage controlled substances? A: With strict inventory controls, secure storage, and documentation. 88. Why are Medicare and Medicaid significant for community pharmacies? A: They cover many prescriptions, especially for elderly and low-income patients. 89. What is a collaborative practice agreement (CPA)? A: An agreement allowing pharmacists to perform certain healthcare functions. 90. How does pharmacist intervention improve patient outcomes? A: By optimizing medication regimens and educating patients on adherence. 91. What is the role of pharmacists in Patient-Centered Medical Homes (PCMH)? A: Providing medication management as part of a coordinated care team. 92. What are some professional challenges faced by community pharmacists? A: Reimbursement issues, high workload, and adapting to evolving healthcare models. 93. Why are consultations important in ambulatory care pharmacy? A: They help address patient-specific concerns and ensure effective therapy. 94. How does a community pharmacist contribute to public health? A: Through disease prevention services and health promotion activities. 95. What is an immunization service in pharmacies? A: Providing vaccines to prevent diseases like flu and COVID-19. 96. Why do community pharmacies offer MTM services? A: To manage complex medication regimens for better health outcomes. 97. How can ambulatory care pharmacists support transitional care? A: By coordinating medications and follow-up care post-discharge. 98. What future trends may impact community pharmacy? A: Increased use of AI, legislative changes, and evolving PBM roles. 99. How has the role of pharmacy technicians expanded? A: They now assist with more clinical tasks like MTM documentation. 100. What is the key challenge of reimbursement for clinical services in pharmacies? A: Limited billing codes and lower reimbursement rates for non-physician services.