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Expansion of Pharmacist’s Practice in Ohio

Late last year I covered a topic close to the heart of all of us at Kit Check: Provider Status. So I was thrilled to read Pharmacy Practice News’ piece on the expansion of pharmacist’s practice in the State of Ohio based on the passage of House bill 188. This law greatly increases the cognitive services that pharmacists in that state can perform, including the ordering and analysis of blood and urine tests, and the ordering and modification of a patient’s drug therapy. The law offers practice enhancements for both community, and hospital-based practitioners, and has apparently been many years in the making. Although not the nationwide recognition we need of Pharmacists as providers, I believe it is a significant step in that direction and a model for other states to consider in the New Year.

Road AheadJon Rawlinson CC BY 2.0

The Hard Work of Expanding the Pharmacist’s Role is Still Ahead of Us

As a former Director of Pharmacy, my mind immediately went to considering the challenges these Ohio health systems will face as they work to capitalize on this new legislation. I’ve been associated with many excellent hospitals and pharmacy departments over the years and, even though this type of practice is exactly what we’ve been training and educating pharmacists to do for twenty years, I’ve never known one that had surplus pharmacists available, just waiting to take advantage of a practice expansion such as this. In fact, I believe that the fight for FTEs has never been more fierce than for today’s health system pharmacy leaders. They are constantly required to perform the same or a greater amount of work, at similar or higher quality, with the same or fewer human resources. I fear this trend isn’t going away anytime soon, either. What ought we do?

Pharmacy Technology, Pharmacy Automation, Optimized Use and Long-term Planning

Drawing on my experience in my later career spent mostly with health system pharmacy technology companies, I’ve seen many automation investments that have delivered the ROI promised. With those time savings, Pharmacists at those organizations were able to focus more of their time on cognitive services such as anticoagulation monitoring, involvement on interdisciplinary patient care rounds, and other decentralized, patient focused services outside of the walls of a central pharmacy or satellite, at the point of care. That being said, I’ve seen an equal number of investments fail to deliver on the ROI promised, investments that left additional efficiency gains unrealized due to the lack of optimization as well as investments that were never made do to insufficient forward thinking and planning.

The solution is taking time to build a long-term pharmacy automation & technology master plan that looks not only at the present, but at the future with an integrated, holistic worldview. This sort of master planning positions health system pharmacy departments to capitalize on the opportunity when (not if) provider status continues to expand to other states. In the nearer term, pharmacies outside of Ohio can still benefit from building a long-term master plan as it will create near term opportunities to increase efficiency and refocus on cognitive services currently allowed in your state.

D J ShinCC BY-SA 3.0

4 Tips to Building a Pharmacy Automation & Technology Master Plan

So it is one thing to acknowledge the importance of building a technology master plan and another to actually do it. I know from experience that building a long term plan can be a daunting task so here are four tips to avoid common missteps in the process.

  1. Don’t build it in a vacuum. Include members of other departments such as IT but also include members from across the Pharmacy. For example, your technicians have a unique view on the day-to-day challenges that result in the greatest inefficiencies.
  2. Be prepared to iterate. It will take a few passes to get to a plan that you like but you’ll also want to revisit that plan at a regular cadence to accommodate for any changes in the dynamics that impact your organization.
  3. Get your vendors to help. Your plan means opportunities for your vendors. Leverage their knowledge and aligned incentives to help gather data and build your argument. If your vendor isn’t willing to help you sell the value internally, then they probably aren’t going to be a partner that supports you to ensure you realize that value once you buy.
  4. Evangelize. Once you have your plan in place, share it with anyone that will listen. Not only do you need to ensure there is support higher up in the organization, you strengthen your position by ensuring other departments understand how the investments you are proposing will benefit them.

Realizing the Potential Impact of Pharmacists on Increasing the Quality and Decreasing the Costs of Healthcare

Whether your are a Director of Pharmacy in Ohio facing a unique opportunity to truly redefine the role of the Pharmacist within your organization or a DOP in another state struggling to meet ever increasing demands with existing resources, taking the action of building a long-term technology automation plan will be well worth the effort in the near term and well into the future. Those who optimize current technology, effectively articulate the need for additional technologies to their health system leadership, and engage with technology vendors to compel them to create solutions to common problems, will deliver the highest quality and most cost effective patient care possible by allowing Pharmacists to practice the elements of their craft that attracted them to this profession to begin with.

If you have additional ideas on how to better plan technology investments with a holistic, integrated worldview or if you would like to better understand how Kit Check could be part of your long-term plan, please email me at

Interested in more ideas on how to position Pharmacists to practice at the top of their license? Download my “7 Levels of Work in Hospital Pharmacy” white paper.