Will My IHS Pharmacy Have to offer mail-order services?

Posted by on July 12, 2012 · Leave a Comment 


Last month you read about how using the VA Consolidated Mail Outpatient Pharmacy (CMOP) for mail-order prescription services in IHS may affect pharmacy staff size. From what we learned during our interview with CAPT Pam Schweitzer, IHS-VA National CMOP Coordinator, the plan is for most sites to stay at the same staff size or to even increase. We asked you what you thought in our poll, and 70% thought that it wouldn’t increase.

Phoenix Indian Medical Center staff visiting the VA CMOP Leavenworth

Another frequently asked question about the program is “Will my pharmacy HAVE to offer mail-order services & use CMOP?” We discussed this with CAPT Schweitzer, and she took the time to address some of thse important and valid concerns:

Q: Will IHS require every site to get on board with CMOP?

A: No. It is optional. One aim of this project is to improve the efficiency of the prescription filling process. This may involve combining automation and mailing prescriptions locally. Many times, adding more staff is not an option.  Some of the sites have long wait times or health through adherence.  CMOP provides an additional/alternative method, which makes sense for improving the quality of health care.
As you can see from the CMOP flow chart below, the programs allows for flexibility for the patient to choose the plan that works best for them, as well as for the IHS site to customize the program to their own specifications:
Q: Will the tribes have an opportunity to get on board with CMOP?
A.  Quite a few tribes are interested. It is expected that they will have the opportunity to get on board.  In fact, three large tribes in Oklahoma have been mailing prescriptions from their facility for quite some time.  Their experiences and challenges were incorporated into the planning of the CMOP project.

Ken Siehr, National CMOP Director snapped this photo of the staff when he stopped by Phoenix Indian Medical Center

Q: Which IHS sites are already implementing CMOP services?

Rapid City Indian Hospital (South Dakota), Phoenix Indian Medical Center (Arizona), Claremore IHS Hospital (Oklahoma), and the Yakama Indian Health Center (Washington), to name a few. Eleven sites are actively using CMOP with at least eight more scheduled for activation by the end of the year.
From our discussions with IHS and Tribal Pharmacy Directors, it is clear that this have been a hot topic of discussion in the IHS pharmacy world. Our goal of part 1 and part 2 of this special IHS and mail-order services series was to help you get answers to some of the FAQs that you were wondering about.  Special thanks again to CAPT Pam Schweitzer for answering questions about this new program.
If you are going to go through the transition to using CMOP in your pharmacy and have pharmacy staffing needs during the transition, click here for your options.

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IHS Pharmacy Directors: Pharmacy staff to decrease with CMOP implementation?

Posted by on June 15, 2012 · Leave a Comment 


I promised you an update on concerns about IHS pharmacies starting to offer central fill mail-order prescription refills through the Veteran’s Affairs Consolidated Mail Outpatient Pharmacy (CMOP) in Leavenworth, KS.

Some concerns I heard from IHS/tribal pharmacy directors were: How would mailing prescriptions impact the current pharmacy staff? Will mailing prescriptions really be in the interest of patient care, and will every site be required to provide mail service? What about tribal pharmacies-can they get involved? Click here to find out the answers

I spoke to CAPT Pam Schweitzer, IHS-VA National CMOP Coordinator, to ask her these and other common questions about IHS mailing prescriptions and using the VA CMOP.

Read on to find out answers to some FAQs about the program and how the goals above will be met:

Q: Is pharmacy staff expected to increase, decrease, or stay the same?

A: The IHS sites where CMOP has been implemented so far have kept their pharmacy staff, and in some cases have increased pharmacy staff. These sites are fortunate to have good CEO support of the pharmacy department. The pharmacists will be able to spend more time reviewing a patient’s records when processing refills, performing medication reconciliation, and/or fulfilling Improving Patient Care (IPC) objectives that allow pharmacists more time to do clinical work.

Q. Wouldn’t mail-order services be worse off for patient care because the patients don’t get as frequent personal interaction, and our work may become less clinical?

A: Mailing prescriptions can increase patient compliance, especially for patients who live in remote areas and may have transportation barriers that prevent access to the pharmacy. Studies have shown that mailing prescriptions can increase patient adherence. Yet if a patient chooses to go to your pharmacy to pick up medications instead, he/she can still choose to do so. The pharmacists’ time will likely be freed up to provide more clinical services for patients, because pharmacists won’t need to be involved with filling nor verifying the prescriptions.

Q: What are the less known features of VA CMOP that will be beneficial to patient care?

A: Patients can be provided with a 30-day supply of medications at each fill, increasing the possibility for billing and reimbursement for drug costs (especially if a site is currently dispensing 90 day supplies).

Patients are able to request their medication early (before the next fill is due) using a new feature in RPMS called Suspense.
Example: patient picked up medication today. He/she can request refill right now for their next fill.

Q: How will staff pharmacists’ & pharmacy technicians’ roles change due to CMOP implementation?

Staff pharmacists will still be involved with processing the refill prescriptions and will likely have more time to review the patient’s electronic record and manage medication therapy.

The pharmacy technicians’ workload of filling prescriptions will decrease, allowing more time for monitoring point-of-sale billing and inventory management. One additional duty the technicians have with CMOP is answering the phone and looking up tracking information if the patient didn’t receive their medication.

Stay tuned in a future issue to find out the rest of the answers to FAQs like whether every site will be required to use VA CMOP and what may be in store for tribal facilities. You’ll also see how CMOP would work if integrated with your pharmacy services.

Expecting pharmacy staffing needs in your IHS/tribal pharmacy?  Not looking for just a warm body?  Get options – select IHS-experienced pharmacists for your pharmacy

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