An Act to Improve Access to and Reporting of Pharmacy Services in Hospitals

The Massachusetts Health & Hospital Association (MHA), on behalf of its member hospitals, health systems, physician organizations and allied healthcare providers, appreciates this opportunity to offer comments in strong support of HB3239 “An Act to Improve Access to and Reporting of Pharmacy Services in Hospitals.”

The goal of sections 1 & 2 of this MHA priority bill is to enhance the team approach to healthcare delivery. Sections 1 & 2 would allow the development of a collaborative drug therapy management (CDTM) system whereby a pharmacist and clinician can partner to provide optimal drug therapy management for each patient while in a healthcare facility. This system allows the pharmacist to have a direct impact on patient care and improve overall clinical outcomes. Currently collaborative drug therapy management is in use in 47 states as well as authorized for use for Medicare patients and within the VA system.

CDTM reduces delays in modifying drug regimens and unnecessary physician office visits, and increases patient compliance and adherence to drug therapy plans, all of which help avert readmissions that commonly occur due to poor prescription drug follow up and compliance.

When pharmacists and physicians work closely together, patients consistently achieve better results from their drug therapies, in part because they are more likely to take their medicines − and take them correctly. Additionally, when physicians and pharmacists work together to monitor a patient’s reaction to a particular drug therapy, they are able to detect adverse reactions more quickly, which ultimately saves lives and unnecessary costs within an acute care setting. And by informing patients and prescribers of possible adverse effects and/or drug interactions, pharmacists help keep their patients healthy and safe − as well as avoid unnecessary costs from complications or hospitalizations.

CDTM is not a new concept, as this is something that nurses and physician assistants do every day with treating healthcare providers. The goal of sections 1 & 2 of HB3239 is to make a technical change to the law to allow pharmacists, after referral from the patient’s attending physician, to be part of this important team discussion. This change would allow a hospital pharmacist to develop a shared responsibility with the treating healthcare provider to improve patient outcomes, including better assessment of patients, earlier initiation and quicker modification of drug therapies, additional monitoring of patients, and direct administration of drugs according to evidenced based, hospital approved protocols.

Section 3 of HB3239 would also provide for a technical clarification to the recently enacted compounding law to provide for an exception to submitting an annual list of compounded drugs within a hospital setting to the state. The compounding law was developed to target those drugs that are developed and shipped to locations that are external to the pharmacy to ensure that there is a system to track when there is an adverse event related to a specific drug. However, the law did not take into account that drugs may be compounded during a surgical or other procedure for active inpatient use, during which the patient would be closely monitored by a team of clinicians. Without this technical change, hospitals would be required to develop a detailed reporting process that would use staff time and resources with no impact on monitoring patient safety.

Thank you for the opportunity to offer testimony on this important matter. If you have any questions, or require further information, please contact Michael Sroczynski, MHA’s Vice-President of Government Advocacy at (781) 262-6055 or msroczynski@mhalink.org.