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LONG TERM CARE PHARMACY OPERATIONS IN INDIA

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Author: Ambati Vamsi Krishna

 

Long-term pharmacy care is an essential setup. It ensures the delivery of needed medicine. It also helps in proper therapy of residents of hospital. India is a country where there is a dire need to focus on the usage and implementation of long-term pharmacy care. This current article focuses in detail on the advantages and need for long-term care pharmacy operations.

Long-term pharmacy care (LTC) is a pharmacy-supporting residential facility which can serve the people who need long-term care. For the benefit of residents of long-term care facilities, pharmacists keep up with the latest developments in drug research.

An LTC pharmacy’s major responsibility is to make sure all drugs are delivered to the LTC institutions they serve and that residents receive the appropriate meds. LTC pharmacies don’t provide the general public any conveniences or services. They only work with LTC facilities in their area, focusing on consulting and administering medicines. LTC pharmacies also offer quality control systems to care facilities to ensure accurate drug delivery.

IMPORTANCE OF LTC PHARMACY:

  • LTC pharmacy improves the quality and decreases the health care expenses. [1]
  • The idea is to create financial incentives in the form of penalties for the hospitals.
  • The long-term care facilities are because of approximately 40% of the hospitalization.
  • It also provides access to the following services;
  1. Reviews of drug protocols.
  2. Handling of prescriptions.
  3. Alternatives for drug packaging and administration.
  4. Delivery oversight.
  5. Administration of medication records.

PROCESS

Figure 1: The Flow of Long Term Care Pharmacy

ADVANTAGES

  • Personalized medical records:

To create simple-to-use documents that will save the staff time and reduce medication errors, the medical records team will work closely with the facility’s nursing department. A wide variety of documents were also provided. Electronic Medication Administration Record (eMAR) technology could also be used to guarantee precision and effectiveness.

  • Drug regimen specialists at your disposal:

Each resident’s profile is carefully examined in compliance with laws and facility policies by the team and the nursing department of the facility. By identifying irrational and/or inappropriate pharmaceutical orders and duplicate therapies, customers could manage their medication consumption and expenditures. In addition to giving regular updates and suggestions to facility management, the pharmacists will even attend meetings of the facility’s quality control committee upon request. [2]

  • Every order comes with a guarantee of accuracy:

When processing customer orders, an LTC Pharmacy can use cutting-edge technology to pay exceptional attention to detail. The highest level of accuracy can be achieved using barcode technology. While barcoding is a dependable technique, a further signature and initial process before any medication is supplied to a patient can be adapted. A vital step in quality assurance is accountability.

By collaborating with an independent pharmacy, long-term care facilities can obtain a variety of pharmaceuticals. Independent pharmacies have access to a wider variety of pharmaceutical suppliers and producers than a regular pharmacy and may thus offer a wider range of medications. This makes it possible for institutions to better meet the requirements of their residents by giving them access to the greatest pharmaceuticals on the market.

Individualized customer service is a further advantage of working with a small-town pharmacy. As a result of being locally owned and operated, a lot of independent pharmacies are able to provide individualized service and develop relationships with their clients. In turn, ordering prescriptions becomes more comfortable as care facilities get to know the pharmacists.

Collaborating with a local pharmacy can result in cost savings. Due to their independence from the huge chain pharmacies’ pricing structure, independent pharmacies are frequently able to provide reasonable prices. In addition to saving money on medication, this can assist long-term care institutions give their residents the finest care possible.

The pharmacies providing long-term care are:

  1. They are giving infusion treatments and supplies to the sending residents to lessen their requirements. When necessary, they return to the hospitals.
  2. They offer thorough medication management.
  3. Distributing medicine at the time of discharge for up to 30 days of community use.
  4. Occasional provision of infusion therapies and supplies to reduce the necessity of returning patients to a hospital.
  5. Keeping an eye on the residents, which may involve counseling and medication reconciliation to increase adherence and reduce issues.
  6. Ensuring that drugs are suitable, accessible, and provided in a timely manner, especially at admission.

The most popular strategy for retail pharmacists to pursue the LTC potential is to just begin providing services to neighboring LTC facilities. You can carry out this as an open-door pharmacy, which effectively operates out of an existing retail pharmacy to provide services to LTC institutions and residents. [3]

It entails making purchases from the same suppliers, utilizing the same contracts, and making use of the same facilities, computer systems, and licensing. It doesn’t call for maintaining different inventories. The least expensive choice, it is also the quickest and easiest. However, some business owners will decide to seize the LTC opportunity by opening a separate, behind-closed-doors pharmacy. LTC pharmacies with closed doors have access to purchasing and reimbursement benefits that open-door pharmacies do not have.

Closed Door Pharmacy

A closed-door pharmacy is one that dispenses medication to patients in a variety of situations but is not accessible to the general public. In addition to having distinct licenses from an existing retail pharmacy, closed-door pharmacies must also maintain a separate inventory.

