ASHP InterSections ASHP InterSections

July 26, 2021

For P1s, Getting Involved with ASHP is Key to Success

Lisa Lubsch, Pharm.D., rounds with student pharmacists.

TAKE IT FROM EXPERIENCED PHARMACISTS: getting involved early on with professional organizations like ASHP is crucial to building a successful career and enjoying all that the profession has to offer.

“Engaging with ASHP as a first-year (P1) pharmacy student allows them to explore more career paths, take on leadership roles within the organization and develop skills that will benefit them in post-graduate training and throughout their careers,” said Lauren Pamulapati, Pharm.D., assistant professor at Virginia Commonwealth University (VCU) School of Pharmacy in Richmond.

Free Membership to P1 Students

Starting in 2020, ASHP has waived the membership fee for P1 students, making it easy for P1s to dive deeper into the field of health-system pharmacy. Members gain access to a host of resources to help them prepare for residency, investigate potential careers, and build an effective CV. Benefits like daily email briefings and podcasts also keep members abreast of pharmacy and healthcare news. Summer internship opportunities and networking and leadership possibilities can help pave the way for professional growth.

Dr. Pamulapati, who advises students and residents and serves on the ASHP Society of Student Health-System Pharmacists (SSHP) Advisory Panel, said she has found that students who get involved in professional organizations early on benefit more from advanced learning opportunities.

“I’ve noticed that students who actively participate in their local ASHP societies tend to feel more prepared for the post-graduate training application process, and they have a good idea of where they want to go because they have often already looked into career opportunities using ASHP resources,” said Dr. Pamulapati.

Moreover, networking through ASHP can give students a competitive edge when applying for a residency, she added. Dr. Pamulapati recalls being a student member of ASHP herself and being told that “pharmacy is a small world.”

“It was not until I was in residency and practicing that I realized how small it truly is, so I recommend to all my students that putting yourself out there early on and building a network helps you develop more quickly and fully as a professional,” said Dr. Pamulapati.

Benefits of ASHP Membership

Lisa Lubsch, Pharm.D., a longstanding ASHP member and clinical professor in the Department of Pharmacy Practice at the Southern Illinois University Edwardsville School of Pharmacy, said there are “outstanding benefits to getting involved with ASHP early in pharmacy school.” For example, she said, students can access internship and leadership opportunities, like joining an ASHP committee, advisory group, or council.

Jerika Lam, Pharm.D., pictured with Prashanti Alekal, M.D., provides student pharmacists with experiential education opportunities.

“Becoming a leader enhances your own professional development and can help you find and cultivate a relationship with a mentor,” said Dr. Lubsch, who said she has built her own network of colleagues and collaborators through ASHP.

One of Dr.  Lubsch’s students, who is now completing her P2 year, is a case study in how participation in an organization like ASHP can lead to a cascade of growth opportunities. After taking advantage of the complimentary P1 ASHP membership, the student, in short order, became the P1 liaison for her SSHP and began developing a professional network. The student also completed an ASHP Summer Internship and then became President-elect of the school’s SSHP.

“I’m eager to hear all about her internship and watch her take on more leadership roles,” said Dr. Lubsch.

This student may be exceptionally ambitious, but all P1 students can expect to come across opportunities for growth and leadership if they join ASHP, Dr. Lubsch said.

“Not only will they have the chance to learn about careers in the acute and ambulatory care settings, but the students will also gain an earlier understanding of the residency process and will be better able to prepare for it,” she added.

A Multitude of Networking Opportunities

ASHP member Jerika Lam, Pharm.D., associate professor at Chapman University School of Pharmacy in Irvine, California, hopes P1 students take advantage of the free ASHP membership and get “the same positive experience I had when I was a pharmacy student member of ASHP.”

“An ASHP membership will connect the student to the ASHP community and social network, which is huge!” Dr. Lam enthused.

Dr. Lam is the faculty adviser of her school’s ASHP-SSHP and works with student leaders to organize social and professional functions, including networking events with pharmacy managers from large health systems and pharmacist leaders in the pharmaceutical industry.

“These events always energize Chapman pharmacy students as they move towards their residency and fellowship post-graduate training programs,” said Dr. Lam.

Lauren Pamulapati, Pharm.D., counsels a patient.

