MTM specialist expands services at progressive pharmacy with old-fashioned feel
Barney’s Pharmacy in Augusta, GA, bustles on a Wednesday afternoon in October. Behind the counter, some 10 pharmacists and 15 techs fill prescriptions, take calls, and talk to patients with whom they seem to share a personal connection. Some customers make a beeline across the spacious store to the medical supplies department or to the chair aerobics class in the wellness room. Bassy dance music—the soundtrack to the exercise class—can be heard faintly in the retail shop. There, patients wait for prescriptions in a small seating area under a framed poster-sized copy of an article from the New York Times.
It was this August 2010 article that brought Andy Hochradel, PharmD, to Barney’s. He was a student at the University of Toledo (UT) College of Pharmacy and Pharmaceutical Sciences when he read about the small-town, independent pharmacy over 700 miles away. The article described an “old-fashioned neighborhood drugstore” that offered cutting-edge services, including medication therapy management (MTM) and a full roster of wellness classes and support groups for patients.
Hochradel took advantage of a UT option to create a new Advanced Pharmacy Practice Experience site and set up a rotation at Barney’s.
“I took it upon myself to set up my own unique experience,” Hochradel told Pharmacy Today. After making arrangements with Barney’s owner Barry Bryant, Hochradel became the first UT student to do a rotation at Barney’s in 2011. Not only did he learn about the day to day of a community pharmacy on this rotation, but he also learned that he wanted to work at Barney’s one day and eventually own an independent community pharmacy himself.
Six months later, after graduating from pharmacy school, Hochradel returned to Barney’s, where he is now the Director of Specialty Pharmacy.
For a pharmacist who marches to the beat of his own drum, Hochradel came to the right place.
“Here, we all specialize or pick something that we’re passionate about. I knew that if I were passionate about something, Barry would be willing to turn me loose—as opposed to implementing the master plan until you work your way up the corporate structure,” Hochradel said.
Hochradel’s passion is for patient care programs, including MTM, that reimburse the pharmacy beyond dispensing. He develops these programs alongside a large staff of pharmacists, techs, student pharmacists, and residents who also enjoy an environment where they can cultivate their own innovative ideas.
Andy Hochradel, PharmD, provides services such as vaccinations and blood pressure and blood glucose screenings, and teaches student pharmacists.
Pharmacy beyond dispensing
When Hochradel came to work full-time at Barney’s flagship store in Augusta, it was the only one of Barney’s seven locations that offered MTM services. The newbie saw an opportunity both to expand the program and to harness the enthusiasm of students.
Hochradel had taken an MTM class during pharmacy school, which set him apart from many of his peers, so he took ownership of Barney’s MTM program. After expanding the Mirixa and OutcomesMTM platforms to all seven of Barney’s locations, Hochradel devised an MTM class to add to the classes that students take while on rotation at the store.
“When I teach, I explain that we’ve been practicing MTM all along. Call it disease state management, call it a unique service, but as a profession, we all do it,” he said.
Hochradel feels that the lack of consistent use of MTM terminology perpetuates other health care providers’ and patients’ failure to understand what pharmacists can do. Terminology is a major focus of his class.
“I want them to understand that the more unified our voice, the better the growth of MTM and the better their chance of practicing it.”
Before coming to class, the students complete an OutcomesMTM online training and learn terms such as comprehensive medication review, personal medication record, and medication-related action plan.
“We learned the system and the software, and then Andy broke down all the ways we can serve patients through MTM,” said Carlie Traylor, a University of Georgia student pharmacist on rotation at Barney’s. “We don’t know about MTM from our studies. This is our only community pharmacy rotation where we could learn about it.”
Hochradel also hopes that pharmacists will unify their voice to dispel the idea that MTM is solely about saving money.
“We need to overcome the barrier that we’re all about cost savings. What we do is efficacious, not just cost savings,” he said.
Hochradel has expanded disease state management at Barney’s far beyond common chronic diseases. He recently launched specialty services for stem cell transplant patients.
“What’s unique about stem cell transplant is that the donor also requires medication in the process,” Hochradel said. “Typically, a colony-stimulating factor such as filgrastim is administered prior to the transplant to stimulate stem cell growth. This needs to be billed on the recipient’s insurance, and we coordinate that.”
