A Game Changing Year! Building Teams and Game Plans for Our Future

Opening General Session
Jenelle L. Sobotka 2012–2013 APhA President


Los Angeles, California

A Game Changing Year! 
“Building Teams and Game Plans for Our Future”


Good morning!  Look at all of you—what an awesome “pharmacy team”!  Yes, I’m delighted to be a member of APhA and our profession’s team.  It has been my honor to serve as your president this past year, and I am excited to share our highlights and accomplishments.  I am even more excited to say our team—the Association and the profession—are in great condition and getting better every day.

My year as president has been amazing—with personal adventure and professional rewards.  I’ve had some really incredible experiences representing APhA as your president, traveling around the country with stops in California, South Carolina, Texas, and Minnesota, and many other places where pharmacists are making patients’ lives better.  I even represented the Association at the International Pharmaceutical Federation (FIP) in Amsterdam.  But all of these travels away from home and work wouldn’t have been possible without lots of support.  I have many people to thank for supporting me; my family, friends and faculty colleagues at Ohio Northern University. Thank you all for making this year possible in my life"

“Game Changing Time” Due to Health Care Reform

Last year in my remarks, I discussed changes that are adding up to the tipping point that will be a game change in our profession.  I shared a list of five reasons why we have arrived at the tipping point for broad implementation of patient care across our profession.  First, there has been significant change in the public’s perceptions and expectations of their pharmacists.  Second, health care decision makers have recognized that quality care delivery will be achieved through a team-based approach and are increasingly recognizing pharmacists as key members of the health care team.  Third, our country has agreed that health care delivery system reform is needed.  The result is a new era of embracing innovative approaches to health care delivery, often including pharmacists in new patient care roles.  Fourth, the drive to reform our health care system is focused on increased quality and decreased costs; both are areas where pharmacists can deliver.  Fifth and finally, the end of the pharmacist shortage will have an effect on pharmacists finding unique new roles in the health care system.  

Who remembers basketball before the 3-point shot?  It was a different game then.  Lots of play occurred inside the paint, near the basket—and tall players and short hook shots were a large part of the game.  Adding the 3-point shot brought out a long game—allowing shorter players with a precise 3-point shot to play key roles in the game, and allowing large leads to swing to the other team quickly with just a few successful 3-point shots.  That simple new rule changed the overall play of the game.

Health care reform changed the game of health care delivery.  New models of care—including patient-centered medical homes and accountable care organizations—are reframing the delivery of health care in our country.  And pharmacists—with expertise in appropriate medication use that results in positive outcomes and quality while keeping overall medical costs down—are positioned to be significant game changers in these new systems.  Tapping pharmacists’ talent in ways as never before will add new elements that change the game in health care delivery.

Attributes of a Strong Team

Every coach knows that it takes ongoing effort and attention to build and maintain a great team.  Each of us contributes effort and attention to multiple teams: APhA’s team, our profession’s team, and our patients’ team every day.  As we build and strengthen our TEAMs for our future legacy in patient care, here are some attributes I believe are important for success:

T for trust, together, transparency—
         Team members trust each other, work together, and are open and transparent with their communications and actions.

Our APhA Board is a terrific team.  Each Board member is unique, diverse in background and perspective, yet prepared, focused, and deliberative at our Board meetings—coming together as a team to reach a united plan for APhA and the profession’s future.  They are fierce advocates for our profession and treasured colleagues.  Many hours of deliberation led to important decisions over this past year, including the decision to place a $1.5 million investment toward our future in gaining provider status.  I’m proud of our work this past year and it has been a privilege to be on the APhA Board team! 

E for efficient (divide the task at hand), equal work, equal recognition—
         Team members are efficient and effective; more hands on deck get the job done.   

Our CEO Tom Menighan and his incredible staff are a top-notch team, working daily, on weekends, and sometimes around the clock to advance APhA’s mission.  It is a great team with positions efficiently lined up to address the practice, policy, and research needs of our profession.  Stopping to recognize the efforts and celebrate the contributions of team members is important.  Thank you, APhA staff, for all you do!

