Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Rheumatology Clinics Add Pharmacists to Care Teams, See Benefits

Susan Bernstein  |  Issue: January 2019  |  January 17, 2019

Jacob Laund / shutterstock.com

Jacob Laund / shutterstock.com

CHICAGO—Could the addition of a pharmacist to rheumatology care teams improve patient satisfaction, decrease staff burnout or reduce medication-related problems? Three panelists in Integrating Pharmacists into the Workforce, a session at the 2018 ACR/ARHP Annual Meeting, shared positive experiences with this interdisciplinary care model.

Less Burnout, More Satisfaction

Ten years ago, the Arthritis Treatment Center at Tufts Medical Center, Boston, added a clinical pharmacist to its interdisciplinary team two days a week, said William F. Harvey, MD, MSc, the center’s clinical director.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

“At that time, there was a rapid increase in the number of complex therapies being administered,” including biologic and biosimilar therapies that required more administrative oversight from his small staff, Dr. Harvey said. “Also, there were changes in insurance requirements. I think we do more paperwork for insurance coverage than we do for anything else in the course of our care.”

Electronic medical records (EMRs) and reimbursement reporting took more staff time away from patient consultations. This contributed to staff burnout and high turnover, increased patient wait times and decreased patient satisfaction, said Dr. Harvey. “We were taking a big hit. It’s easy to feel assaulted by all this technology.”

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

In the first year, the clinic’s pharmacist focused on point-of-care benefit analyses and prior authorizations for outpatient biologics filled by Tufts’ 340b specialty pharmacy. “Our patients loved our pharmacist. They treated the pharmacist like a member of the team,” said Dr. Harvey, noting patients frequently spoke to the pharmacist more often than to their providers.

The clinic’s model for covering the cost of adding a pharmacist included increasing revenue for its specialty pharmacy, and in just the first year, the clinic found revenue rose slightly. Revenue grew substantially over the next 10 years to make the arrangement cost effective, he said.

‘The pharmacist’s scope of work increased tremendously, & the impact on our practice was profound.’ —Dr. Harvey

Five years into the arrangement, the clinic increased its pharmacist’s responsibilities to include obtaining all prior authorizations, conducting patient education and follow-ups regarding medications, talking with patients about manufacturers’ assistance programs, working rounds in the infusion center, performing medication reconciliations for complex patients and providing injection training.

“The pharmacist’s scope of work increased tremendously, and the impact on our practice was profound,” Dr. Harvey said. The clinic is also able to leverage a pharmacy technician’s time along with other departments at the hospital. “It has completely transformed the operations of our clinic.”

In a typical day in clinic, Dr. Harvey said he may meet with a new patient to review the treatment pathway, then call in the pharmacist to “go over anything the patient will need to know about the medication, and I focus my conversation on their prognosis, the natural history of the disease, what to expect,” he said. “Our pharmacist might teach patients how to do their injections, or if patients are afraid to do their own injections, she arranges for them to come back so we can do this in the office.” The pharmacist consults with patients about the cheapest therapies under their insurance plan and alerts providers when patients have drug side effects, he added.

When Dr. Harvey and his staff analyzed data collected for standardized reporting purposes, “we noticed our provider rating going up,” he said. “Why would our provider rating go up when we started turning over half the conversation about a patient’s medications to the pharmacist? Patients really respond to having an accessible team for their care.” Patient referrals, staff quality measures and provider satisfaction rose after the clinic added a pharmacist. “There were also increases in our scores for culture of safety. We felt like we were taking better care of our patients.”

Did this new concept reduce staff burnout? Although this is hard to measure, Dr. Harvey cited the Quadruple Aim, a model for high-functioning clinics that includes improving patients’ health, experience of care and per capita cost of care, as well as providers taking joy in practice.1 “How many people would love to come home from their day at clinic and say, ‘I had joy at work today?’” he said. With rising administrative burdens and healthcare costs, “It’s becoming increasingly difficult to feel that way. But what if you could do that?”

Adding a pharmacist helped the clinic achieve several Quadruple Aim measures, including adding capacity by sharing care among a team, saving time by re-engineering prescription refill work out of the practice and reducing unnecessary physician work with email management, said Dr. Harvey.2 “We are all a lot happier, have a lot more fun, and one of our providers said that bringing in the pharmacist is the best thing we’ve done in years.”

Page: 1 2 3 4 | Single Page
Share: 

Filed under:Meeting ReportsPractice Support Tagged with:2018 ACR/ARHP Annual MeetingElectronic medical recordspharmacist

Related Articles

    In-Office Pharmacist Improves Patient Care

    May 26, 2017

    Would your patients and practice benefit from an on-site pharmacist? Jessica Farrell, PharmD, says a pharmacist enhances patient education and frees up a rheumatologist’s time, enabling them to see more patients and provide better all-around care…

    Evolution of Medicare’s Merit-Based Incentive Payment System: MIPS Value Pathways

    December 1, 2022

    In November, the CMS finalized 12 MIPS Value Pathways (MVP) in the Quality Payment Program, including a rheumatology MVP. In 2023, clinicians can opt to report via traditional MIPS, the rheumatology MVP or both.

    MACRA: More Points, Smarter Future

    December 14, 2016

    As the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is implemented in January with new models for quality-based reimbursement payments, rheumatologists must seize control of how they will be paid now—and in the future. This message was stressed by speakers during Holy MACRA! How to Survive and Thrive in the Era of MACRA,…

    The Pharmacist’s Role in Managing Rheumatic Diseases

    August 1, 2013

    An overview of the many benefits pharmacists can bring to a multidisciplinary healthcare team

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences