Good morning! I am delighted to be here and excited to serve as our Association's next president.
As Marialice affirmed yesterday, the state of our Association and profession are strong and getting stronger. I am looking forward to the next year and continuing to work with a great team of board members, our CEO Tom Menighan, and his incredible staff. I also want to acknowledge the outstanding year of leadership that President Marialice Bennett has provided. It has been a privilege to “be her shadow” this past year.
Over the past year, Marialice has been a constant reminder to us to remain focused on the opportunities being placed before us with the Affordable Care Act and other activities. It is up to us to focus on the transforming health care system and continue to build recognition and demand for pharmacists' roles in the system. This job is our responsibility and the goal of my presidency. I know that our Association is up to the task of driving connections and transforming patient care.
Since its publication in 2000, many of us have read Malcolm Gladwell's book The Tipping Point. Gladwell analyzes what makes something move from the preference of a few to the acceptance of the masses. Many of us asked ourselves, “When and what will be pharmacy's tipping point? When will pharmacist-delivered patient care be embraced and valued throughout the health care system?” Well 12 years later, I believe that time has arrived. Gladwell argues a tipping point occurs when the conditions and circumstances are right. I believe the conditions and timing are right for our profession. Many who know me would agree that I'm clearly the optimist—my glass is always more than half full! But thanks to the work of this Association, my predecessors, and all of you, the timing and conditions are right for a tipping point. There are five reasons our time is now. It is up to all of us to continue the work that got us to this point and ensure we are valued for the care we provide.
First, there has been significant change in the public's perceptions and expectations of pharmacists. The public is embracing our patient care activities and role whether it is immunizations, diabetes management, or adherence programs. How many of you now frequently hear someone talking about “my pharmacist” who gave me “my flu shot,” or addressed “my medication need”? These stories are far more frequent and the public attitude is far more acknowledging and receptive.
Second, health care decision makers have recognized that quality care delivery will be achieved through a team-based approach and that pharmacists are key members of the team. These team-based models could be in the form of medical homes, accountable care organizations, or collaborative arrangements that utilize pharmacists' expertise. More pharmacists are now practicing in these team models—working together with physicians and other health professionals. These are exciting new positions and roles for pharmacists in settings that didn't previously exist.
Third, our country recognized that health care delivery system reform was needed. The result is a new era of embracing innovative approaches to health care delivery, often including pharmacists in new patient care roles. Here are two examples:
- The Center for Medicare & Medicaid Services (CMS) Center for Medicare & Medicaid Innovations was established to test payment and service delivery models and determine their effect on program expenditures and quality of care. The CMS Innovation Center has requested proposals and provided funding for programs that approach delivery of health care differently than in the past. Pharmacy can lead the way here, and the Association is supporting pharmacists submitting proposals to the CMS Innovation Center.
- Community-Based Care Transitions Programs focus on decreasing complications when patients transition from one care setting to another. Pharmacists must have a major role in these programs, and the Association and our partners are advocating on your behalf. Connections have been established with hospital administrations, physicians, state pharmacy associations, colleges of pharmacy, and local community-based organizations.
Fourth, the drive to reform our health care system is focused on increased quality and decreased costs. While quality is “job one” for measuring the success within our health care system, as we all know, cost effectiveness is not far behind. That is why the Association is and must play a leadership role when it comes to medication use and quality indicators.
The Pharmacy Quality Alliance, a collaborative of multiple pharmacy organizations, has helped ensure that pharmacy metrics for medication use and adherence have been incorporated into the new star ratings for Medicare health plans. This positions pharmacists as valued contributors to health outcomes in our country's health plans.
In today's environment focused on cost savings, we have heard from many decision makers that any proposal regarding health care must provide cost savings. While we all know that increasing compliance, adherence, and appropriate medication use may increase pharmaceutical expenditures, we also know it saves overall health care costs and improves quality of life. We will work to ensure Washington and our partners keep their eyes on the full balance sheet and the big picture.
Fifth and finally (while this may be an unpopular statement), I believe that as the pharmacist shortage is ending in some areas, it will encourage pharmacists to seek out new roles and opportunities in patient care. Our graduates are extremely bright, entrepreneurial, and clinically prepared for these new patient care practices. We should not try to hold back these innovators; we should be actively encouraging them. With our support, they will create and develop new roles and services that don't exist today.
These factors support why I believe the time is right. The U.S. health care system is seeking the “outcomes and value to patient care” that we can and are delivering to patients today. The time for the tipping point is here!
So what is it going to take to see this through? Why aren't more pharmacists and decision makers taking advantage of the opportunities before us? It has simply been too easy to stick with what is comfortable. I recognize that change is not easy; but if it is change that we desire, then we cannot depend upon someone else to do it for us. We, along with our predecessors, have worked hard to get to this point. We must keep going and maintain our focus on the patient. I know I am talking to the believers here today, but we need your help in getting others to recognize that our collective future rests on the commitment across our profession to transform patient care.
