Finding a dream job in patient-centered practice

Allen works on creating an ideal pharmacy practice at Hy-Vee

As spring comes to an end and colleges of pharmacy across the country induct another class of graduates as new practitioners, hundreds of newly accredited pharmacists enter the workforce, searching for the right fit. Jane K. Allen, PharmD, MBA, found what she calls her “dream job” after she graduated in May 2012, but her ultimate goal is to make sure that every pharmacist can practice to the fullest extent of his or her license.

As a Medication Therapy Management (MTM) Pharmacist with Hy-Vee in Des Moines, IA, Allen has created a unique practice, working with 19 community pharmacies across the area to provide a higher level of patient care. Within the first 5 months, this program has yielded 738 MTM claims with an estimated cost-avoidance of $498,534, showing the true value that pharmacists can have in the community.

Comprehensive care requires teamwork

As an MTM pharmacist, Allen’s days are rarely the same. Much of her day is dedicated to performing and documenting comprehensive medication reviews, broken into 1-hour segments per patient. She conducts patient and provider follow-up within 7 days, in order to address any changes made and allow for patient questions and further interventions, such as education or additional changes in drug therapy.

Just 5 months after the practice launched, 717 Medicare and dual-eligible patients have been identified through OutcomesMTM, a Des Moines–based company that provides billing and support for MTM programs across the country. With the help of OutcomesMTM, Mirixa, and Iowa Medicaid Pharmaceutical Case Management, Allen has continued to pinpoint other eligible patient groups in the area. Once these patients are identified, Allen and her Hy-Vee pharmacist colleagues contact them and refer interested patients to the MTM service.

Since Allen spends only 1 day a month at each of the 19 Des Moines–area Hy-Vee stores, she relies heavily on the staff at individual locations to gauge interest in the program and spread the word to patients and dietitians. “I could not be doing this without having all the pharmacies working as a team with me,” Allen told Pharmacy Today. “Without them continuing to work hard and continuing to teach patients about what we can offer and what the MTM services of Hy-Vee can offer, we would not be as far as we are today.”

Creating her dream job

Allen’s passion for MTM services began when she was a student pharmacist at Drake University College of Pharmacy and Health Sciences in Des Moines. Like many schools of pharmacy, Drake offers dual-degree program options. Seizing this opportunity, Allen completed an MBA at the same time as her PharmD, giving her the tools to think beyond the traditional role of a pharmacist and create an innovative pharmacy practice.

As an MBA student, Allen created a business plan, marketing plan, and SWOT (strengths, weaknesses, opportunities, threats) analysis for what she envisioned as her “dream job.” After graduation, she presented her proposal to Hy-Vee leadership. “Hy-Vee’s mission is to make lives ‘easier, healthier, and happier,’ and MTM services really aligned with that statement,” she remarked. “Without encouragement from pharmacists at my [internship] site as a student pharmacist and my district pharmacy supervisor who believed in what I could do, I would not have this position. There was a lot of faith put in me from people I worked with.”

Allen’s inspiration for this MTM-focused concept came from her time as a student pharmacist intern for Hy-Vee, which exposed her to practitioners working with patients on an individual basis. She attributed her comfort with providing MTM services to the mentorship and didactic and experiential education she received, adding that she has learned more as a practitioner than she had ever imagined.

“It’s been an absolutely amazing experience and I wouldn’t trade it for anything in the world,” Allen told Today. “I think in these past 5 months, I’ve learned more about pharmacy and about myself and what I can really do.”

The importance of education

Allen noted that her biggest challenge in starting the MTM program at Hy-Vee was addressing education gaps among pharmacy staff at the different locations. Many pharmacists wanted to get involved in providing MTM but did not know billing processes or specific billable activities, and many pharmacy technicians and support staff needed more MTM education.

Hy-Vee addressed these gaps with MTM classes in which Allen informed pharmacy staff about existing opportunities for providing MTM services, how to use billing platforms, and ways to approach patients about the new services. Through these classes, Allen built the pharmacists’ confidence by teaching them that they were already providing many MTM services by addressing cost issues, adverse effects, and other patient and prescriber concerns.

Allen said that student pharmacists from Drake University who work at many of the area Hy-Vee locations come prepared to provide MTM services because of their hands-on experience with performing, documenting, and billing for MTM. Pharmacy technicians and staff feel like they have ownership of their positions, Allen added. 

“I tell all the technicians that I work with that they can be that MTM point person and drive MTM services at their store,” Allen said. “They’re in the position to really drive MTM services forward.”

Lessons learned

For pharmacists getting new MTM programs off the ground, Allen said that persistence and organization are key, noting that a system for billing and documentation is essential for the latter. 

“Identifying one person, whether it’s a pharmacist, a technician, or a student pharmacist, to be the point person at each store can relieve stress on the rest of the staff to keep track of patient concerns,” she said. Allen also encouraged pharmacists to ask for help, especially on billing issues, and find local mentors for encouragement, support, and guidance.

As a new practitioner herself, Allen tells students to pursue the job they want. “Just find what you’re passionate about, and you never know what kind of opportunity will arise—and when you least expect it,” she said. She recommended that students and practitioners alike stay up to date on the changing field of pharmacy, particularly on increasing opportunities within the profession, and continue involvement in local and national professional associations.

Allen also wants to educate and inspire others within the profession to seize existing opportunities in pharmacy practice. Amy Wadstrom, BSPharm, Hy-Vee Pharmacy Supervisor, who has been integral to launching the MTM, told Today, “Part of having a successful MTM program is having the right person in that position. Jane is definitely that person for Hy-Vee. She is motivated and always looking for a way to expand her role with Hy-Vee and her role in her patients’ lives.”

Looking forward

Allen’s greatest hope is a self-sustaining patient care service. “I hope that we are able to create that patient-centered service in order to improve the lives of patients by addressing their medication therapy, increasing adherence through education, and providing cost-effective therapies to improve overall health care outcomes,” she explained.

The next step toward such a broader role includes a referral-based system and more specialized services for patients with diabetes, including participation in Iowa’s state-certified diabetes education program and American Association for Diabetes Educators (AADE) accreditation. Allen believes that the positive patient reaction thus far is a good omen for future success.

“I see so much growth that can occur,” Allen told Today. “I feel like we’re just slowly chipping away at what can be, and it’s just a matter of continuing to keep going every day and continuing to be persistent. … By the end, [patients] … say, ‘This was great, I’m so glad that I came in!’”