Apart from residency-focused activities, Dr. Lam said P1 ASHP members have the chance to engage their political muscles by participating in advocacy campaigns and student-focused activities like the annual Clinical Skills Competition, and they can pursue scholarship opportunities.

These days, Dr. Lam enjoys participating in ASHP’s clinical sections, dropping in on conversations covering a range of topics, from COVID-19 vaccination efforts to drug shortages, and discussions around policies and protocols that affect patient care and safety.

“ASHP has a treasure trove of expert and specialist pharmacists who can be easily connected with through the clinical sections and other forums,” noted Dr. Lam.

Dr. Lam said her own early participation in ASHP’s student forum community informed her career choices and led to opportunities to work with pharmacy leaders across the country. The benefits of networking through ASHP have continued throughout her career, and she regularly learns about models of best practices from other institutions, Dr. Lam said.

“ASHP is a very large organization, but its community is close-knit, and the interactions are professional and personable,” Dr. Lam noted.

The way VCU’s Dr. Pamulapati sees it, joining ASHP is not only beneficial for members, allowing them to enjoy professional and academic perks — it is an act of service to the entire pharmacy profession.

“The future of our profession is in the hands of student pharmacists and new practitioners, and we need them to share their perspectives and help shape policies and create new initiatives,” said Dr. Pamulapati. “I think students should dive feet first into an organization, apply for leadership positions early on and take risks. You may not feel qualified at first but know that your voice is so valued.”

 

By David Wild

January 12, 2021

Pharm.D. Candidate is a Long-Time Champion for Diversity

Jeffrey Clark is a fourth-year Pharm.D. Candidate at the Philadelphia College of Osteopathic Medicine School of Pharmacy.

AFTER GRADUATING FROM a Bachelor of Science program, Jeffrey Clark was torn between applying to pharmacy school or medical school. As fate would have it, that hesitation dissipated when Clark entered the post-undergraduate working world.

While working as a program and wellness manager at the University System of Georgia, Clark was surprised to find out that pharmacists worked in managed care positions. “I’d always thought of pharmacists as being limited to the retail setting,” Clark said.

Discovering the range of options available to pharmacists and feeling gratification from helping individuals achieve better health through the wellness programs inspired Clark to pursue a career in pharmacy.

Diversity Leadership

As a fourth-year Pharm.D. Candidate at the Philadelphia College of Osteopathic Medicine School of Pharmacy in Suwanee, Georgia, Clark’s professional interests include pharmacy operations management, medication safety, and quality assurance. His plan at the moment, however, is to pursue a two-year residency in health-system pharmacy administration and leadership.

That choice of specialization is a natural one for Clark, who serves in several leadership roles, including Chair of the ASHP Pharmacy Student Forum Executive Committee and as a student representative to the ASHP House of Delegates.

Clark is perhaps most passionate about being a leader in diversity. This interest was sparked in high school, where he spearheaded the formation of diversity groups, and a task force. “I remember explaining to [my high school’s] administration that we didn’t have a diversity-focused organization and that we needed to hold a conversation around the topic,” he said. After speaking up and voicing his concerns, Clark was asked to start a campus diversity organization.

Clark was called on again to lead diversity initiatives at college, where the campus president asked him to facilitate a task force on the issue, with the goal of finding ways to recruit individuals from underserved communities to college positions. “Those discussions ultimately led us to build awareness among faculty and staff and promote discussions on matters related to race,” he recalled.

Clark’s rich history of diversity leadership has led him to his current position as a member of the ASHP’s Task Force on Racial Diversity, Equity, and Inclusion (DEI). His mentor, Joshua Blackwell, Pharm.D., clinical pharmacy manager, ambulatory services, at the University of Texas Southwestern Medical Center in Dallas, is excited to see what Clark will help achieve during his tenure on the ASHP DEI Task Force.

“When the call to action came from ASHP, Jeffrey immediately contacted me and expressed interest in serving as the student voice on the DEI Task Force,” said Dr. Blackwell. “I think one of Jeffrey’s greatest strengths is that he understands and listens to what other students around the country say their challenges and opportunities are within pharmacy schools. He wants to help them at every stage of their journey.”

Diverse Mentors, Leaders, and Students

Clark has reached impressive heights as a leader, but the path as a black male has come with some challenges. “I initially struggled to find a leader in pharmacy that I really connected with and felt comfortable telling my life story to, and I partly attribute that to not having someone who looks like me,” Clark said.

