ASHP survey of ambulatory care responsibilities of pharamacists in managedcare and integrated health systems - 2001

The results of a 2001 national survey of the ambulatory care responsibiliti es of pharmacists in managed care organizations (MCOs) and integrated healt h systems are reported and compared with the results of similar surveys con ducted in 1997 and 1999. Three hundred and seventy-six MCOs and, integrated health systems participa ted in the telephone survey. The survey elicited data about organizational structure and pharmacist functions in the ambulatory care environment. Surv ey respondents were asked about 24 specific ambulatory care pharmacist func tions. The performance of functions was related to five "enabling" factors: pharma cists on interdisciplinary care teams, automated dispensing systems, integr ated electronic medical records, very supportive medical staff, and very su pportive senior management. Twenty previously measured functions decreased since 1999. Decreases were greatest in negotiating pharmaceutical contracts (-28%), administering, immunizations (-27%), and immunization screening (- 24%). Enabling factors supported continued expansion. Two clusters of funct ions, patient-related and population-related activities, were identified an d supported differentially by enabling factors. Group-model and staff-model HMOs had the most enabling factors and the broadest scope of pharmacist fu nctions. Independent practice associations had fewer enabling factors and a different mix of functions, with an emphasis on population-focused functio ns. Ambulatory care functions of pharmacists have expanded to new areas and hav e decreased in more traditional areas, perhaps because of the current pharm acist shortage and the increase in the number of prescriptions and patients .