‘CHC pharmacy benefits hospital, patients’

Improved quality care, low-cost medicine, and the possibility to generate profit are some of the benefits the Commonwealth Health Center and patients could enjoy with a hospital-controlled outpatient pharmacy, according to Commonwealth Healthcare Corp. chief executive officer Esther Muña.

Muña told Saipan Tribune that the most important benefit the pharmacy will bring to the hospital and its patients is increased quality of care.

Muña said a network of information may be shared between the pharmacy and the physicians so that there is a second view from the “pharmacist who is trained to look at the patient and to determine whether the medication is really fit for the particular diagnosis.”

“When you run your own pharmacy, you share your own electronic health records, or EHR. When you share EHRs, the pharmacists have access to the patient’ lab results, doctor’s notes, etc.,” said Muña.

A pharmacists’ concern is crucial to the prescription of medicine because of the concept of specialization in the medical field. Given how broad the field of medicine is, not one doctor could specialize in all medical fields. Because of this, a pharmacist may voice out recommendations to the doctor based on a patient’s prior health records, creating an interaction between the professionals that could lead to overall better care.

“There is room for improvement and [with the new outpatient pharmacy] having access to patients’ EHRs make things better,” she said.

Reduction of cost

Muña said an outpatient pharmacy controlled by CHC significantly reduces the costs of medicines compared to other outpatient pharmacies. This, in turn, raises the continuity of care, all through the 340B Drug Discount program.

The 340B is a federal program created in 1992 that requires drug manufacturers to provide outpatient drugs to eligible healthcare organizations or entities, allowing CHC to provide cheaper medicine that is accessible to all.

According to Muña, discussions on the application for the program are already underway with the Office of Pharmacy Affairs.

“When patients don’t have access to medication, patients would return to CHCC as an inpatient or in [an even] worse situation,” she said.

According to Muña, CHCC has records showing that one of the causes for readmissions is “because after a patient is admitted and discharged, sometimes they don’t have access to medication [because of the high costs].”

“We end up giving it to them as an inpatient, which is a more costly way of doing it because the patients lack access to proper prescription medicine,” she said.

There are times where patients have had to choose between “putting food on the table or buying medication. A lot of times, they chose the former.”

According to Muña, the repeated return of patients as inpatients is costing CHC more.

“It costs us overtime. When we have admissions that could be managed as an outpatient, it would cost CHCC more money than having the patient be given access to medication,” said Muña.

Profit for CHC

According to Muña, a CHC-controlled outpatient pharmacy could help the financial standing of CHCC in general. Through 340B, the CHC outpatient pharmacy may obtain medicine at a discounted price, allowing the pharmacy to sell medication at a cheaper price.

Muña believes that the fact that the outpatient pharmacy has access to cheaper medication is reason enough to consider it as one of the many benefits of an in-house outpatient pharmacy.

“Obviously, it’s a money-maker. It makes business sense for PHI Pharmacy [the pharmacy that is currently holding the exclusive lease] to extend their lease and it also makes business sense for [CHCC] to take over and do it ourselves,” she said.

PHI Pharmacy has been in CHC for 15 years. The lease is set to expire this Aug. 14.

CMS compliance

Not too many know about CHC having an inpatient pharmacy. That is because most pharmaceutical needs are supplied by PHI Pharmacy.

CHC’s inpatient pharmacy is in a tiny room that has been sectioned to accommodate equipment for the production of intravenous fluids, chemotherapy medicine, and other medications.

According to Muña, the CHC inpatient pharmacy is due for remodeling due to a new Centers for Medicaid and Medicare Services requirement.

The deadline to be compliant with the new CMS regulation is July 2018.

“CHCC belongs to the people. Any savings that [CHCC] makes out of cutting costs by improving quality of care goes back to the people because we could pay for other things such as medical supplies, nurse salaries, specialty care expenses, etc.,” Muña said.