Although he eventually found leaders who supported and guided him, that lack of an early connection may have translated to some missed opportunities, he believes. “There are lots of opportunities available to pharmacy students, but you have to know about them and figure out where to put your time and effort,” Clark said. “If you don’t have a mentor to guide you, that can be difficult.”

Clark hopes to dedicate part of his time on the ASHP DEI Task Force to ensuring that other potential and current pharmacy students do not similarly miss out on opportunities. Promoting awareness to communities and schools that have historically been less of a focus for pharmacy schools is one way he believes this can be done. Sharing the stories and achievements of diverse members of the pharmacy community should also make students feel more comfortable and interested in getting involved with pharmacy organizations, Clark believes.

“People of color sometimes don’t feel like they stand a chance, and they don’t see how they’re going to find a mentor or some kind of connection to break through racial barriers,” he said. “We need to be proactive in seeking out people from diverse backgrounds and to communicate better with them to let them know, ‘Hey, you can do this!’”

Practitioner Diversity Improves Patient Care

Clark is a member of the ASHP Task Force on Racial Diversity, Equity, and Inclusion.

Clark believes that having practitioners that represent the mirror the diverse range of patient backgrounds – whether it is race, sex, or socioeconomic level – can help improve the quality of care that individuals receive.

For example, he recalls finding some patients from minority backgrounds reluctant to share information with the hospital rounding team during some of his patient rounds. While the sheer size of a large medical team may have intimidated them, “in some cases where the patient we treated was black, I noticed that when I went into the room alone, they would be much more open to talking,” Clark recalled. “There are some people that feel more comfortable talking to a person who is like them.”

For all the reasons that diversity is so important to him, Clark is excited about the changes he and his peers stand to make through ASHP’s DEI Task Force. “Diversity is already happening,” he said. “We’re working hand-in-hand with ASHP staff to make sure we find every opportunity to grow, and to develop policies and accountability systems that keep us expanding our diversity, not just once, but on an ongoing basis.”

By David Wild

 

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November 12, 2020

Tips for Students: Getting the Most Out of the 2020 Midyear Meeting

Marissa Chow, a fourth year Pharm.D. candidate at St. Louis College of Pharmacy

WITH SOME ADVANCE PLANNING AND PREPARATION, students will find this year’s virtual Midyear Clinical Meeting as enlightening and productive as the in-person meetings of previous years. The meeting is loaded with student programming, so attendees like Marissa Chow, a fourth year Pharm.D. candidate at St. Louis College of Pharmacy, are getting down to work preparing for a few jam-packed days of education, networking, and interviews.

“Since in-person meetings will most likely not happen due to safety concerns during the COVID-19 pandemic, it will be even more important to chat with the right people at this year’s Midyear,” said Chow.

Preparation is key

Her preparation includes looking through the ASHP Midyear’s student-specific programming, which will be offered both in on-demand and simu-live formats. Residency-focused student sessions will cover all aspects of residency applications and interviews, ranging from navigating the PhORCAS application system to understanding the Match Algorithm. Professional development student sessions will aim to help students of all classes explore post-graduate opportunities and personal success topics like branding and financial guidance.

As with every year, the ASHP virtual residency showcase will give students a chance to interact with residency programs, learn more about what they have to offer, and narrow down their options prior to applications. Additionally, the Personnel Placement Service (PPS), free to all fourth-year student registrants through advance sign up, will provide an opportunity for dedicated interviews and one-on-one time.

Chow said she is already researching programs that are participating in this year’s residency showcase and writing down criteria and questions ahead of time to help her evaluate programs.

Advice for first-timers

One piece of advice Chow had for students attending the Midyear for the first time is to map out where they want to go ahead of time and to read and learn about the virtual platform prior to the meeting, “so you aren’t scrambling to find the next item to attend and there are no technical errors.”

“And consider finding a “Midyear Buddy” to support each other for meetings, residency talks, and even PPS,” Chow said.

Elizabeth King, Pharm.D.

Students should also work with their preceptors and professors ahead of time to make sure they can dedicate time to the meeting, said Elizabeth King, Pharm.D., who graduated from pharmacy school in 2018 and is now a hematology/oncology pharmacist at Mayo Clinic, Rochester, Minnesota.