Medication management for stem cell transplant doesn’t stop there. Hochradel enjoys his work because he gets to accompany patients from diagnosis through completion of their treatment.
“The nurses and physicians see me as part of the transplant team, and I know the patient does,” he said. “You’re holding their hand from A to Z, not just W, L, or whenever the pharmacy pops into the A-to-Z process.”
As Hochradel identifies patients with other conditions that bring unique needs—whether medical or administrative—he learns about the treatment process, streamlines the services and coordination that Barney’s can provide, and then alerts health care providers in the community of those services.
The pursuit of personal passions
While Hochradel expands the pharmacy’s specialty services to address more conditions, his colleagues are hard at work on their own projects.
Some of the wellness classes on offer at Barney’s, including Sweet Spot for patients with diabetes and Healthy Heart Club, were created by staff pharmacist David Pope, PharmD. Through Creative Pharmacist, the company he founded with Bryant, Pope licenses the curricula for these classes to other independent pharmacies.
“Creative Pharmacist makes the business case for implementing clinical programs in your pharmacy,” Hochradel said. “If someone asked me how to start a wellness class and wasn’t sure how to get started, I’d look at Creative Pharmacist.”
Pope’s Sweet Spot diabetes education class is full on the Wednesday afternoon a week before Halloween. Cara Jones Dantzler, PharmD, leads the class in a discussion about the three-legged stool of diabetes management: diet, exercise, and medication. The 17 participants fill in blanks on a worksheet with the information that comes up in the slides.
Before class, Traylor, the University of Georgia student pharmacist, distributes healthy snacks. Today, class participants enjoy a Halloween-themed, candy corn–colored fruit salad and trail mix. The trail mix, served in single-serving bags, comes with nutrition information, including carb count.
Hochradel greets a loyal Barney’s patient before counseling him.
This is not Traylor’s first encounter with Sweet Spot. The pharmacy where she worked in rural south Georgia, 5 hours from Augusta, began to offer Sweet Spot classes after the pharmacist learned about the program at a meeting of the Georgia Pharmacy Association.
“I wanted to bring the class with me to my rotation here at Barney’s. Then I found out it came from here,” Traylor said. “That just shows how one community pharmacy can make an impact outside of their community.”
Upon arriving in Augusta for her rotation, Traylor partnered with pharmacist Jake Galdo, PharmD, BCPS, Clinical Pharmacy Educator at Barney’s, to create Sweeties, a support group for kids with type 1 diabetes.
Pharmacy techs pursue their own interests at Barney’s, too. Emily Harrison is a technician and Barney’s long-term care department leader, as well as a personal trainer and aerobics teacher. She runs the chair aerobics classes at Barney’s, and like the Sweet Spot program, Harrison gets a full house.
Progressive pharmacy with an old-fashioned feel
The innovative ideas of the team at Barney’s culminate in departments and programs that aim to address all the needs of patients, not just their needs for prescription drugs.
“Filling prescriptions is the least of what we do,” said store owner Bryant. In addition to the community pharmacy and wellness classes, Barney’s runs a compounding pharmacy, a long-term care pharmacy, a medical supply department, an ostomy department, and Hochradel’s comprehensive specialty services. Bryant also owns a home medical equipment shop, Medequip, that’s housed under the same roof. He rents a portion of the 26,000-square-foot building to independently operated Med Now urgent care.
Barney’s fills 1,000 prescriptions per day, while offering patients numerous resources in the process. The classes and support groups are free, even to people who don’t get their prescriptions filled at the pharmacy.
“We ultimately win most of them over,” Bryant said.
Barney’s progressive philosophy may seem to strike a sharp contrast to the community pharmacy’s old-fashioned feel. But for Hochradel, Barney’s is just letting pharmacists get back to what they always did best: care for patients.
Patients notice the difference
In the waiting area, in front of the giant New York Times story, Dewayna Jacobs banters with Hochradel, who knows her by name, while she waits for her prescription. Jacobs drives 20 minutes from home—passing several national chains on her way—to go to Barney’s. She says she would be lost without Barney’s ostomy support group. And she appreciates when pharmacists call to check on her if she’s late picking up a prescription.
“It’s worth the drive. It’s a hometown pharmacy with big-time service,” Jacobs said. “I wouldn’t go anywhere else.”
Hochradel stands in front of Barney’s with owner and president Barry Bryant.