Pharmacists' role evolves with 21st century health care


Pharmacy in the 21st century will be more integrated into provision of health services than ever before. Electronic health records will become increasingly important, as will e-prescribing, prescription data, pharmacist intervention/counseling, and collaboration with other healthcare providers.

Key Points

To realize the potential benefits of EHRs and e-prescribing, the pharmacy field must be seen as an integral part of evolving healthcare. Mounting challenges of medication management, increasing patient loads, and insufficient numbers of clinicians and pharmacists prepared to care for an aging population must be addressed in order to reduce costs and increase efficiencies. These challenges can be met only through greater cooperation and communication between pharmacists and physicians.

The 21st century pharmacist

It is well known that present numbers of physicians and nurses are inadequate to meet the needs of an aging population. With pharmacists, this shortfall is far more pronounced, which puts greater demands on the already inadequate time pharmacists can devote to medication counseling with patients. While not a panacea, the EHR will allow faster and more accurate access to prescription data. Availability of data will reduce miscommunications and the amount of back-and-forth messaging between physician practice and pharmacy, increasing efficiency and ultimately benefiting the patient.

The entry of pharmacists into the field will foster greater collaboration with physicians as pharmacy programs continue to emphasize clinical aspects of training. Many of these educational tracks provide actual patient case-load rotations that allow pharmacy students to follow cases in a hospital or clinic setting. This gives students the opportunity to put their knowledge of medications to greater use by making recommendations to physicians about appropriate drug regimens. Ultimately, this will help physicians to treat patients and pharmacists to engage with patients in medication encounters.

Retail clinics and pharmacies

In the long run, the growth of retail medical clinics is likely to help retail pharmacists, physicians, and consumers. These clinics provide a valuable alternative to hospital emergency rooms for those who cannot see their primary physicians in a timely manner. The clinics also will help physician practices reduce patient backlogs as retail clinics begin catering to more nonemergency patient visits such as immunizations and school physicals.

Although pharmacy organizations are strong proponents of retail clinics, the lack of a unified communication protocol for clinic and pharmacy is a major deterrent to progress. This is also true in the broader healthcare world among other healthcare stakeholders such as hospitals. Retail clinics and hospitals use HL7 as their data-communication protocol, while pharmacies use the standard of the National Council for Prescription Drug Programs (NCPDP). The lack of interoperability across these groups inhibits effective communication. To address this urgent need, the Standards Charter Organization (SCO) was created with the intent of bringing together senior members of the U.S. healthcare standards development community to eliminate these barriers to communication.

The SCO is one more way that providers are beginning to work together to facilitate accurate bilateral communication for improved patient care. All who participate in healthcare delivery must work together to find faster and easier ways to improve patient outcomes. In the creation of this new healthcare landscape, pharmacists will play a critical role.

John Klimek is vice president of industry information technology for the National Council for Prescription Drug Programs as well as chair of the Standards Charter Organization.

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