A for accountable with measures of quality—
          Teams must be accountable to measure and monitor their output and assure quality and to deliver on expectations.

APhA is fortunate to be part of extended teams, such as the Pharmacy Technician Certification Board (PTCB), the Pharmacy Compounding Accreditation Board (PCAB), the Pharmacy e-HIT Collaborative, and others that are delivering accountability and driving quality for our profession.

One organization had a particularly great season.  The Board of Pharmacy Specialties (BPS) provides a credentialing process to recognize unique skills and knowledge of pharmacists.  BPS has grown this past year and has reached international levels of engagement.  The number of BPS-certified pharmacists has doubled over the past 5 years and BPS is working to add more specialties to meet increasing need.  This growth is being driven as pharmacists gain greater responsibility in patient care, including with the most complex patients.  It is also being driven by demands for accountability from health care professionals.  This is a good thing.  We want patients to have access to a pharmacist who can address their medication use needs, whether simple or complex.  There is a place for all pharmacists to meet the needs of patients, and board certification is a way to demonstrate a certain level of knowledge.   

M for magic, momentum, moving mountains— 
          Teams bring together magic and momentum, often described by that overused word “synergy” that results from uniting diverse and powerful forces.

Our entire profession together represents a very diverse yet powerful team.  All of you are individual All-Star players in your own communities, in your own practices, and in your lives.  Uniting our profession, building APhA’s team, and then adding the power of players from across our profession will give us the forces we need to build our legacy as a profession that delivers patient care.  It will be necessary to unite our profession and our professional organizations to achieve recognition of pharmacists as valued starting team members in the health care system.  Consider that old African proverb: “Alone I go fast.  Together we go far.”

I will give you one example of magic and momentum from our profession.  This past year just after Christmas, a student pharmacist, Steve Soman of St. John’s University, started a White House “We the People” petition to recognize pharmacists as health care providers.  I watched the petition numbers grow from a few hundred to over a thousand, ever so slowly the first few days.  Then early in the New Year, it just went viral—flashing through mass e-mail communications at national and state pharmacy associations and through schools of pharmacy.  The number of petition signees jumped quickly, and on January 9th, it exceeded the 25,000 required signatures to get a White House response.  This quick response by the profession signaled the critical priority of attaining health care provider status by our profession.  But will this excitement continue?

It is easy, with just a click, to sign a petition from your home computer.  But to secure provider status means the hard work is only beginning.  My successor Steve Simenson will talk tomorrow about the steps you can take toward this goal.  But it will take all of those pharmacists who signed the petition and many more to step up and educate legislators, donate to political action committees, and activate patients to support access to our pharmacist clinical services.  Team ends with “M” for that “magic that moves mountains.” We must have a team effort, united across our profession, aligned to a plan with everyone engaged and activated!  Now is not the time to be a bench warmer.  I hope you are ready and saying—put me in coach, let’s win this game!

Building Teams With Game Winning Results

During my presidential year, one of my greatest delights has been witnessing the strength and collaboration from growing positive relationships with our sister national and state pharmacy associations.  I was especially inspired by the Joint Commission of Pharmacy Practitioners (JCPP) meetings, which involve the elected presidents and CEOs of our pharmacy practice organizations.  The JCPP meeting always involves extensive, healthy, forward-looking dialogue about our professional issues and opportunities.  The open and dedicated discussions by our pharmacy organization representatives at the JCPP table is extraordinary.  While there may be differences in approaches, I’m delighted that all are teaming up toward achievement of a common goal—“providing consumer access to the pharmacists’ clinical services, no matter of the practice setting, and optimizing medication use and patient care.”  We must go forward united as a profession.  Thank you to the elected and staff leaders of our state and national associations for your continued collaboration and teamwork.

A new team was formed this past year, the Center for Pharmacy Practice Accreditation (CPPA), when APhA partnered with the National Association of Boards of Pharmacy (NABP) and the American Society of Health-System Pharmacists (ASHP).  CPPA was established to develop and implement pharmacy practice site accreditation programs.  The three partnering organizations believe that patient care will be improved through the development and widespread use of voluntary accreditation standards that help ensure and recognize quality throughout the entire medication-use process.  Accreditation gives patients a way of identifying pharmacies that satisfy certain criteria critical to ensuring patient care, safety, and quality.  This program empowers pharmacists, it empowers patients, and it ensures measurable, safe, and effective patient care for the health care system.  Talk about a game changer!

