New Year's Goals to be a High Performing Pharmacy

What goals should a pharmacy set to become high performing pharmacy? Podcast Host Nick Dorich, PharmD, PQS Associate Director of Pharmacy Accounts talks with Ray Arizmendi, Sr. Account Executive, Payer Relations at PQS about things that pharmacies can do now to become high performing pharmacies in 2023. 

Arizmendi also talks about performance programs and the ultimate goal of improving patient outcomes in this episode.

Transcript

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00:00:01:06 - 00:00:23:20
Speaker 1
I don't know about anybody else, but I don't have my doctor on speed dial. I have their office number, but it's not like I'm going to get a hold of the doctor directly. At best, I'll get someone to call me back another staff member hours later, or maybe even days later. Conversely, I could literally pick up the phone right now, call the pharmacy and ask to speak to the pharmacist about my medication.

00:00:24:07 - 00:00:42:14
Speaker 1
Either the pharmacist themselves will pick up or a staff member will transmit to them. And guess what? I'll get most of my questions answered from there. So patients and pharmacies have a far more direct line of access than a patient and their doctor.

00:00:42:14 - 00:01:07:07
Speaker 2
Welcome to the Pharmacy Quality Solutions Quality Corner Show where quality measurement leads to better patient outcomes. This show will be your go to source for all things related to quality improvement and medication use and health care. We will hit on trending health topics as they relate to performance measurements and find common ground for payers and practitioners. We will discuss how the equip platform can help you with your performance goals.

00:01:07:17 - 00:01:28:20
Speaker 2
We will also make sure to keep you up to date on pharmacy quality news. Please note that the topics discussed are based on the information available at the date and time of recording. Information or guidelines are updated periodically and we will always recommend that our listeners research and review any guidelines that are newly published. Buckle up and put your thinking cap on.

00:01:29:05 - 00:01:39:11
Speaker 2
The Quality Corner Show starts now.

00:01:39:16 - 00:02:02:13
Speaker 3
Hello Quality Corner Show listeners. Welcome to the PQS podcast, where we focus on medication use, quality improvement and how we can utilize pharmacists to improve patient health outcomes. I'm your host, Nick Dorich, in on the episode today, we are wishing you a Happy New Year for this show. We plan on kicking off 2023 with the topic of setting your pharmacy up for success.

00:02:02:22 - 00:02:26:16
Speaker 3
It is our first episode of the year. We have many more to go, but we're going to go over a few things today that a high performing pharmacy can do each and every year so that they could be prepared to take on the new year and the challenges and the success that may be on the road ahead. Now, I know some of you may view this as cliche or boring or tedious to set up New Year's goals or resolutions.

00:02:26:16 - 00:02:55:06
Speaker 3
And I have to be honest, and I have to admit that for a long time I had that same exact feeling. But for myself a few years ago, I spent more time understanding the concept of intentionality, short and long term goal setting and being present in your experience. So today's show was going to help us provide our pharmacist and pharmacy technician audience with some key points to consider when setting or adjusting their annual goals.

00:02:55:06 - 00:03:16:04
Speaker 3
So they can be intentional. They can be reliable, they can be consistent, and they can lend themselves to success for your team. Now we are going to be introducing a new guest on today's episode. In our guest is a new member of the team, but our guest is quite experienced with the use of equip and also with the community pharmacies.

00:03:16:15 - 00:03:29:23
Speaker 3
So with that, I'm happy to introduce our guest, and that is Ray Arizmendi, Senior Account executive Payor Relations at PXP. Ray, welcome to the PQS Quality Corner Show. And how are you doing today?

00:03:30:03 - 00:03:32:24
Speaker 1
I'm doing really well, thank you. How are you doing today.

00:03:33:07 - 00:03:51:24
Speaker 3
Ray! Thank you. I'm doing well. I appreciate you asking. Is normally in these podcasts, the guest always gets asked. No one asks how I'm doing. So I appreciate getting the the question back to me. It's an afternoon, Sunny afternoon in the winter while we are recording this particular episode. So and it's a Friday and we are recording it.

00:03:51:24 - 00:04:09:14
Speaker 3
So I'm very much excited for what's to come ahead. Now. Ray, you and I have known each other for a number of years. As I mentioned, you are new to the PQS team, but you are not new to working with PQS. So you and I have had the pleasure of working together in a couple of different capacities. And now I'm glad to call you a teammate.