“When we attend in person, there is a natural separation from other responsibilities so we can focus on the meeting, but this may not be the case in the virtual setting,” Dr. King said.

Students should carve out a time and space with minimal distractions and dress as if they were attending the conference in person, “to get yourself in the right mindset,” she recommended. “And just like in person, you will need breaks so don’t be afraid to walk away from the screen,” she added.

Although the meeting is chock-full of student programming, Dr. King suggested attending at least one new practitioner session and one pharmacist session.

“If students have a clinical area they’re interested in, it’s a great idea to attend some of the clinical sessions on that topic to hear about how clinical practice is changing,” she said, noting that the virtual format means attendees can spend more time viewing posters and listening in on sessions and less time “shuttling between locations.”

Another reason to venture outside of student programming is to get a better sense of the faculty at an institution where one might apply for a residency, Dr. King said.

“You can get an idea of what the people you will be learning from are like and what their academic passions are, which also gives you talking points for interviews,” she said.

Dr. King recommended actively participating in sessions by asking questions. If there are private messaging options, contacting others to network can help you connect with people who have similar interests, she added. “Also make sure also to build up your profile on ASHP and PPS so that others can find you based on your interests and reach out to you,” Dr. King said.

Residency search

Younger students interested in learning about the residency process should attend the PhORCAS session to find out what programs are looking for in residency candidates, Dr. King said.

“Knowing this can help you set your priorities so that you end up getting to where you want to be academically,” Dr. King said. “The earlier you can start thinking about and preparing for residency, the better.”

For residency applicants, it’s a good idea to formulate a set of criteria that can help decide on a program and also to formulate questions tailored to that specific institution, Dr. King advised.

Nelly Adel, Pharm.D., BCOP, BCPS, supports her student during an ASHP Midyear meeting poster presentation.

“These questions can help you understand the culture of the institution, the educational offerings they have, or explore key non-negotiable items that you want in a residency,” she said.

As a residency recruiter herself, Nelly Adel, Pharm.D., BCOP, BCPS, chair of the department of pharmacy practice and associate professor in oncology, Touro College of Pharmacy, New York, appreciates when residency candidates distinguish themselves from others in the candidate pool.

“Ask questions that are not answered on the program’s website,” she recommended. “For example, I like to be asked about projects that I have worked on with students or residents and that have made a difference.”

Dr. Adel also recommended highlighting co- and extra-curricular activities and volunteer work. “I speak with 20-30 candidates a day and it’s sometimes hard to remember each one.  This can help to separate you from your peers,” she said.

Virtual etiquette

One thing Dr. Adel emphasized is to approach the Midyear with professionalism. “Even though the meeting is virtual, the same rules as in-person meetings hold,” she said. She encouraged students to wear professional attire, find a room without visual distractions in the background, smile when speaking to others or presenting a poster, and to not be “sitting or lounging at your bed.”

“There’s also no reason to be late for a meeting or a presentation, particularly when it’s virtual,” she said. “So become familiar with the platforms you’ll be using by playing around with them ahead of time. This could help avoid technical glitches and delays.”

Having attended and hosted numerous virtual meetings herself, Dr. Adel said student presenters and residency applicants should look straight into their computer’s camera rather than at the picture on the monitor.  “This helps you connect better with the person in front of you,” she said. Another technical consideration to keep in mind is the possible lag time during remote conversations, Dr. Adel added.

“Avoid interrupting the other person by waiting for the end of their sentence,” she said. “If you want to interject, find the right moment and know how to interrupt without being offensive. That holds true whether it’s a live or a virtual meeting.”

Despite the checklist of considerations that students should keep in mind prior to this year’s Midyear, Chow, the student pharmacist, is enthusiastic about the potential of the meeting.

“I’m excited to attend this year’s meeting!” she said. “Although this is not the traditional format or the format that most people would have wanted for the Midyear, as the pharmacy profession as a whole has shown, we are good at adapting to change.”

 

By David Wild

October 29, 2020

VA Clinical Pharmacy Practice Office and Pharmacy Residency Program Office Win ASHP Board of Directors’ Award of Excellence

Anthony Morreale, Pharm.D., M.B.A., BCPS, FASHP

WHEN ANTHONY MORREALE, PHARM.D., M.B.A., BCPS, FASHP, started working for the Veterans Health Administration (VA) in 1985, only a few pharmacists had advanced practice prescriptive authority in the ambulatory care setting, and the majority of their clinical practices were in hospital-based acute care. As the VA evolved into more of an ambulatory care-based system, the role of clinical pharmacists continued to expand.

