From the September 2006 issue

Recently, the Los Angeles Times reported that there are currently more than 150 retail pharmacy based health clinics nationwide, and thousands of new clinics are planned in the next year or two. According to Pharmacy OneSource, retail health clinics are a hot market right now. These clinics, run by nurse practitioners and physician assistants, are popping up in pharmacies and grocery stores across the country. In July, CVS announced plans to acquire MinuteClinic, the largest provider of retail-based health clinics in the U.S. Walgreen’s also announced that they have opened ten Take Care Health Systems in Kansas City. Target has plans to open pharmacy based health clinics as well.

Do you have a clinic opening or under consideration for your store? If so, make sure you meet with all the clinic practitioners as well as their office staff. During the meeting consider these safe practice recommendations (Note: the same steps should be considered for office practices from which you frequently receive prescriptions.):

• Introduce them to all staff in the pharmacy. Take them for a tour and show them how prescription intake, preparation, and dispensing are performed.
• If you have prescription scanning capabilities, show them what a scanned prescription looks like in your system. Demonstrate how different prescription blanks scan and point out which ones to avoid using so as not to distort the actual order (e.g., colored prescription blanks, blanks with watermarks designed to discourage diversion). Help them design prescription blanks that include indication icons.
• Encourage them to use an electronic prescribing system; work with them and their vendor to ensure information is printed, faxed, or electronically sent in a clear format.
• Ask them to include the indication for use whenever they write, electronically send, or call in a prescription.
• Ask the prescriber to print his/her name on the prescription or circle it if it is pre-printed on the prescription blank. Patients may not remember hearing the provider’s name, which makes it difficult for a pharmacist to communicate directly with the prescriber when there is an issue with the prescribed therapy
• Review with prescribers the various informational tools, patient profiles and data sets available through your pharmacy system and Pharmacy Benefit Manager connectivity. Describe how drug utilization review (DUR) and prior authorization processes take place.
• Recommend drug information reference materials that they should have available in their clinic/office. Encourage them to contact one of your pharmacists for any drug information questions.
• Let them know you will dispense appropriate measuring devices every time they order a liquid medication. Make sure they know the risks of using or recommending parenteral syringes for oral liquid use.
• Share with them ISMP safety tools (e.g., List of Error Prone Abbreviations, List of Confused Drug Names) found at www.ismp.org/Tools. Also, familiarize them with ISMP’s newsletters and other publications.