00:04:10:03 - 00:04:19:13
Speaker 3
But for our listening audience who may not know you, can you tell us a little bit about yourself? What is your career in pharmacy and health care? And then what do you do at PQS today.

00:04:19:21 - 00:04:45:10
Speaker 1
Too? So I'll start off with the with the first part here and pick us this year kind of executive working with health plans and peers alike and programs and their performance, basically looking to see where our products and services can help bridge the gap in care and how we can help achieve mutual goals. I've been here since the end of November, as you said, but at this point that that's pretty much last year, right?

00:04:45:18 - 00:05:04:21
Speaker 1
We're not really looking at this year. Right. All kidding aside, though, I have worked with, as you mentioned, I have worked with PQS in the past in various different roles, which I hope will make this a great fit. That being said, I've been in the industry for almost 20 years At this point. I did do the math and it's officially hitting 18 years now.

00:05:04:21 - 00:05:24:05
Speaker 1
So my career has just become an adult. It can't drink yet, but definitely hitting adulthood. It's going to have to get a job since. So I started in the pharmacy at the pharmacy technician at Walgreens and moved into a few different roles. From there, I worked on the third party operations team working on billing issues, plans at UPS and some other back end work.

00:05:24:05 - 00:05:56:06
Speaker 1
That's when I moved over to the the Enterprise Adherence team as a coordinator. I was there for a little bit. I remember when I first joined the team, there may be about four or five plans that had some kind of performance based network attached to them, and that's really just not the case anymore. Today, after that, I moved over to the 340 B space for a little while, had just over 50 clients that I manage and covered entities that I worked with, and then I came back to the adherence team or I went back to the adherence team and someone said that I then I boomeranged back to the adherence team.

00:05:56:06 - 00:06:18:03
Speaker 1
So I like to use that analogy when I talk about that. But as you said, that's actually when I first got to meet you on my second stint with the adherence team. From there I went over to a pharmacy services administrative organization or a at the time it was known as Arete. They went through a joint venture with BPO and is now known as Align.

00:06:18:03 - 00:06:46:12
Speaker 1
Arete at the time, specialized on independent and small chain pharmacies. My work specifically was was working with the Topco group. We worked on building a nationwide network designed by aggregate and regional based grocer pharmacies. They could they could not only fill prescriptions like any other pharmacy, but could also incorporate the whole food as medicine mantra, along with space for additional services like testing sites and clinics and things like that.

00:06:46:16 - 00:07:05:20
Speaker 1
Most recently I was with Tabula Rasa. In that role, I got to work with Health Plan more directly, focusing on all things MTM from a call center perspective and all that background has led me here with PQS basically another boomerang into the pharmacy space. I guess some would say I'm a glutton for punishment.

00:07:06:02 - 00:07:27:05
Speaker 3
Excellent. Ray, I'm really excited to have you here. Both part of the PQS team, as you mentioned, and as I did, I did as well. We've worked together directly for some time, so definitely excited to have you as part of the organization providing your insight to how pharmacies really can use data and improving patient care. And then excited to have you here for the episode today.

00:07:27:11 - 00:07:35:06
Speaker 3
Now, before we jump into our questions for today's episode, we're going to hear a quick bit of information from the PQS team.

00:07:36:24 - 00:08:01:00
Speaker 2
Now it's time for the breakdown as quality quarters show those little as three main topic questions, Our guests will have a chance to respond and there will be some discussion to summarize the key points. This process worksheet for the second and third questions, which will wrap up the primary content for this. The and after that it's to end on a closing summary, usually containing the bonus question.

00:08:01:14 - 00:08:09:02
Speaker 2
Now that we have the start of the process, let's jump into the questions.

00:08:09:02 - 00:08:34:22
Speaker 3
All right, Ray, I hope you're ready to start our questions for today's episode. And we're going to begin at the beginning at the beginning of the New Year, pharmacist are going to be setting goals for their pharmacy team and their pharmacy team members. What are your particular recommendations for pharmacist and the pharmacy team as they set their goals and as they set their resolutions for the new year or specifically now in January, What should pharmacist be doing?

00:08:35:05 - 00:08:55:13
Speaker 1
Yeah, that's a really great question. The reality is the beginning of the year can be really difficult on pharmacies as a whole. On the planning changes, new insurance card, restarting of deductibles, even all that can really become a recipe for disaster. That said, it doesn't mean that we should lose sight on on the goal as it relates to quality measures.