To do so, we must take the LEAD. Pharmacy's transformation across the tipping point from a model of drug distribution to one of patient care will require everyone, not just you, to LEAD through a commitment to Leadership, Engagement, Action, and Determination to do what is needed to make a difference.
This is my call to action and my goal as president: We must provide leadership, engage and foster additional leaders throughout our profession, take action, and demonstrate our determination to make a difference in our patients' health. The Association will be there to support you. The Association's new strategic plan focuses on strategies to enable, empower, and inspire our members to LEAD and transform patient care.
First, we must provide leadership. Each of us has the ability to lead and model the way to our profession's success by pursuing our vision with a passion, challenging the status quo, doing the right things for our patients, and celebrating our successes. As leaders, we are challenged with influencing and inspiring others to see and follow our collective vision. As Harles Cone, a leadership consultant who has worked with the profession for years, said, “A leader is anyone who is trying to close the gap between the way something is and the way it could be.” You don't need a management title or elected position. Each of you fits this definition and is part of my “LEAD from where you are” plan.
In addition to your practice level leadership work, the Association too is working to lead the profession and to give you the tools to be a leader. Two examples of LEADership by the Association include work being conducted by the Pharmacy e-Health Information Technology Collaborative and the Health Resources and Services Administration (HRSA) Pharmacy Services Support Center (PSSC).
The Pharmacy e-HIT Collaborative includes APhA and eight other pharmacy practice organizations focused on addressing the profession's needs and desires for integration within the health system's information technology infrastructure. The collaborative recently released a “roadmap” document to educate stakeholders on our profession's goals in this area.
Through a contract with the Association, HRSA PSSC provides education and training to our nation's critical-access hospitals, community health centers, and other designated safety net health care providers, including local pharmacies. These stakeholders provide invaluable low-cost medications and services to the medically underserved, and many act as innovation sites for the integration of pharmacist-provided patient care services. This program helps prevent the very issues the government is focused on: avoidable readmissions, inappropriate medication use, and nonadherence in our nation's underserved population.
Second—and this is critical—it is essential that we all create and engage additional leaders throughout our profession if we are to assemble the masses needed to reach the tipping point.
I am here before you today because there were leaders and mentors who guided me through my professional journey. I ask you to do the same for others, especially our new young practitioners. Find a pharmacist, resident, or student pharmacist and support these individuals as they start their career. Help them see a vision for pharmacy's future and their own future. Coax and encourage them to try new things, develop new services, and expand their roles. Help them learn from and progress past their attempts that fail. Share with them what you have learned through your experiences and be supportive if things aren't progressing as fast as they would like. Bring them along with you to a professional meeting and help them network with others. If you aren't currently one, become a preceptor to students and residents.
Again, the Association also is working hard to foster the next generation of leaders and to give you the tools to do so too. The Association has tools to help you succeed such as the medication therapy management (MTM) advanced pharmacy practice experience resources for pharmacy preceptors that translate real MTM experiences into teaching techniques for student pharmacist rotations.
Third, take action and engage others. Those of us here today are not enough to drive the change we need to reach our tipping point. Activate your colleagues! There are a few things you can do:
Commit to continuing the transformation of pharmacy practice
This work is not isolated to those on the frontline but to all who have knowledge, resources, and ability to drive change in these areas. Regardless of your practice setting or role, you can contribute to our profession's transformation by helping change what is expected of us. In doing this, remember to listen carefully to our stakeholders, our patients, other health professionals, payers, insurers, and policy makers. As I learned at Procter & Gamble, they are successful because of their longstanding focus to listen carefully and learn about the consumers' needs for their products. For us to succeed, it is not whether we can do a good job but whether we can best meet the job needed and expected by the recipients and purchasers of our services.
The Association will stand with you in these efforts. Building upon strengths, like immunizations and the diabetes projects of the APhA Foundation—or helping practices demonstrate their commitment to quality with the recently announced collaboration between APhA and the National Association of Boards of Pharmacy in community pharmacy practice accreditation—these are just some of the ways the Association is taking a leadership role to support practice transformation.
APhA and the APhA Foundation have partnered with the Centers for Disease Control and Prevention and pharmacy thought leaders on work that will facilitate adoption of pharmacist collaborative MTM agreements, particularly for chronic diseases. In addition, these entities will be exploring case studies to better understand and describe the key policies, components, facilitators, barriers, strengths, and effect of the pharmacy collaborative MTM initiatives on health outcomes, such as high blood pressure.