Prescriptive Privileges

Now, a decade after the VA and Dr. Morreale launched a dedicated Clinical Pharmacy Practice Office (CPPO), the health system has a highly interactive, supportive infrastructure to engage pharmacy leadership, share best practices, and promote the role of clinical pharmacy specialists (CPSs) system-wide. Over 4,500 CPSs, about half of all pharmacists in the VA. have prescriptive privileges as part of their advanced practice roles managing patients in primary care, pain management, mental health, acute care, and antimicrobial stewardship.

It’s a primary reason why the VA Pharmacy Benefits Management CPPO and Pharmacy Residency Program Office (PRPO) were among two recipients of the 2020 ASHP Board of Directors’ Award of Excellence.

“The VA CPPO and PRPO developed and implemented comprehensive strategies to expand advanced clinical practice excellence and post-graduate pharmacy residency training,” ASHP said in a formal announcement. “These innovative efforts resulted in greater patient access to care, improved patient safety, identification and treatment of substance use disorders, and enhanced care coordination.”

According to Dr. Morreale, the CPPO work started in primary care with the VA’s system-wide adoption of the team-based care medical home model, which embraced pharmacists with prescriptive privileges playing key roles in those teams.

“That just happened to be a natural marriage that really helped expand the role of clinical pharmacy specialists in ambulatory care,” he said. “Having pharmacists embedded in all of those teams really launched a number of initiatives.”

Boot Camps for Pharmacists

The pharmacists initially helped manage patients with core diseases like diabetes and hypertension, said Dr. Morreale. Then the CPPO created clinical boot camps in different geographic regions to train primary care pharmacists on additional conditions they would encounter in ambulatory care, including osteoporosis and pain management, utilizing a train-the-trainer model where they would go back and teach their colleagues. In 2015-2016, with the approval of better drugs for hepatitis C, CPPO held national boot camps to train hundreds of pharmacists, who eventually managed over 30% of all hepatitis C patients, resulting in nearly 100% of those patients having a clinical cure from the disease.

More recently, CPPO, in conjunction with the Office of Rural Health, has held boot camps focused on expanded primary care, mental health, and pain management efforts to fill an identified gap in comprehensive medication management in the veteran population. In this project, over 180 CPSs were hired across 63 VA medical facilities focused on improving veterans’ access to comprehensive medication management in rural settings.

“The physicians really appreciate the comprehensive medication management support, because many of those disease states have either complex pharmacotherapy or require a lot of hand-holding of the patients, and they may not have the time or bandwidth to do it,” Dr. Morreale said.

Additionally, CPPO holds leadership trainings for pharmacy champions, conducts site visits with VA center leadership to promote the role of clinical pharmacists, and operates a coaching and mentoring program through which new clinicians and pharmacy leaders are paired with seasoned pharmacists. It’s been a multi-pronged approach to expanding roles for CPSs that was built one step at a time, said Dr. Morreale.

“We obviously don’t do all of this work to win an award—we’re doing it to do the right thing and take care of the Veterans,” he said. “But it’s always nice, after 10 years of hard work with some major successes, to have the recognition of ASHP and national attention to the program. Maybe as a result, there will be more programs that will start to implement the same type of strategies.”

Innovation in Residency Training

Lori Golterman, Pharm.D.

The VA also was recognized for its work in post-graduate pharmacy residency training. The VA operates the largest pharmacy residency program in the country, said Lori Golterman, Pharm.D., National Director of Residency Programs and Education for the PRPO, with some 272 residency program directors, and 628 residents and fellows. About 60% of residents are recruited into full-time positions with the VA when they complete training.

“We’re extremely innovative with our programs,” Dr. Golterman said. Residents have trained in a variety of areas including mental health, rural health, pain, neurology, and oncology. “We are the leaders in psychiatric training, with approximately 77 residents trained annually, as well as pain, neurology and other specialties such as ambulatory care. We were recognized with this award for our latest expansion of pain residencies. We are training 15 residents a year, and it continues to grow as former residents are eligible to become residency program directors.”

Besides monthly calls with residency program directors and residents, PRPO supports teaching and preparing for accreditation visits, responses to surveys, preceptor development, resilience, and much more, Dr. Golterman said. “PRPO supports its trainees throughout the year, with a variety of learning opportunities. The residency year starts with a project design and statistics course, a learning program for presenting articles and evaluating literature, quarterly leadership presentations, monthly conference calls, resilience training, and periodic surveys to check on well -being,” she explained.

The Federal Resident’s Council —a group of 25 residents that include VA and Indian Health Service residents (next year it will include the Department of Defense)—provides information to residents nationally through several committees such as a professional development committee; research committee; networking committee; and an IT committee. The Council works with the Residency Advisory Board to support issues like virtual interviewing and mentoring.

Promoting Resilience

The program also dedicates a lot of time to resilience. “We were among the first to identify stress, anxiety, and depression among

Virginia Torrise, Pharm.D.

residents and report it to ASHP,” Dr. Golterman said. PRPO brought in a psychologist to help with these issues and promoted using mental health resources offered through the VA’s employee assistance program. And, with the start of the COVID-19 pandemic, the residency program quickly adopted virtual training methods for situations where residents could not be on-site.

Dr. Golterman noted that receiving the ASHP Board of Directors’ Award of Excellence is a reflection on the entire team. Her residency advisory board has a combined 240 years’ experience in pharmacy. “They are the heartbeat of the program, and they spend a lot of their own time to support the residency program directors and preceptors and strive toward excellence,” she said.

Virginia Torrise, Pharm.D., deputy chief consultant of Pharmacy Benefits Management professional practice for the VA, added, “Drs. Morreale and Golterman have ensured that the VA has highly qualified, advanced pharmacist-practitioners serving our veteran patients on interdisciplinary teams to meet VA priority needs in primary care, mental health, and pain specialty.  Their work has ensured VA expanded clinical pharmacy telemedicine services to our Veterans who reside in rural health settings and addressed difficulties commuting to a VA clinic. I couldn’t be prouder of their leadership, foresight, and dedication to advancing residency training and clinical pharmacy practice in the VA.”

By Karen Blum

 

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April 30, 2020

ASHP Continues to Support Members and the Healthcare Community Through the COVID-19 Pandemic

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

THE COVID-19 PANDEMIC is changing our country’s healthcare landscape every day. Critical health policy changes are occurring at an unprecedented rate. We continue to engage with state and federal policymakers to ensure that pharmacists’ expertise is fully utilized and that healthcare providers are equipped to safely and effectively respond to the pandemic.

Update on States’ Response Efforts

State governors are issuing executive orders that expand pharmacists’ ability to provide high-quality care to patients during this crisis. For example, Michigan now permits pharmacists within licensed health facilities to contribute to routine health maintenance and manage chronic disease states without physician supervision. This expansion alleviates burdens on primary care providers and expands access to care, especially in rural and underserved communities where pharmacists are the most accessible healthcare professionals.

We are also seeing a positive trend in pharmacists’ ability to manage therapeutic interchange. In Iowa and Kentucky, executive orders grant pharmacists the authority to substitute medications in response to drug shortages.

Point-of-care testing for COVID-19 is critical to the national pandemic response. Some states already permitted pharmacists, under their scope of practice or through collaborative practice agreements, to order and administer these tests. Pennsylvania, which previously allowed pharmacists to order and administer tests, has taken emergency measures to grant pharmacists explicit authority to order and administer COVID-19 tests. States like Florida, Illinois, Kentucky, and, most recently New York, issued executive orders that permit pharmacists to order and administer COVID-19 tests. State-level COVID-19 response is a rapidly changing situation as local healthcare providers respond to patient surges and the demand for testing. Please check with your state’s board of pharmacy for more information about the status of COVID-19 testing in your area. Helpful information on COVID-19 testing can also be found on the National Community Pharmacists Association’s website.