Drugstore Combo

A “combo pharmacy,” refers to an existing retail pharmacy that makes use of its retail license, pays retail rates, and is otherwise considered as a retail company. ADVANTAGES OF ACQUIRING A THIRD PARTY IN LONG-TERM CARE PHARMACY

One can acquire more facilities after they can guarantee that high-volume prescription processing is carried out precisely and in accordance with the established rules, methods, and comprehensive regulations. However, for this to work in a proper manner, a third-party team member who can work with the organization on both the original acquisition and the ongoing day-to-day company is essential. [4] Their role includes at various areas like;

  • Order entry

Using the established procedures and guidelines, a third-party team may access incoming orders and enter them into your pharmacy’s computer system. They would be experts in pharmacy operations and would be aware of specific Run-Times, Cut-Offs, and overall priorities.

  • Admissions and Daily Census

By working with a third-party team, the admissions process may be expedited. Patient files, which would automatically be created, would include details about the patient’s demographics, allergies, diagnosis, guarantors, and payment arrangements. To make sure that all plans are found and added, eligibility searches can also be performed. Partners would also go over the daily census data to make sure that the admissions, discharges, hospital departures, bed holds, room changes, and coverage changes are all appropriately documented.

  • Refills for prescriptions

Rejected claims, early refills, duplicate paperwork, and cycle medications will be handled properly around-the-clock, and they’ll be supplied on the earliest runs.

  • Pharmacy billing

The third-party partner would handle the daily workload, including intake registration, insurance eligibility, census maintenance, claims processing, payment posting, and Medicaid pending status, in addition to keeping prior authorizations for prescriptions.

  • Processing at the end of the month (EOM)

It can be time-consuming and difficult. Census reports may be examined and amended with the assistance of a third-party partner. To ensure accurate billing, all monthly claims can be examined, and if needed, EOM reports can be created and delivered.

PROCESS WHICH INDIA SHOULD ADAPT FOR OPERATING A LONG-TERM CARE PHARMACY

A number of measures should be followed in India in a long-term pharmacy care to develop the pharmacy business. Industries related to health care are expanding nowadays in India post-COVID. The census indicates that individuals who have reached the age of 65 or older require long-term pharmacy care and this set of population is more in India. [5] The operation of a long-term care pharmacy involves following multiple processes;

  • STEP 1: Develop an entrepreneurial mindset

By succeeding in this line of work, one might develop an entrepreneurial mindset in the pharmacy. Success in any sector is a result of an individual’s ideals and efforts.

  • STEP 2: Consider the competitors and look for the differences

Those working in this business can make educated guesses about their rivals. After such encounters with rivals, one should adjust their strategy in order to achieve success. Depending on the concepts each person holds, ideologies vary from person to person.

  • STEP 3: Take this into consideration

        A person extending their business into the long-term care sector has more options throughout their lifetime. Working with the state government is one of the options.

  • STEP 4: Develop a company action plan

The most important step in this process is creating an effective plan for their firm. The primary sustaining system for a firm is its plan.

  • STEP 5: Internal process optimization

After business growth, the pharmacist may overlook their operations. Negligence has the power to demolish their ideals. This could damage the process. The individual with a business mindset is capable of having a business-centric thinking. It can help a company find the ideal personnel. One should not trust someone readily, and one should not make snap judgments. They are likely to believe someone in the business process for a number of reasons.

  • STEP 6: Knowledge of marketing strategies

By making some special offers, a firm must be able to draw people in. It should collaborate with some of the businesses that supply long-term pharmacy care. In online marketing, the process is built. At the moment, anyone can utilize online marketing to expand their long-term pharmacy care.

The above said actions could help India to be a successor in long-term pharmacy care operations by which it could setup the standards and attract all other developing and developed countries to adapt this process.

  • The long-term pharmacy care requires a PharmD candidate as the minimal educational requirement. For the provision of long-term pharmacy care, a degree and some specialized training is necessary.

CONCLUSION:

Pharma background students are responsible for the long-term pharmacy care opportunities. Independent pharmacists can increase their possibilities and business in the long term pharmacy care. It is herewith concluded that India is in need to adapt long term pharmacy care which could also create and show job opportunities of many Pharm.D graduates.

REFERENCES:

  1. Jared A, Colin Y, Mary C, Ellen L and Protima A. Long-term care pharmacy: the evolving marketplace and emerging policy issues, Avelere Health LLC, Washington DC, 2015.
  2. Russ P. The value of the long-term care pharmacist in the delivery and continuum of care. Managed Health Care Associates, 2020.
  3. Gonçalves JR, Sleath BL, Lopes MJ, Cavaco AM. Prescribing-Assessment Tools for Long-Term Care Pharmacy Practice: Reaching Consensus through a Modified RAND/UCLA Appropriateness Method. Pharmacy (Basel). 2021 Dec 3;9(4):194.
  4. Aislinn A, Managing the challenges of long-term care pharmacies for at home patients. Pharmacy Times, 2020.
  5. Caitlin M, Strategies for operating a long-term care pharmacy, Pharmacy Times [Conference Proceedings], October 27, 2019.

 

 

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