Tuesday, September 11, 2012

A little bit of Everything

Posted by David Plumley at Tuesday, September 11, 2012

Sorry for my absence and delay in posting, but the last 6 weeks have been very busy for me. I recently finished my non-traditional rotation with Dr. Lindsey Kelley, as well as my PharmD. seminar presentation with Dr. Randy Regal.

I most definitely felt a ton of pressure to perform during my seminar, especially with Dr. Regal as my preceptor.  While I didn't steal all his jokes or puns I borrowed a fair share from him. I felt like my presentation went well overall and, hopefully, the people in my room managed both to stay awake and learn something about the use of protease inhibitors in treating HCV.

As far as my administration rotation with Dr. Kelley, I very much enjoyed working with her and would recommend her rotation to anyone interested in administration or anything to do with transitions of care.  My 5 weeks with her flew by, both because we were very busy with many projects but also because I was having so much fun.  It was possibly my favorite rotation thus far.

Dr. Kelley is involved in UMHS's specialty pharmacy program, transitions of care, 340B contracting, and ACP.  I will talk a little bit about each area and do my best to explain what took me the better part of 5 weeks to understand.

Specialty pharmacy(SP) is something new to Michigan and an area that is rapidly evolving.  Basically SP involves the dispensing special drugs to specific populations — transplant and cancer patients to name a few.  These drugs are special because they are limited in distribution from drug companies, require special monitoring, are very expensive, and often times insurance companies restrict where a person can get these drugs.  As a healthcare institution UMHS's goal is to provide these drugs to their patients and employees on their own or by partnering with other parties. My part in this effort was to compare different SP companies to see what they offer, what UMHS currently offers, and what we should offer.

Transitions of care (TOC) is something that Dr. Kelley is very interested in and an activity we spent a lot time working on.  This is because it is a important initiative for health systems and crosses over into other areas we were working on.  TOC from a pharmacy standpoint involves medication management/reconciliation at every transition (change in location) a patient goes through.

I was involved in projects relating to better ways to get patients discharge meds (there were some very interesting ideas for this), how we help patients get access to their meds as an outpatient, and the inner workings of our own ACP.  This  was specially fun because it involved a lot of creativity and I was able to work with many different groups all over the hospital.

Finally 340B, in my own simplistic view, is a special drug pricing strategy that UMHS has access to due to out patient population.  Again, UMHS is very cutting edge with these programs in order to better serve our patients and make our health system more sustainable.  This activity involved many meetings with many different groups, and took me weeks to understand.  I will not go into too much detail on this latter topic, but if you want to know more I have a sweet diagram I can share with you.

Being involved in all of these different activities required many 10+ hour days filled with meetings and special projects.  But it did not feel like work all the time, Dr. Kelley allowed me tons of autonomy to work on my own and to select projects that I was interested in.  This really helped me succeed. I hope to take the skills I learned from this rotation and bring them to bear on all of my other experiences this year.

If you have any questions about this rotation feel free to find me and ask.

Thanks for reading.

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