00:08:56:04 - 00:09:12:15
Speaker 1
And that's really a proactive approach to adherence. It's easier for a patient to stay on track taking their medications than it is to get them back on track, since you really can't make those lost dates, it's not like you get one more 90 day feel at the end of the year to make up for those missing dates. That's just not how it works.

00:09:13:08 - 00:09:32:16
Speaker 1
So what I mean by this is that if you can get the patient to start on the right foot, I can make a world of difference. Whether it's encouraging them to go to 90 day if it's available. Of course, auto refills, ensuring that communication methods are accurate, like phone numbers, emails and signed up for the correct outreaches or the ones that they want.

00:09:33:00 - 00:09:55:02
Speaker 1
If you send a patient a text and email and call them when their medication is ready or do well, then typically one of two things is eventually going to happen. If not right away, they'll either ignore those outreaches altogether or they'll ask to be removed entirely. So pharmacies will want to ensure that they're they're turned on to specifically how they want to be contacted for these reminders and notifications.

00:09:55:14 - 00:10:19:12
Speaker 1
You really want to avoid outreach exhaustion. It's also a really good opportunity to start looking at adherent nonadherence patients for the previous year. And no, this does not mean a pharmacist should sit there with a pen and paper. They can also use an abacus if they want. Or maybe better yet, a calculator enrolling them on the enhanced population program where you can do some of the calculating for them is a huge lever that can be pulled.

00:10:19:23 - 00:10:41:11
Speaker 1
It helps identify those patients that need their focus and when you think about quality performance, there's really going to be a bell curve and a large portion late on the cost of it here and not adherent for those that just barely missed the 80% threshold of create a plan, maybe a pill organizer, or to ensure that their meds are taken as they should and when they should.

00:10:42:04 - 00:11:04:10
Speaker 1
I remember auditing some CMRs in my previous role and I would be thoroughly impressed by the patient that had a sheet of paper, a pill organizer in front of them, things like that that would tell them exactly how they're supposed to be taking them when they're supposed to be taking them. And those patients really became the most adherent or were the most adherent when we would speak with them, they understood what they needed to do.

00:11:04:19 - 00:11:28:10
Speaker 1
They understood the assignment for those just barely missed the mark of being it here. Help solidify a plan. Target those patients, print out an outlier screen to ensure that when they come through you can easily identify them. I worked I worked with a chamber with about 20 pharmacies. They had a really cool program where a patient would pay a fee and the pharmacy would fill out a whole pill organizer for a month.

00:11:29:07 - 00:11:50:10
Speaker 1
The fee would cover the cost, the pharmacist to come in and prep for them for their patients. And these pharmacies had outstanding adherence performance scores. Even if the program itself was a wash. The benefits and quality performance impacting their reimbursement rates compounded that value. And when it comes down to it, I would relate the role of a pharmacist similar to that of a parent.

00:11:50:18 - 00:12:03:03
Speaker 1
You give them the tools, the tips, the recommendations, but at the end of the day, the onus falls on the patient. All they can do is help, quote unquote, start at the pharmacy in the hopes that it quote unquote, doesn't end at the pharmacy.

00:12:03:19 - 00:12:21:09
Speaker 3
Thanks, Ray. I'll I'll follow up here a couple of key points that I think about. We often get questions from pharmacy as well. What do pharmacies do that I don't think get them to be high performing. And a lot of it comes down to simply does the pharmacy have goals and do they stick with them? If you think about New Year's resolutions.

00:12:22:01 - 00:12:38:12
Speaker 3
Right. And a lot of people have New Year's resolutions about eating healthy or working on a routine basis. I think the math tells us and just some of the statistics point, that most people give up on their resolutions two or four to between 2 to 4 weeks in the course of the year. What do they do? They start, they stop, right?

00:12:38:13 - 00:12:56:11
Speaker 3
They start and then stop tracking those goals or stop doing those daily routines. So I think point one, that's a lot of what your point is here at the pharmacy is right. They need to continue. They need to start these behaviors and habits in January. So they continue throughout the year. Is that a correct summation point, number one?

00:12:56:11 - 00:13:00:21
Speaker 1
Absolutely. Absolutely. Starting them up. Right. And set them up early.

00:13:01:17 - 00:13:29:01
Speaker 3
Yep. So that so that's point number one. The other part of it and as you talked a little bit about what the pharmacies are setting for goals, it's also important, I think, for those goals to be somewhat multipurpose, right? If you're working on an objective that only ends with one result or only really helps one faction of your pharmacy or your operations, it's going to be a binary response.

00:13:29:01 - 00:13:48:20
Speaker 3
Yes or no, It doesn't work and it does or does not work. But if you have operations or if you have goals and it can impact and touch multiple aspects of your pharmacy operations and how your staff is working, you may not achieve all of the desired goals. But hey, even if it helps you hit one out of three of those goals, that can still be a successful item.

00:13:48:24 - 00:14:08:09
Speaker 3
A key part to goal setting is having different levels, so some that are attainable and then some that are stretch goals as well so that you can make sure you're hitting some level of success and getting some kind of serotonin, some positive feeling from that. But then having a stretch goal to to help you go in once you get past that first initial goal rate.

00:14:08:10 - 00:14:11:22
Speaker 3
Any other final comments before we move to our next question for today?

00:14:12:21 - 00:14:27:24
Speaker 1
No, I think I think that's a great summary and I think that that really helps sort define understand those pieces that that, you know, it's not a one size fits all for all. But, you know, we have the tools and capitalize on that perfect right.

00:14:28:00 - 00:15:03:22
Speaker 3
Moving to our second question or second topic for today, and I want to tap into your experience with the community pharmacy. You shared that you've worked on the chain pharmacy side, you've worked on the independent pharmacy side supporting pharmacies as it relates to value based care, value based arrangements, eye based contracts, etc.. So we know that with value based care in health care, the intent is that for improved patient outcomes, that that's certainly going to relate itself to a bigger financial impact for the pharmacies, for the providers in 2023, value based value based care is going to increase.

00:15:03:22 - 00:15:29:01
Speaker 3
We don't expect that to stop or to slow down and it is something that's impactful in both federal programs but also in the private sector or employer based insurance, commercial programs, etc.. So can you help us kind of set the stage for quality based, value based health care quality programs? Why do they matter for pharmacies in 2023? And how can pharmacists see that impact?

00:15:29:13 - 00:15:57:00
Speaker 1
Yeah, that that's a really good question. So when we think about quality performance as it relates to things like adherence, this is such a vital piece for pharmacies. So let's think about this for a moment. If a patient asleep on average 3 to 5 days and you extrapolate that out to 12 months, that comes out to anywhere between 36 and 60 days of missed therapy, which translates to one or two fills per year.

00:15:57:10 - 00:16:25:05
Speaker 1
Now, let's say the patient is exactly 80% adherence. The quality performance thresholds are typically measured around the 80% and become essentially binary where they're either adherent or not adherent. So we're going to stick to that 80% in one year or 365 days. A patient can miss 73 days of therapy and still be adhere to their medication. That translates to six days a month on average, which is even more than the 3 to 5 days.

00:16:25:05 - 00:16:46:23
Speaker 1
I just talked about. The EQUIPP dashboard tells you exactly how you're performing in any one of those measures. You can look quickly. You can actually quickly calculate the impact for yourself by seeing how many patients you have in a measure and how many patients are or are not adhere. You multiply those patients by the gap, and that is the minimum amount of prescriptions you missed in a year.

00:16:47:10 - 00:17:12:00
Speaker 1
So if you have 100 patients in a measure on the dashboard and your performance is 80% the gap, there's 20% right to 100 or 20 patients that are not in here at the end of the year. That means that 40 prescriptions at minimum, where never feel that your pharmacy, those 40 missed prescriptions only go up when you start to consider how many patients are even further away from 80% here.

00:17:12:04 - 00:17:38:15
Speaker 1
Then consider how Medicare patients are more than one medication on average, and more medications that are currently not even being weighted or measured today. And those numbers just continue to compound whether you're a large chain store pharmacist or an independent pharmacy owner. These things matter. And at the core of it all are quality performance programs. 15 years ago, an independent pharmacy billing 75 prescriptions a day would be more than sufficient.

00:17:39:06 - 00:18:11:01
Speaker 1
That's not why we're at today, and that's not the only thing that matters anymore. It is important, don't get me wrong, but the role of pharmacies has shifted and will continue to do so. While pharmacists and pharmacy owners can't directly control the regulations or control the contracts in place today, they can't control how they react to them. They just they need to figure out how to adjust and how to solidify their future programs like controlling blood pressure and soon agency testing for their showcase how the landscape is changing and how impactful pharmacies can be for the health of their patients.

00:18:11:13 - 00:18:20:09
Speaker 1
And see the value of the pharmacist role. And looking to them and reimbursing them for those additional services and we are here to facilitate that.

00:18:20:19 - 00:18:40:13
Speaker 3
Excellent. Thank you so I'll want to dig a little bit deeper on a couple of the points that you made in focusing on some of these areas, the numbers that you've focused on. And I really like how you broke some of that down. Can you reiterate those numbers for us in terms of what makes that patient adherent, non adherent, like what can they what can they miss on that month by month basis.

00:18:40:24 - 00:19:00:11
Speaker 1
Right. So, so I started out by talking about just 3 to 5 days because on a regular basis anyone can be 3 to 5 days late to pick up your medication. So I'll call it in part four pickup tomorrow and hope something came up. I can't pick it up today. A couple of days go by, 3 to 5 days take place or consider how many patients are not adherent.

00:19:00:11 - 00:19:28:15
Speaker 1
That's 80%, right. If you're not hitting that 80% threshold, that means that for the year you missed 73 days altogether of therapy. That translates to just over six days a month. That means that every patient that you didn't hit an adherent threshold missed over six days a month. Again, that translates to one to over two prescriptions a year.

00:19:28:22 - 00:19:48:05
Speaker 1
And let's say I'm 50% adherent. That's 4 to 5 prescriptions that I didn't fill that year. So all those numbers just it it doesn't it seems like a lot and yet it's so small of what can change to that would make it an impact of of getting a patient from non-Indian to it here.

00:19:48:15 - 00:20:05:16
Speaker 3
Yeah it really speaks to a key number and I've given the example previously when I speak with pharmacy teams that you know, a patient does not need to be perfectly 100% accurate. There's a lot of things that can cause a patient's miss a few days here and there. There could be delays for getting a medication, etc., things that could be very valid.

00:20:05:16 - 00:20:26:04
Speaker 3
But it's not requiring a patient to be 100% adherent. And when we break down the numbers the way that you just did, Ray, where these could be patients that are missing six days each month and having or, you know, maybe it's two months, a year, effectively, those are pretty large gaps where the patient is not getting that benefit of of that medication.

00:20:26:04 - 00:21:00:22
Speaker 3
But then from the pharmacy practice, these missed fills that's missed opportunities that the pharmacy has to fill for those prescriptions and then which which equates to revenue. And we know that that impacts how pharmacies look at staffing. But it also impacts where those are missed opportunities for the pharmacy to have other conversations with the patient. Right. If that patient isn't coming into the pharmacy and filling in October or November, well, they might also be missing their flu shot or if they're missing their pharmacy appointment at other times of the year, they may be missing your blood pressure screenings or they may be missing some of the other opportunities because we know that pharmacists do more

00:21:00:22 - 00:21:19:05
Speaker 3
than just dispense the medications and losing out on those touchpoints. That's the advantage that pharmacist have as health care provider. So it really becomes essential that that patient is there and having their conversation with the pharmacist on a regular basis. Ray, I'll kick it back to you. Anything else you want to add before we move on to the next point?

00:21:19:12 - 00:21:51:01
Speaker 1
No, I think I think you hit the nail on the head there. Again, the reality is that every opportunity a patient comes into your pharmacy, opens it up to help identify those ways, to narrow those gaps, to improve the health as a whole for the patient, whether it's, again, patient, you know, adherence to the medications, controlling blood pressure, testing, all those things have lasting effects and all those missed opportunities are opportunities that you didn't get a chance to talk to them about those programs.

00:21:51:16 - 00:22:13:17
Speaker 3
Thanks. Right now, our third question for today, and this is something that we're actually going to be applying across really all of our podcast episodes are. We intend to apply across all of our podcast episodes in 2023. This is sort of a goal not only for myself, but we've also referenced and he's made an appearance or two on the podcast from time to time, that being our producer for the episodes.

00:22:13:17 - 00:22:34:22
Speaker 3
David So last year or late last year, David found this thread on the Internet that was really interesting and it provoked a conversation internally between us and some others at the PQS team. And it's actually something I want to address really in every conversation that we have on this show. The idea or the question was what does improving patient outcomes mean to you?

00:22:35:08 - 00:22:54:12
Speaker 3
So given the nature of our conversation today, we've talked about value based care, pharmacy setting goals. Kind of given that context and that point of view, I would love to hear your thoughts on, you know, what does improving patient outcomes mean to you from the considerations of how does community pharmacy practice and how do they operate?