ASHP applauds state governors’ efforts to expand pharmacists’ scope of practice during this state of emergency. However, we are concerned that authorizing the expansion of pharmacists’ services without authorizing payment for those services will limit the delivery of care in some pharmacy practice settings. COVID-19 is already highlighting shortcomings in state Medicaid payment systems and commercial payer policies that prevent qualified pharmacists from fully serving patients. ASHP is working closely with our state affiliates and other organizations to request reimbursement for the new services they are providing under the state of emergency. This advocacy aligns with ASHP’s Pharmacy Readiness for Coronavirus Disease 2019 (COVID-19) Recommendations for State Policymakers. The recommendations address shortages of drugs and medical supplies and reimbursement of pharmacists for patient care services and also provide readiness and resilience resources for clinicians.

Pharmacists are Essential Healthcare Personnel

ASHP continues to voice our support for all pharmacists who are working tirelessly across the continuum of care in response to the COVID-19 pandemic. Yesterday, I sent a letter to the chief executive officer of Novo Nordisk responding to a full-page NovoCare ad that ran last weekend in the Wall Street Journal and other publications. Pharmacists were omitted from a list of individuals, including nurses, doctors, researchers, and other essential workers who were acknowledged for their caring efforts on the front lines of the COVID-19 response.

In the letter, I reinforced that pharmacists are highly skilled, licensed healthcare professionals who play a key role in selecting and optimizing medication therapy for patients. Pharmacists also oversee the entire medication-use process in hospitals and health systems, including the purchasing, distribution, preparation, and administration of pharmaceuticals. I further explained that, as members of interprofessional healthcare teams, pharmacists are providing a broad range of patient care services during the COVID-19 public health emergency, from directly caring for mechanically ventilated patients in critical care settings, to providing point-of-care testing and medication management to patients in community pharmacy settings and beyond.

It is my hope that Novo Nordisk will appropriately recognize pharmacists and the important role they play in future communications.

ASHP’s Response to Disruptions in Residency Training

In last week’s blog, I discussed the COVID-19 pandemic’s impact on residency training. As a result of disruptions in routine or elective procedures and reductions in inpatient hospital stays, some hospitals and health systems are facing the difficult situation of furloughing their PGY1 and PGY2 pharmacy residents. These actions can disrupt patient care and make residents ineligible for board certification and professional positions that require postgraduate pharmacy residency training. We believe that educating future generations of pharmacists is more critical than ever, and ASHP has issued a statement opposing the furlough of residents.

As always, ASHP is here to support residents and residency programs. If you need assistance with a furlough situation, please reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services.

ASHP is Here for You and the Entire Healthcare Community

Over the past several weeks, I have been sharing information about new and timely resources that ASHP has developed and made available to optimize medication use and patient outcomes during this public health emergency. The response to these offerings, which is captured in a new ASHP infographic, has been tremendous. We are immensely proud of our staff and volunteers who have been working tirelessly to deliver highly relevant information across multiple channels. Our COVID-19 Resource Center is updated regularly with new content and I hope you continue to find the tools and information produced by ASHP valuable as needs related to the pandemic response evolve.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

April 9, 2020

Important Wins on the Advocacy Front in the Fight Against COVID-19

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

AS THE IMPACT OF THE COVID-19 PANDEMIC CONTINUES TO ESCALATE ACROSS THE COUNTRY, there is increased urgency to ensure that frontline pharmacists, pharmacy technicians, and our healthcare partners have the medications and equipment they need to successfully treat their patients. ASHP continues to spearhead multiple advocacy efforts that support your ability to provide the best care possible for those in need.

Mitigating shortages of critical medications like propofol, fentanyl, midazolam, paralytics, and others remains a high priority. We continue to engage with relevant federal agencies to improve access to medications. I am pleased to report that the Drug Enforcement Administration (DEA) and the Food and Drug Administration (FDA) have taken critical actions in direct response to ASHP’s advocacy efforts.

ASHP, in coordination with the American Medical Association, the American Hospital Association, the Association for Clinical Oncology, and the American Society of Anesthesiologists, sent a letter last week to the DEA requesting an immediate increase in the annual production quota allocations for Schedule II controlled substances. This would enable manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to the care of COVID-19 patients on ventilators. As a direct result of this collaborative advocacy effort, the DEA announced yesterday that it is taking immediate actions to address this critical issue. These actions include increasing the annual production quota for controlled substances, including fentanyl, morphine, and hydromorphone, that are used for the treatment of mechanically ventilated COVID-19 patients, and increasing the amount of ketamine, diazepam, and other controlled substances that can be imported into the United States.