The standards for community pharmacy practice accreditation have now been released.  Our goal was to ensure these standards were developed by the profession and are specific, predictable, and measurable—so consumers know what they’re getting, and services provided by accredited pharmacies are of consistent quality.  Community pharmacy practices will now have a mechanism to distinguish themselves in the marketplace for the services they provide and their commitment to quality.  It will ultimately advance pharmacy practice and lead to greater public and health system recognition.

The Season in Review

As with any season, this year APhA has managed curve balls and hit a few home runs.  We have played hard on behalf of our members, profession, and ultimately the patients we serve.

One curve ball we faced was responding to the unfortunate tragedy that occurred as a result of a product contamination and resultant fungal infections and deaths across the nation.  While this was clearly unauthorized manufacturing, this incident increased scrutiny on the compounding services provided by pharmacists and the role of state, federal, and accrediting bodies in regulating both compounding as well as manufacturing in our country.  APhA quickly recognized the need to distinguish the difference between unauthorized manufacturing and compounding.  Our goal was to communicate the recognition of compounding as a valued patient care service that should continue to be accessible to patients. 

As the news of this case spread across the country, APhA took quick leadership to bring together stakeholders within and outside the profession to develop action steps to maintain the public’s confidence in the pharmacy profession and address system deficiencies.  In testimony to the Food and Drug Administration (FDA) and Congress, we acknowledged a need for change and emphasized the benefit of quality compounding services.  We were fortunate to have both existing APhA policy to guide our response and the Pharmacy Compounding Accreditation Board (PCAB), of which APhA is a cofounder, and its standards, to provide rational and credible perspective on an emotional issue.  During this time, PCAB has continued to review its processes and has added another layer of evaluation to ensure accredited pharmacies are not manufacturing medication under the guise of compounding.   

We’ve also scored several home runs this season with our continued role in providing immunizations as our leadoff hit.  This past year, we surpassed 200,000 trained pharmacists providing immunizations in this country.  We even had a state governor declaring pharmacists provide pediatric immunizations in his state to meet the needs of the flu pandemic.  Another success this year was the work of thousands of pharmacists who conducted blood pressure screenings as part of the Million Hearts campaign.  The Association led pharmacy discussions on the issue of potential revisions to the drug paradigm with the FDA, making the line between prescribed and over-the-counter medications more flexible through “conditions of safe use” and pharmacists’ role in working with these medications.  And last, our staff has completed a relaunch of pharmacist.com and is now undertaking a comprehensive overhaul to our membership database to be available in 2014 to enhance our members’ experience and ability to network more effectively. 

The APhA Foundation also had some home runs this year in their research and innovation efforts for patient care improvements and system change.  There are now over 2,000 participants in the APhA Foundation’s Project IMPACT: Diabetes receiving patient-centered, team-based care that is improving clinical process and outcome measures.  Quantitative and qualitative project results are expected this summer.  This initiative is supported by the Bristol-Myers Squibb Foundation.  The APhA Foundation also facilitated a meeting of stakeholders to look at innovative care delivery and collaborative practice, which resulted in consensus recommendations for advancing pharmacists’ patient care services and collaborative practice agreements being published in a March/April 2013 Journal of the American Pharmacists Association article available online at JAPhA.org.  The meeting was supported by the Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention.

The APhA Foundation also assembled the Committee to Advance Pharmacogenomics in Pharmacy Practice that has led to a strategic plan for advancing pharmacogenomics in pharmacy practice.  The activity was supported by URL Pharma and the recommendations can be found at APhAFoundation.org.  In January 2013, the APhA Foundation convened the Innovative and Appointment-based Adherence Consortium to bring key thought leaders together for informed dialogue to develop consensus on essential pharmacy practice strategies to improve adherence.  This activity was supported by Pfizer.  Stay tuned for an action plan and outreach to key stakeholders in the coming months. 

