One of the more interesting and important findings from a pilot we recently participated in was the financial impact pharmacy can have on a payor’s total health spend. Spoiler alert: it can be very significant. But teasing out exactly what a pharmacy is doing to decrease health spend is difficult, and one of the only ways to do this is to look at what differentiates a high-performing pharmacy from those not saving the payor money. In our case, our pharmacy offers a variety of uncommon and even unique services, and we suspect that this is one of the driving forces of our impact on total health spend, but finding concrete examples requires thinking in a different way. This weekend, while taking care of a patient, I had an epiphany. I realized that what I was doing was saving the system a lot of money.
It was a dark, and stormy Saturday night. Well, not really stormy, just dark. One of our patients was scheduled for an appointment on the previous Friday. The appointment was to administer an injection of haloperidol, a medication used to treat the patient’s mental illness. The patient missed their appointment, and our pharmacist called to remind the patient’s helper by phone that afternoon. By closing time on Saturday, the patient still had not presented to the pharmacy to receive their injection.
So on Saturday night, well after our pharmacy closed, I received a call from the patient’s service coordinator. They had just recognized that the patient missed their appointment and the medication. To make matters worse, the patient’s behavior was becoming a problem. If the patient could not get the dose soon, they were instructed to go the the emergency room where they would have administered the medication. Based on previous history, it was likely that if the patient did go to the ER, they would likely also be admitted for observation or even admitted.
I found myself at my pharmacy after 9 pm giving the patient the medication they required. Sometimes, because we are so involved in what we are doing, we fail to recognize the bigger picture. It was not until later in the weekend, while taking care of another patient after hours, that I had my epiphany; by taking the after hours call, I undoubtedly created a significant savings for the payor. I have since started thinking about the impact of many of the day-to-day activities I do as a pharmacist in a different light. It doesn’t take a lot if imagination to see the value in the services we offer.
At this point, however, pharmacists are not reimbursed for their time. This must and will eventually change. By sacrificing 30 minutes of my Saturday night, I earned the gratitude of the patient and their advocate. My sacrifice also created a significant impact on healthcare costs. I can truly say that I made that encounter that count. I challenge everyone here to start thinking differently, and be sure to make every encounter count.