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OBJECTIVE: To describe the types of services provided at primary community pharmacy residency program (CPRP) sites and the levels of intensity devoted to different levels of patient care. DESIGN: Descriptive nonexperimental study. SETTING: United States during May and June 2012. PARTICIPANTS: 120 key informants from CPRPs. INTERVENTION: Key informants from CPRPs were surveyed. MAIN OUTCOME MEASURES: Proportion of residency sites providing selected patient care services, proportion of each service provided by residents, estimates for the number of repetitions needed for a typical resident to become proficient in each service, and services provided at other practice sites. RESULTS: Of the 120 respondents, 70 identified themselves as preceptors/directors, 45 identified themselves as residents, and 5 did not identify their position. Variation was achieved for representation from different practice settings and geographic locations. The findings revealed variability in the types of services provided at CPRP practice sites and the experiences offered for residents. Collaboration with other practice sites, in order to enhance residents' training and experiences, also appeared to be occurring. CONCLUSION: The results showed that the types and intensity of services provided at CPRP sites gave residents opportunities for advancing patient care services training, directing patient contact, and creating opportunities to be engaged in practice innovation.

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OBJECTIVE: To convene a diverse group of stakeholders to discuss medication therapy management (MTM) documentation and billing standardization and its interoperability within the health care system. METHODS: More than 70 stakeholders from pharmacy, health information systems, insurers/payers, quality, and standard-setting organizations met on October 7-8, 2008, in Bethesda, MD. The American Pharmacists Association (APhA) organized the invitational conference to facilitate discussion on strategic directions for meeting current market need for MTM documentation and billing interoperability and future market needs for MTM integration into electronic health records (EHRs). APhA recently adopted policy that specifically addresses technology barriers and encourages the use and development of standardized systems for the documentation and billing of MTM services. Day 1 of the conference featured six foundational presentations on health information technology (HIT) trends, perspectives on MTM from the profession and the Centers for Medicare & Medicaid Services, health care quality and medication-related outcome measures, integrating MTM workflow in EHRs, and the current state of MTM operalization in practice. After hearing presentations on day 1 and having the opportunity to pose questions to each speaker, conference participants were divided into three breakout groups on day 2. Each group met three times for 60 minutes each and discussed five questions from the perspective of a patient, provider, or payer. Three facilitators met with each of the groups and led discussion from one perspective (i.e., patient, provider, payer). Participants then reconvened as a complete group to participate in a discussion on next steps. SUMMARY: HIT is expected to assist in delivering safe, effective, efficient, coordinated care as health professionals strive to improve the quality of care and outcomes for individual patients. The pharmacy profession is actively contributing to quality patient care through MTM services focused on identifying and preventing medication-related problems, improving medication use, and optimizing individual therapeutic outcomes. As MTM programs continue to expand within the health care system, one important limiting factor is the lack of standardization for documentation and billing of MTM services. This lack of interoperability between technology systems, software, and system platforms is presenting as a barrier to MTM service delivery for patients. APhA convened this invitational conference to identify strategic directions to address MTM documentation and billing standardization and interoperability. CONCLUSION: Participants viewed the meeting as highly successful in bringing together a unique, wide-ranging set of stakeholders, including the government, regulators, standards organizations, other health professions, technology firms, professional organizations, and practitioners, to share perspectives. They strongly encouraged the Association to continue this unique stakeholder dialogue. Participants provided a number of next-step suggestions for APhA to consider because of the event. Participants noted the pharmacy profession's success in building information technology systems for product transactions with systematic, organized, methodical thinking and the need to apply this success to patient services. A unique opportunity exists for the profession to influence and lead the HIT community in creating a workable health technology solution for MTM services. Reaching consensus on minimum data sets for each functional area--clinical, billing, quality improvement--would be a very important short-term gain. Further, participants said it was imperative for pharmacists and the pharmacy community at large to become actively engaged in HIT standards development efforts.

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OBJECTIVE: To review and discuss the importance of pharmacists having access to patient-specific health care information in order to provide pharmaceutical care. DATA SOURCES: Articles identified through searches of MEDLINE and International Pharmaceutical Abstracts using the following key words: information, decision making, and pharmacist. STUDY SELECTION: English-language articles were evaluated for inclusion. DATA SYNTHESIS: Pharmacists have demonstrated their ability to positively affect patient outcomes related to medication use, including reducing patients' risk for medication-related adverse effects. CONCLUSION: Pharmacists, with proper access to patient-specific health care information, can reduce patients' risk for medication-related problems and improve the quality of their health care.

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