00:22:55:10 - 00:23:21:00
Speaker 1
Yeah, So so for me, what it means to me, I've seen pharmacies as a whole being on the precipice from simply filling and billing prescriptions to be more health help, health care outcomes oriented, more reliant on pharmacists asking them to practice at the top of their license. I'll put it like this before you buy your next car, phone, TV or other big ticket item.

00:23:21:18 - 00:23:42:07
Speaker 1
Typically you'll either do your research or ask plenty of questions. But yet when patients go to their doctor, minimal questions get asked whether they're afraid or haven't had enough time to digest and digested new information, many questions are just not being asked. If this was a product, you could simply just go online by its mantras. But that's not really what you can do for a new medication.

00:23:42:20 - 00:24:00:03
Speaker 1
If you look online and have no medical background, you'll either think that you're possibly dying or just don't understand the verbiage because of all the medical terms, pharmacies are really going to be a go to here. They're they're going to be the ones that you trust to provide you the best answers as it relates to you and your medication.

00:24:00:03 - 00:24:25:09
Speaker 1
And just health care as a whole. That is ideally the pharmacy where pharmacies land, filling in the gaps from doctor to treatment. I don't know about anybody else, but I don't have my doctor on speed down. I have their office number, but it's not like I'm going to get a hold of the doctor directly. At best, I'll get someone to call me back another staff member hours later.

00:24:25:09 - 00:24:49:11
Speaker 1
Or maybe even days later. Conversely, I could literally pick up the phone right now, call the pharmacy and ask to speak with the pharmacist about my medication. Either the pharmacist themselves as well pick up or a staff member will transfer me to them. And guess what? I'll get most of my questions answered from there. So patients and pharmacists have a far more direct line of access than a patient and their doctor.

00:24:50:06 - 00:25:18:06
Speaker 1
And because of this, it really does make sense in the way the landscape is changing. The future of the pharmacies playing an even bigger role in improving patient health, improve patient outcomes is what I would somewhat apply the invisible hand theory, health plans and PBMs are pushing both hearings and improving patient outcomes due to CMS guidelines. Sure. But while the pharmacy is trying to hit performance goals and additional paid services, the result is improving patient lives.

00:25:19:07 - 00:25:52:11
Speaker 1
The this causes reduction in out-of-pocket costs, reduction in hospital visits, basically the ability for folks to live happy and healthier lives, and how do we improve patient outcomes. The U.S. has been laser focused on quality adherence and quality measures will always play an important role. Controlling blood pressure programs. A1 C Testing the call to action will have a conversation about adherence to their medication, and these programs direct payments from health plans to pharmacies not only for completing those tests but for actual improvement in health.

00:25:53:10 - 00:26:27:06
Speaker 1
And that's just the tip of the iceberg. Additional programs are being vetted and assessed where again, is geared toward improving patient outcomes and pioneering the way ensuring pharmacies not only are involved, but models that are financially viable as we move forward. Lastly, one major piece I didn't focus on is capitalized on your technicians. Truly, the operating costs of pharmacies far exceeds that of a technician, so pharmacies need to rely on them to do everything they can and we can help outline some of those capabilities that are available to them.

00:26:28:01 - 00:26:34:11
Speaker 1
Pharmacist oversight is still necessary, of course, but if it helps, if some of the weight of the pharmacists, it's a win win.

00:26:35:07 - 00:26:58:14
Speaker 3
Our audience cannot see this Ray, as we're on video. But it's a standing round of applause for me in terms of your response. And I really love everything that that you said. And I'll highlight just a couple of parts before we we get to our closing and summary. But this is absolutely a team effort myself coming from background of I'm educated, trained as and have that license as a pharmacist.

00:26:58:21 - 00:27:21:15
Speaker 3
Your background coming from the pharmacy technician, there's 100% different roles and opportunity is that different members of the team can play and it to move forward to move pharmacy forward everyone's going to have to play a role. We really want to elevate the role of pharmacy technicians. We want to elevate the role of the pharmacist. We want pharmacists using that clinical knowledge and doing things related to that.

00:27:21:24 - 00:27:41:20
Speaker 3
We want pharmacy technicians doing everything that they can within their scope of within the scope of what they're able to do in the pharmacy. So there are going to be and I present that in a way that for some pharmacy teams that's going to mean a change in workflow or change in how you operate. And as it goes to these different value based programs and different arrangements, different services.