Honoring “All-Star” Players

As we all know, winning teams often have All-Star players.  We in pharmacy also have our own All Stars—Joseph Remington, Gloria Francke, Linwood Tice to name a few—who have helped our profession reach this point today. 

This past year, we lost an All Star in global pharmacy, Ton Hoek, FIP’s CEO for the past 12 years.  Ton was a real game changer.  He had organized a landmark event for the 100th FIP Congress in Amsterdam this past September—a Global Health Ministers Summit.  At this summit, health ministers from around the world gathered to hear and discuss the IMS report on “responsible use of medicines” with data confirming $500 billion in global health spending can be avoided annually through more responsible use of medicines and the integration of pharmacists.  The data and the discussions from that meeting were taken back to the respective countries and undoubtedly will change the pharmacist’s role in health care delivery around the globe.  Unfortunately, Ton passed away last July just prior to this Congress, yet he was a game changer.  In Ton’s honor, a new scholarship fund has been started at the APhA Foundation to support a young student or resident with the opportunity to attend the FIP Congress each year.  We are already nearly half way to our fundraising goal of a $25,000 endowment, but we are still a bit short of the goal.  If you can, I ask you to contribute to honor Ton and support the next generation of pharmacists.

Teams will often give out game balls after games as a way to honor those who contribute most to the team’s play.  I’ve brought this game ball with me all the way from Ada, Ohio, where the Wilson factory makes all the NFL footballs and the Super Bowl footballs.  This one was made especially for today with APhA’s logo and the phrase “A Game Changing Year.” It has been signed by the APhA Board team.  This is unique and special—something you can’t buy anywhere else.  But you can buy this one.  My friends from ONU and I have donated this to the APhA Foundation’s silent auction tonight.  Please stop by and bid on this for a donation to the Ton Hoek Scholarship and bid on many other items to donate to the APhA Foundation General Fund to support their great work in research and education.

Game Plan for the Future: Building a Legacy Playing Field with Access to Pharmacists’ Clinical Services

We, along with our predecessors, have worked hard to prepare for these game changing times in our profession.  Last year at this meeting, we heard loud and clear your desire to attain public recognition of the value of pharmacists’ clinical services (aka “provider status”).  We have fought to remove regulatory limitations, advanced professional education, and gained ground on introduction of new payment models for pharmacists’ services.  Throughout the past year, the Association also has held discussions with stakeholders in pharmacy, medicine, managed care, health systems, and government to drive the positive recognition our profession deserves.  The Association made proactive efforts to work with physician groups including the American Medical Association, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American College of Physicians.

While much has been done, we must keep going.  It is our choice whether this game change in the health care system engages our talents in medication management or ejects us from the game for other players and technology who they believe can play our position better or at lower costs.  We must continue to be guided by what our patients need—and our patients need a game change in how they experience care from pharmacists.  Ensuring access to pharmacists’ services that make a difference in medication outcomes is our goal.

We know the voice of one individual is not enough and that is why we join an association like APhA.  We also know that when we work together with other organizations as one profession, we can get more done.  With such lofty ambitions for our profession, we need to make sure all pharmacists are on the same game plan.  When we speak with a collective voice, we help strengthen health care—and our profession—overall.  Together, we can continue to build a legacy that lasts.  All of these efforts support the building of a legacy ball park for the profession, dedicated to improving medication use and advancing patient care.

In my comments this morning, I have provided an overview of the importance of having a strong and committed team.  Tomorrow, you will hear from APhA President-Elect Steve Simenson regarding our game plan to pursue attaining provider status for pharmacists and ensuring patients have access to pharmacists’ clinical services—a plan that includes continued collaboration with other national pharmacy organizations and stakeholders.

We need your commitment as part of the team to keeping your eye on the ballto help ensure pharmacists are the game changers in our new health care system and are recognized and valued members on the health care team.  To accomplish this, we cannot do it alone.  It will take a strong TEAM effort to establish our profession’s legacy as patient care providers.  I hope you will say—put me in coach!