Randy McDonough, B.S., Pharm.D., M.S., CGP, BCPS, FAPhA is Co-owner of Towncrest and Towncrest Compounding Pharmacies in Iowa City and Solon Towncrest Pharmacy in Solon, IA. Recently, he and his business partner started Innovative Pharmacy Solutions, a consulting and clinical documentation software company. Dr. McDonough is responsible for developing, implementing, and overseeing clinical services, managing staff, and marketing the business. He has helped to foster collaborative working relationships with several solo and group physician practices in areas such as immunizations, anticoagulation, disease state management, and medication therapy management services. He also helped to develop and implement health screening and case management programs for private pay patients and self-insured employers. He was instrumental in implementing Medication Therapy Management (MTM) services for the Iowa Medicaid Pharmaceutical Case Management Program. He provides MTM services for Iowa Medicaid, Medicare Part D and private pay patients. Dr. McDonough has been committed to the education of community pharmacy residents through the training and/or supervision of over twenty post-graduates. Towncrest Pharmacy is a current community pharmacy residency site. Dr. McDonough received his BS, MS, and Pharm.D. degrees from the University of Iowa College of Pharmacy, where he is adjunct professor (clinical). He is frequently asked to speak on topics related to practice development and implementation. He has published articles and book chapters about pharmaceutical care and co-authored a book on this same topic. He currently writes the monthly MTM Pearls column for Pharmacy Today. He is a member of APhA, NCPA, ACCP, ASCP, and the Iowa Pharmacy Association.
How do you envision pharmacy practice 10 years from now, and what should APhA do to lead us to that vision?
My vision for pharmacy practice ten years from now is that all pharmacists, regardless of their practice setting, have responsibilities to ensure that patients are achieving their therapeutic outcomes with safe and effective therapy. The knowledge and clinical skills that pharmacists need are the same for all practice settings. Pharmacists will be drug therapy interventionists—identifying and resolving drug therapy problems, working collaboratively with other health care providers, counseling and educating patients, and documenting their patient care activities. Electronic medical records (EMRs) will be standardized and integrated among all providers and across practice settings so that pharmacists can review patient records and document their clinical activities in real time.
Payers, legislators, and regulators will recognize the unique skill sets of pharmacists as medication managers. There will be different payment models ranging from risk sharing to pay-for performance. Payers will utilize performance measures to determine quality performance of all providers including pharmacists. Pharmacists will be integrated into the health care team contributing, as medication managers, to the care and outcomes of patients. Pharmacists will be involved in drug therapy selection, dosing, and monitoring. Pharmacists will continue to have responsibilities for efficient, safe, and effective dispensing processes, but automation and technology will be the standard.
APhA’s role, in this transformation of pharmacy practice, is to ensure that pharmacists are prepared to accept these new responsibilities. Informing and educating pharmacists to develop their clinical skills and knowledge continues to be an important and challenging task for the association. The advocacy role of APhA cannot be underestimated. As our health care system continues to evolve, it is important that the public, legislators, payers and other stakeholders continue to be aware of the essential and important role of pharmacists as drug therapy managers. APhA needs to be our voice for pharmacy ensuring that pharmacists are recognized, reimbursed, and integrated within the health care system.