The Invaluable Role a Clinical Pharmacist Brings to an Ambulatory Care Setting

Geri Buderwitz, PharmD, MBA, Senior Director of Strategy
June 29, 2023

Ambulatory pharmacy represents a critical, yet sometimes overlooked, aspect of patient care. When a patient is prescribed a specialty medication, the pathway to getting that medication is often marked with many obstacles. An ambulatory pharmacist’s role is to help patients navigate this path and ensure they are getting the care they need.1

In the ambulatory pharmacy setting, the pharmacist becomes part of the care team within a hospital or health system, working directly with a patient’s providers and staff to improve access to care and personalized support. They provide comprehensive medication management to patients across all healthcare settings, including in direct patient care environments. Spanning a wide range of services beyond medication counseling, clinical pharmacy intervention by ambulatory pharmacists can include ordering and interpreting lab values to assess medication efficacy, initiation, adjustment, and/or discontinuation, as well as assessment of drug-drug interactions, referral to disease education, nutrition, social work and other social services. Further, ambulatory pharmacists can provide patient education on medications, diet, lifestyle, and devices such as glucometers.

Ambulatory pharmacists significantly improve patient outcomes by proactively assessing and eliminating barriers, streamlining medication delivery and ensuring patients stay adherent to their medication regimens. However, health systems can experience challenges when implementing models that acknowledge the extensive role clinical pharmacists play on the care team when they attempt to expand the boundaries of the established role. One of the main challenges involves defining the pharmacist’s role within clinic. While ambulatory practice is an increasingly expanding field within pharmacy, each clinic remains unique; physicians and advanced practice practitioners may have a limited understanding of the scope of each clinic’s practice and the value a clinical pharmacist can provide. Therefore, it is important to communicate to physicians, other providers, and staff the current workflow within the clinic and gaps that may exist in a practice. By facilitating open communication, it becomes possible to ensure a productive working relationship among all care team members moving forward.

Payors can also vary widely in their reimbursement structure for pharmacist-based visits, and pharmacist’s visits on the same day as a physician’s visit are likely non-reimbursable. To properly implement a model where pharmacists bill for their services, there must be an appropriate workflow, revenue cycle integration, and documentation of services provided. While these represent challenges, the ability to overcome these barriers is not insurmountable and the benefit is substantial for the patients and care teams. To read the full published article in Pharmacy Times, click here.