00:27:41:20 - 00:28:00:15
Speaker 3
Ray, you pointed out a couple. So you know, for our listening audience, if you didn't happen to catch some of the items that Ray mentioned, rewind, go back about 60 to 90 seconds to raise comments. See if you can pick out some of those items, because we are absolutely we have been seeing new opportunities for pharmacies to be reimbursed, to be paid for services.

00:28:00:23 - 00:28:24:07
Speaker 3
But as we move forward in this new world, one of the biggest barriers for pharmacy to be paid in provide these services services is simply the engagement of the pharmacies or the pharmacy organization. Do they jump on these opportunities and do they help close these gaps for patient outreach, improving adherence and some other services that are new and upcoming?

00:28:24:21 - 00:28:45:15
Speaker 3
So it's definitely online. Pharmacy has been very much wanting to provide these services and everybody, and that's good to want them and to say that you can do them. But when they are presented to you, you actually got to pick up the ball and run with it. So that's my, if you will, that's my my challenge to the pharmacy community here at this point as we begin the 2023 year.

00:28:45:15 - 00:29:03:18
Speaker 3
And I think that's something that should be on every pharmacies, resolutions and goals for the 2023 year. With that, Ray, I think we're done with going over the questions and kind of our considerations for goal setting. I hope we didn't really too hard. I know you've got some some goals and ideas as you come here to the PQS team.

00:29:04:02 - 00:29:25:11
Speaker 3
And really I think as as I look at summarizing this particular episode, what did we talk about? What did we discuss? It's really important for a pharmacy to set those goals early in the year and to practice them throughout the course of the year, just like setting a New Year's goal about getting in shape and lifting weights. If you miss one day, that might lead you to missing a couple of days.

00:29:25:11 - 00:29:43:23
Speaker 3
Next thing you've missed a week, a month, and you're suddenly no longer on your New Year's resolution. It's important for pharmacies to stick with their goals. You want to evaluate them, and at certain points it may be worthwhile to reconsider what your goals are. That's okay. That's allowable. But if you don't set the goals in the first place, it's going to be difficult to achieve anything new.

00:29:44:10 - 00:30:11:05
Speaker 3
The second part of it is going to be around value based, you know, health care, value based payments. This is absolutely essential to pharmacies really understanding how their performance on these quality based measures, how that relates to, one, their contracts externally with payers. But also internally for their operations. So really need to understand those contracts. Keeping those patients adherent, it's creating additional touchpoints with the patient that lends itself to better patient care, which is the ultimate goal.

00:30:11:10 - 00:30:31:23
Speaker 3
And Ray, we talked about that, that item, what is patient what what is patient outcomes? It's keeping that patient healthy. It's keeping them out of the hospital. It's reducing and reducing out-of-pocket costs for patients and ultimately improve the health care system. So we covered a lot today in our time. But Ray, you're not done. You're not off the hot seat yet.

00:30:33:07 - 00:30:50:00
Speaker 3
Typically, at the end of the episode, we go through a few questions with our guest just to help understand them a little bit, maybe see a different side of them. So I've got some questions for you. And these are going to be questions where you might just have a short and brief answer focusing. It might it may just be a yes no.

00:30:50:00 - 00:31:01:14
Speaker 3
But I think some of these questions may elicit a little bit of a longer response and give you some additional capacity to provide insight about who you are. So are you ready to run through the gantlet of questions that we have for you today?

00:31:02:07 - 00:31:02:21
Speaker 1
Let's do it.

00:31:03:14 - 00:31:09:03
Speaker 3
Okay. Question number one is it better to be a morning person or a night owl?

00:31:09:03 - 00:31:32:16
Speaker 1
Yeah. So I've always I remember seeing this on a show went to and not that I want to stick to, but it's what happens. The statement was people who go to sleep on the same day they wake up are quitters. So for me personally, I have difficulty finding sleep. So I'm going to be biased here and say it's better to be a night owl.

00:31:33:09 - 00:31:37:15
Speaker 1
You get sunshine before while everyone else is asleep.

00:31:37:15 - 00:31:52:18
Speaker 3
I find that regardless of what answer you pick, it's kind of nice to pick one of them because at some point you're going to be awake when a lot of other people are asleep and it's just focusing on you. Things that you need to get done. Next question. Do you prefer to read the book or watch the movie?