We also sent a letter to the FDA advocating for regulatory flexibility in compounding drugs in shortage and compounding in hospitals. ASHP’s advocacy efforts, including significant staff engagement on the issue, directly triggered the FDA to clarify existing compounding guidance, including the removal of the one-mile radius requirement for hospitals compounding medications. FDA’s quick action to reduce regulatory hurdles for health systems is an important step to help clarify compounding guidance during this crisis.

ASHP will continue to advocate for additional compounding flexibility, including the expansion of FDA’s drug shortage list to include products ASHP has identified as in shortage. We will also continue to seek 503B outsourcing facility flexibility, particularly for hospital-owned or affiliated 503B operations, to help ensure they can meet hospitals’ medication needs.

Yesterday, we were pleased to see that the Department of Health and Human Services (HHS) authorized pharmacists to order and administer COVID-19 tests pursuant to the Public Readiness and Emergency Preparedness (PREP) Act. The authorization is responsive to the joint COVID-19 recommendations we created with other national organizations. While this authorization does not address pharmacist reimbursement, we are encouraged to see HHS providing pharmacists with a greater role in supporting the COVID-19 response, and we continue to work on that issue.

We also continue to actively advocate for Congress to recognize pharmacists as providers in the Medicare program to further support the COVID-19 response and beyond. Yesterday, ASHP and 11 other national organizations sent a letter requesting that Congress immediately support legislation that would establish pharmacists as providers in Medicare Part B on an emergency basis to provide COVID-19 and flu testing. This authority is an important step in being able to rapidly expand access to testing across our country to support the national response to this crisis. We also see this as a step toward expanded recognition of pharmacists by payers, including Medicare.

Finally, ASHP is also working with our members and other stakeholders to gain access to medications from the Strategic National Stockpile (SNS). Most recently, we joined with several organizations to request that FEMA immediately release all available quantities of a number of critical drugs from the SNS to the New York and New Jersey Departments of Health to address urgent patient care needs. We are also working to support other state affiliates and members across the country with these important requests.

ASHP and its government relations team will continue to work tirelessly with our collaborating partners to ensure that U.S. regulatory authorities are responding to the current needs of pharmacists and healthcare providers.

While our collective attention is on the needs of frontline practitioners, I wanted to take an opportunity to highlight some positive news about the newest members of our profession. ASHP’s 2020 Residency Match concluded this week, and I want to congratulate the 5,269 future pharmacists who matched with 2,551 PGY1 and PGY2 pharmacy residency programs across the country. This number represents a 46% increase in the number of available positions over the past five years – a remarkable rate of growth. I am pleased that our accredited residency programs have demonstrated an outstanding commitment to training during the pandemic. While managing multiple critical priorities, these programs continued to interview applicants virtually. This undoubtedly will be a unique time during which to begin a residency program regardless of its focus. ASHP is committed to ensuring that these young practitioners and their programs have the needed resources to successfully conduct critically important resident training this year and beyond.

In the same vein, please know that ASHP stands ready to offer you and your healthcare colleagues that same level of steadfast support. In addition to advocating to give you access to critical medications, ASHP continues to update and create new resources and tools that can be found on our COVID-19 Resource Center. We have also opened access to many evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community.

Over the last few weeks, I have heard countless stories from members and others about the challenges they are facing, but I’ve also heard many stories of hope and heroism. I, and David Chen, ASHP assistant vice president for Pharmacy Leadership and Planning, have listened in on calls from pharmacy leaders at major health systems in New York City, the pandemic’s current epicenter. We are incredibly impressed by how these leaders have shared their information and experiences and how they support each other and their frontline staff. This is a tremendous example of how peer-to-peer connection and communication can aid in the pandemic response. Their experiences and willingness to share their stories will undoubtedly help others in responding to COVID-19 in facilities across the country. We applaud them for these efforts.

Please also know that ASHP is here to support your well-being, which should remain a priority for all healthcare personnel during this challenging time. Please make sure that you are taking care of yourself and your family.

“ASHP has our backs.” These are the words of a member who recently reached out to us. This really resonated with me, and I can assure you that we will continue to work across all fronts, leveraging our talented staff, our valued partners, and our amazing members to provide you with the information, connections, and resources you need today and in the future.

Thank you for everything you do for your patients and the profession.

Sincerely,

Paul

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