As I survey the landscape of health care delivery and finance, I am reminded of the difference between cost and worth. Cost, of course, defined by the Oxford Dictionary as the “required payment before something can be acquired or completed;” as opposed to worth, “the value equivalent to that of someone or something under consideration.” Our goal is to ensure that the value of BPS certification credentials far outweighs the cost to every interested stakeholder, including providers, payers, and most of all, patients. BPS board certification represents a pharmacist’s personal, professional, and public commitment to the standards of specialty practice and the promise of providing the highest quality care.
From the broader health system perspective two recent examples deserve mention. First, the October 1, 2017 issue of the American Journal of Health System Pharmacists showcased a UW Health initiative that required certification for all pharmacists in direct patient care roles. [i] This excerpt encapsulates the rationale for the initiative: “Raising expectations for ourselves as professionals will translate into higher expectations by our patients, our colleagues, and society.” Lead author Dr. David Hager also shared his insight into practice advancement amid increasingly complex patient care needs on a BPS podcast.
Another recent publication, led by researcher Dr. Kimberly Brunisholz from Intermountain Health in Salt Lake City, found that improved care for patients with diabetes (as evidenced by achievement of therapeutic goals for blood pressure and hemoglobin A1c) correlated with the presence of integrated Collaborative Pharmacist Support Services. Notably, the clinical pharmacists who were integrated into the ambulatory clinics were board certified and co-managed diabetes and hypertension under a Collaborative Drug Therapy Management Agreement.[ii]
While health systems increasingly recognize the value of BPS certification, it is equally important to consider its value to individual patients, who have increasingly complex medication-related needs. Consider the emerging umbrella term medication optimization, which encompasses a suite of related professional activities and services (e.g., comprehensive medication management, medication synchronization, and medication quality and safety initiatives among many others) aimed to address this complexity, for the benefit of individuals and populations, and across the continuum of care. It then follows that successful medication optimization requires pharmacists to fill differentiated roles and perform specialized functions, underscoring the realization that patients increasingly need more than one pharmacist on their care team.
This notion aligns well with evidence-based principles of team-based and patient-centered care. Perhaps this means that now, more than ever, coordination of pharmacist-provided care is paramount. Recognizing that certain practice silos exist, there is a critical need to implement existing health information technology to better connect community-based pharmacists to integrated clinical pharmacists to enable truly comprehensive care for patients. Ensuring adequate information handoffs between practice settings would create needed cohesion within the care delivery system. This is what must occur to achieve medication optimization. Ultimately, this strengthens not only the value proposition for board certification, but for all pharmacist-provided care.
[i] Hager DR, Hartkopf KJ, Koth SM, Rough SS. Creation of a certification requirement for pharmacists in direct patient care roles. Am J Health Syst Pharm. 2017;74(19):1584-1589.
[ii] Brunisholz KD, Olson J, Anderson JW, Hays E, Tilbury PM, Winter B, Rickard J, Hamilton S, Parkin G. “Pharming out” support: a promising approach to integrating clinical pharmacists into established primary care medical home practices. J Int Med Res. 2017:300060517710885.