Participate in legislative advocacy
Whether you like it or not, politics is a reality of life, and success in that arena requires a critical mass of our profession speaking with one voice in a common language that is easily understood by decision makers. The Association is leading several coalitions and collaborations attempting to achieve this goal and needs everyone's active participation in the process. Whether it's hosting a decision maker in your practice or visiting the office of a decision maker in your state capitol or Washington, DC, your efforts can make a huge difference. Let me paint a picture of the influence you can have. If every pharmacist in our country made a political outreach contact, there would be 300,000 outreach contacts. Then, if every pharmacist convinced one patient to do an outreach on their behalf, the total outreaches would rise up to 600,000 contacts. Then, if every pharmacist also would get just one physician or other health professional to advocate for the pharmacist's role on their team, that would result in a total of 900,000 outreaches. Nearly a million contacts from three e-mails or phone calls! What an impact this would make!
Thanks to the work of the Association and our partners, we have a specific bill in the U.S. House and Senate aimed at recognizing and enhancing MTM services. We are adding cosponsors every day and have 44 in the House and 16 in the Senate. The message we are delivering to Capitol Hill is that pharmacists' services can be part of the solution to the debt-reduction challenge.
This year is an especially important one for our legislative advocacy efforts, since it is a presidential election year. APhA's Political Action Committee and Advocacy Key Contact Network play an important role within the Association's strategic directions as we increase engagement and influence with elected officials. You should visit the Government Affairs booth to learn more about how you can play an active role.
Fourth and last, I ask you to demonstrate to others our determination to make a difference in our patients' health. This is the easiest of all: just let your passion, your dedication, and your enthusiasm communicate about our profession. As my high school coach said of my basketball abilities, “Jenelle's dedication and enthusiasm make up for any gaps in talent on the court.” You can help educate the public, payers, other health care professionals, and stakeholders about our value in the health care system. On a national level, the Association conducts media outreach aimed at increasing awareness and recognition of pharmacists' knowledge, skills, and role in improving medication use and advancing patient care. This same outreach is needed at the local level and with your patients. Meet with your local newspapers and TV news and community groups. Be a resource of expertise on medication-related topics. Through common and consistent message delivery and action, we will continue to change perceptions and facilitate support from various stakeholders.
The Association has done a great job with its participation in the Department of Health & Human Services (HHS) Million Hearts campaign. This program provides an opportunity to educate others about the important role pharmacists play in good heart health. The Association took this message recently to a giant jumbotron in New York City's Times Square. We are also collaborating with HHS, CDC, the American Heart Association, and other health professionals to improve the heart health of our nation. The APhA Foundation is working with CDC to develop messaging about the meaningful role pharmacists play in helping patients with high blood pressure. CDC plans to roll out this advocacy messaging later this year.
The recent report to the surgeon general, which you will hear more about shortly, articulates the contributions of pharmacists as health care providers within federal programs that could be transposed to other practice settings and lead to improved care delivery and outcomes. Letters of endorsement from the surgeon general and others have highlighted its credibility and acceptance. When you speak with others about pharmacy's expanding role, be sure to use this report to validate and reinforce your message. It is a timely and powerful tool!
As Marialice said yesterday, the state of our profession is strong because our Association gets better every day. New health care delivery systems are still being tested and patient care needs transformed. We must keep our focus to ensure pharmacists are recognized as the health care team member responsible for ensuring optimal medication therapy outcomes for patients.
As our meeting theme describes, the Association is focused on driving connections that will support our transformations in patient care and better position pharmacists within the evolving health care system. It is up to us to influence the systems we work within and to LEAD from where you are. Join me this year in engaging new LEADers and being committed to actions that advance our profession and facilitate change. Demonstrate your determination to make a difference! In times of great change, we must find the opportunities and take advantage of them.
Thank you for your time. I look forward to working with you toward a stronger tomorrow. Let's move beyond the tipping point!
Jenelle L. Sobotka, PharmD, FAPhA
Jenelle Sobotka is Professor and Endowed Chair of Pharmacy Practice at Ohio Northern University Raabe College of Pharmacy. She has served on numerous other APhA committees and as a delegate. She received her BS and PharmD degrees from the University of Iowa. Sobotka was Director of Professional Relations at Procter & Gamble (P&G). Before joining P&G, she was Associate Director of the Iowa Pharmacy Association and Director of the Iowa Center for Pharmaceutical Care (ICPC). ICPC received the 1999 APhA Foundation's Pinnacle Award for work to advance patient care practice. She coauthored the APhA publication A Practical Guide to Pharmaceutical Care. Sobotka's pharmacy practice background includes community pharmacy, clinical specialist/internal medicine (Department of Veterans Affair Medical Center), and academia. Sobotka has served two terms with the Ohio Pharmacists Association Board of Directors. She serves as a student pharmacist preceptor and is a board member of St. Vincent de Paul Charitable Pharmacy in Cincinnati, OH. She received the 2009 National Pharmaceutical Association Foundation Excellence Award, the 2008 Kappa Epsilon National Career Achievement award, the 2005 Pharmacy Technician Certification Board Service Award, and the 2003 University of Iowa Rho Chi Honorary Alumni Award, and she is an APhA Fellow.