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An industry first in measuring pharmacy quality

23 April 2013 Ahmed Bayat, Metropolitan Health
Ahmed Bayat, Pharmacy Networks Manager at Metropolitan Health Risk Management.

Ahmed Bayat, Pharmacy Networks Manager at Metropolitan Health Risk Management.

Metropolitan Health Risk Management has developed the first industry tool to provide tangible evidence of quality outcomes from pharmacy services.

“Quality service is a watchword for any large medical scheme, but definitively measuring quality standards, especially by service providers, is not always easy,” explains Ahmed Bayat, Pharmacy Networks Manager at Metropolitan Health Risk Management.

“In the past, without a tool to verify quality in pharmacy services, it was assumed that good quality was being delivered. While there have been previous attempts to measure the quality of services delivered by pharmacies, the measures used were often linked to criteria outside of the pharmacist’s control.”

The focus in developing the tool was to ensure the profiling process does not add operationally to the workload of pharmacists, but increases awareness of the need to comply with the profiling measures.

“We see pharmacies as one of the critical building blocks of an emerging healthcare system with a far stronger primary healthcare foundation. The role of pharmacists is shifting from dispensers of medication towards patient management. Measurable quality management in this emerging environment is key,” says Bayat.

The tool, which allows for accurate self-assessment, was developed after wide consultation and in-depth investigation. Quality indicators are selected on the basis of their relevance to the medical scheme for which profiling is implemented, as well as ease of implementation at pharmacy level.

The measures selected to initiate the tool provide specific quality indicators around ICD-10 coding compliance for over-the-counter dispensing; acute-to-chronic conversion of drugs that qualify for reimbursement from chronic benefits; and generic as opposed to branded drug dispensing. Ongoing development and enhancements will see the addition of new measures, in consultation with the relevant stakeholders that will further demonstrate the quality and value of pharmacy services.

Measurement across these three key areas is expected to stimulate positive behaviour changes across participating pharmacies that will be of direct benefit to medical scheme members accessing pharmacies in the network.

The new profiling tool is expected to drive an overall rise in quality outcomes across pharmacy networks. It affords pharmacists an opportunity to demonstrate their commitment to a world-class pharmacy service and tangibly reinforces the value pharmacies can deliver in an NHI environment.

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