Texas Pharmacy Today 4-4-14 - Texas Pharmacy Association

State of Healthcare in Texas
Shannon Jones III, Deputy Director of Austin/Travis County Health and Human Services kicked off the 2014 TPA Leadership Symposium with the "State of

Healthcare in Texas."

Jones launched his session by defining public health: The activities that ensure conditions in which people can be healthy. These activities include community wide efforts to identify, prevent, and combat threats to the health of the public, and pointed out that public health efforts have increased the average life span by nearly 30 years during the past century.

He went on to list the 10 Essential Services & three Core Competencies of Public Health, as follows.

Essential Services: Monitor Health; Diagnose and Investigate; Inform, Educate, and Empower; Mobilize Community Partnerships; Develop Policies; Enforce Laws; Link to Provide Care; Assure Competent Workforce; Evaluate; and Research.

Much of the session focused on an overview of the governing authority healthcare provision process & methods in Houston, Dallas and Austin, with a more in-depth look at Travis County, and how these areas implement programs for county indigent healthcare.

Zooming in on Travis County, Jones said that, " Central Health and Seton Healthcare Family entered into an agreement last year to develop an integrated delivery system focused on improving quality of care and patient experience and reducing cost. This effort will knit together a previously fragmented array of services into a unified system that provides consistent, high quality care, supports patients in connecting to the right level of care and uses data to continuously improve the system of care. As system savings are achieved by increasing efficiencies and reducing cost, these savings will be used to expand care to more people." He added that, "Central Health is working closely with University of Texas on the development of the new medical school which will be an important partner in expanding care and bringing innovation to healthcare."

In closing, Jones said that groups like TPA are very important to "inform, educate, and empower" in their efforts to advocate for healthcare professionals. "The role of public health is to engage pharmacists and other healthcare providers," he said. "I encourage TPA to play a role in the health arena and to educate the public."

Preparing Pharmacists for an Expanding Role in Healthcare
Panelists Dr. Ed Stemley, Dean, Texas Southern University College of Pharmacy and Health Sciences; Dr. Lamar Pritchard, Dean, University of Houston College of Pharmacy; and Dr. Myron Jacobson, Dean, University of North Texas College of Pharmacy helped shed light on what future pharmacists should expect.

Responding to TPA President Carole Hardin Oliver's opening question, "What do you envision in pharmacy's future?," Stemley told attendees that we need to prepare our graduates to go out and manage all sides of the profession in regards to the health management arena.

A key theme from all three deans was that pharmacists should be part of a healthcare team which can help prevent diseases, rather than treat existing ones.

"Pharmacy plays a crucial role in making healthcare better, and pharmacists need to become players on the healthcare team, working together with different members of the team to coordinate healthcare, and to give people better access to healthcare," said Jacobson.

Pritchard followed with a call to action: "We have to make sure that our student leaving our hallowed halls remember that the patient is the most important aspect of healthcare. I want to see more pharmacists talking to patients. We cannot maintain our current state of healthcare in terms of expenditure. We need to be leaders. We need to train our students to be agents of change. But what an opportunity for pharmacists! Seventy-five percent of healthcare expenditures are for chronic diseases, most of which are preventable. But we are doing very little to prevent them. We can't just throw pharmaceuticals over the counter and expect good things to happen. It's our responsibility to make sure good things happen."

Future Leaders
In addressing student pharmacists, Stemley said, "We want to graduate students who are practice-ready. And we want them to be leaders in the practice. There's a huge gap in leadership, and we want to address that area.

The Evolving Role of Pharmacy Technicians: Are You Prepared for Change?
Panelists Gay Dodson, R.Ph., Executive Director, Texas State Board of Pharmacy; Brad Miller, CPhT, TSBP Board Member; Kim Stengel, CPhT, TPA Board Member; and Lisa McCartney, AAS, CPhT, Department Chair, Austin Community College talked about how pharmacy technicians should prepare for the future.

Dodson opened up with recommendations from TSBP, echoing some of the same ideas as the Deans Panel presentation. Recommendations included that pharmacists must become participating members of the healthcare team and work collaboratively with physicians and others to provide total care to the patient. This process is currently occurring in Texas in that many pharmacists provide expanded patient care services such as drug therapy management, administration of immunizations, disease state management, disease screening, and health promotion and disease prevention.

"TSBP must ensure that the training of pharmacy technicians supports the scope of services that they are expected to perform. TSBP expects to establish a training program that the technician must complete prior to completing expanded duties."

–pharmacist on duty allows the technician to perform the expanded duties while that pharmacist is working.

McCartney stated that driving change for pharmacy technicians is a national issue, and that we should be looking toward advanced roles for pharmacy technicians. She went on to point out that studies have proven that pharmacy technicians have high level of accuracy in the filling process, but that techs need education and training to perform their duties.

In wrapping things up, Stengel outlined factors pharmacy techs should consider when choosing training/education:

In addressing how techs can prepare themselves for the future of pharmacy practice, she suggested that, "For some of you it may be a broad goal – get an AAS degree or graduate from an ASHP accredited training program; for others it may be more general – learn more about hospital/retail/oncology pharmacy etc.; for others it may be very specific – get an advanced specialty certification in sterile compounding and aseptic technique."

Around Texas

Diabetes Care Training Program Offered in Dallas (May 15th)
The Pharmacist and Patient-Centered Diabetes Care Certificate Training Program is a newly revised, practice-based activity designed to equip pharmacists with the knowledge, skills, and confidence needed to provide effective, evidence-based diabetes care. Five self-study modules provide comprehensive instruction in current diabetes concepts and standards of care. The live seminar incorporates case studies and hands-on skills training focused on the situations most likely to be encountered—as well as the services most needed—in community and ambulatory care practice settings. Participants will gain experience evaluating and adjusting drug therapy regimens for patients with type 1 and type 2 diabetes, counseling patients about lifestyle interventions, analyzing and interpreting self-monitoring of blood glucose results, and assessing the overall health status of patients to identify needed monitoring and interventions. For more information click here.

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Association News

Nario Cantu Joins TPA Board as Treasurer-Elect
A big thanks to John TPA Treasurer-Elect John P. Calvillo of Life Check Drugs for serving on TPA's Board. Calvillo is leaving his post and Nario R. Cantu of Cantu's Pharmacy will serve as Treasurer Elect for the balance of John's term

Member Perspective, featuring Lydia L. Aguilera Pharm.D., University of Texas – Pan American/University of Texas at Austin College of Pharmacy
Long before Lydia L. Aguilera became a pharmacist, she had several mentors in

her South Texas community. Local pharmacists B.L. Garza, who owned Garza Pharmacy, and Manuel Ruiz of Edinburg Pharmacy served as role models, inspiring a young Aguilera to pursue a similar career path.

"My family did business at both pharmacies, and I saw what a difference

community pharmacists make in people’s lives,” says Aguilera. "It’s not just about providing medication, it’s about advice and resources for folks when they get their prescriptions filled. What I really liked was the rapport with the patients. Unlike a mail-order pharmacy, you build relationships. The human touch is important—sometimes people just need to talk with someone and that’s therapy too.

Aguilera went to University of Houston, and she did what was called an "externship” with Edinburg Pharmacy after her freshman year, gaining valuable early practice experience.

After graduating from the University of Houston, Aguilera worked in a hospital for a while, and later worked for Walmart for 14 years. After leaving Walmart, she went to work for Med-Aid in Edinburg, and in 1999, following their model of having a pharmacy next to a clinic, she opened Mom’s Pharmacy, which was connected to a pediatric clinic.

"Operating Mom’s Pharmacy from 1999-2012 were wonderful years,” says Aguilera, who has two daughters that are pharmacists and a son in medical school.

"It was scary opening my own store, but two months later I was in the black. It was great being my own boss, making my own decisions, and getting to know my own customers. It’s what pharmacists dream about—building a rapport and treating your customers like your own family.”

Aguilera had earned a bachelors in Pharmacy in 1980, and in 2000 requirements changed so that new pharmacists entering the profession had to have a Pharm.D. As an existing pharmacist, Aguilera did not need to, but in 2005, she decided wanted to earn a Pharm.D.

Career Change
"As part of the curriculum, I had to give some lectures,” says Aguilera. "So I contacted the UT Pan American Cooperative Pharmacy program in Edinburg and started lecturing. I loved it, and liked the interaction with the students. When a position opened, I thought about it long and hard, and applied. I had two pharmacies open, and my husband thought I was crazy to go to academia.”

Aguilera got the job, and now serves as Assistant Dean for the University of Texas at Austin College of Pharmacy, and Director for UT Pan American Cooperative Pharmacy program.

"When I came to teach in 2009, I saw so many students who were like I had been, but did not have a role model,” says Aguilera. "So that’s one thing that motivates me to teach pharmacy students and train them. It’s a challenging job—there’s a lot of interaction, and I feel a need to advocate and be a voice for students who do not have one.

When Managed Care rolled out, Aguilera realized that the business model for Mom’s Pharmacy would not be sustainable.

"I did primarily pediatrics, and my customer base was 90% Medicaid, and the reimbursements were cut drastically,” says Aguilera. "We actually lost money on some prescriptions. I closed Mom’s Pharmacy in 2012. It was a hard decision.”

Continuing Role
Aguilera served on TPA’s board of directors in 2013, and is currently on the Texas Pharmacy Foundation committee.

"I’m an advocate for the entire pharmacy industry—every facet and career is important to me, whether it’s community pharmacies, hospitals, or chains. We really need to get healthcare provider status! We need to learn all we can and talk to our legislators to ensure healthcare provide status. It’s a win-win situation. We need more providers, and pharmacists are the most accessible healthcare providers. Collaboration is the key.”