00:31:53:09 - 00:32:29:07
Speaker 1
Yeah, I have to go with the watch the movie. I know most people always say the book is better. I get it. I understand that there is no cost to imagination Financial. At least there's no financial costs. Imagination. So it's a lot easier to make these stories in your mind and picture everything there. But when it comes to the whole filming piece of it, the art that goes into it, the effort, all of that, I can appreciate that maybe doesn't fall along with the storyline, but if you're ever going to go see a movie because you love the book so much, didn't didn't you already see it?

00:32:29:21 - 00:32:35:24
Speaker 1
So wouldn't you want a little bit of a different story? I'm not against that. I just hope that they they do it well.

00:32:36:05 - 00:32:40:20
Speaker 3
Creative license, I believe, is what they call that. Right. And it's the artist's interpretation for it.

00:32:40:20 - 00:32:41:05
Speaker 1
I like it.

00:32:41:23 - 00:32:55:24
Speaker 3
Ray, Next question. What's your recommendation for living a healthy life where we are a pharmacy health care podcast? So I got to ask you one question on here. That's a release related a little bit to how you stay healthy. Yeah.

00:32:55:24 - 00:33:15:23
Speaker 1
So trying to stay active is a big piece of it, but really trying to eat better and you can't do that on a whim. You actually have to put time and effort to figure out, you know, what are what are going to be your meals. You can't just go to the grocery store and just pick things, Oh, this looks healthy or what are you going to take with it?

00:33:15:23 - 00:33:27:12
Speaker 1
I have no idea. And it just looks healthy, Right? So so try to better that. That goes a long way. So that that's eating eating better but planning for it correctly.

00:33:28:18 - 00:33:47:10
Speaker 3
Ray, I'll give you a hint or tip that I've kind of been going with part of my New Year's resolutions around eating healthier. I find if I eat healthy snacks that I can share with the dog. So something like carrots, right? My dog loves carrots. So it's it's you know, 3:00 roughly. I'm going to peel and cut some carrots.

00:33:47:10 - 00:34:02:21
Speaker 3
I can sit down for a couple of minutes, have a couple of carrots. And I also get that time to have the dog maybe begging, wanting the carrots because he knows he's going to get some, but having some kind of companion to do it with, even if it is your furry companion, helps a little bit in that regard.

00:34:03:09 - 00:34:18:10
Speaker 3
And then, Ray, final question, We are a Quality Improvement podcast, as well as being a health care podcast. So part of quality improvement is is goal setting is what we talked about in this show. So I can't let you go without asking what is one goal that you are working towards?

00:34:18:18 - 00:34:39:09
Speaker 1
Well, I kind of already talked about it, but I'm going to go with it again. It's it's eating better. It's so easy to eat bad. It's so easy to stop by a drive thru and pick up some bad food for yourself. But but eating better to be healthier. And I know that there's a lot of people that complain about the COVID 20.

00:34:40:06 - 00:35:02:15
Speaker 1
I actually lost 20 pounds during COVID because I had a better opportunity to actually to actually make the food and things like that. But I found each one of those pounds later on and then some. So I definitely want to get back to that a little bit better and get back to eating healthier cells. So my wife and I have been really working towards that excellent.

00:35:02:15 - 00:35:22:00
Speaker 3
Well, I appreciate having you on the show again. You and I have had the experience to work together and be involved with helping community pharmacy practice for a number of years. But now I'm really pleased to have you as a teammate here at PQS. This is probably for some folks, maybe it's the first time that they've heard your voice or heard about you.

00:35:22:00 - 00:35:44:24
Speaker 3
And for some folks, maybe it's just the first time they've heard from you in the context of you being a part of the PQS team. But going forward, you're going to be absolutely an essential member of our organization as we work with health plans, PBMs, pharmacies on promoting value based care initiatives and all those sort of things. So if folks want to get in touch with you about these sort of items at picks, what's the best way to reach out?

00:35:45:17 - 00:36:04:06
Speaker 1
They can always email me at RArizmendi@pharmacyquality.com. You can reach me through there. And I do have I am on LinkedIn as well, so you can't seem to find it or know how to spell it. You know, it's always somewhere close. You'll find me and I'll be there as well as the next easiest way to reach out.

00:36:05:10 - 00:36:23:01
Speaker 3
Excellent. Well, thank you. I appreciate having you on the show for the first time. Probably not the last show when when you get an email or a message from me about coming back on the show. We know you've been a great guest on time, number one. And that's usually usually the reward for doing a job well done is that you get asked to come back and do it again another time.

00:36:23:02 - 00:36:45:07
Speaker 3
That's a fair warning. All right. Well, for our listening audience, want to give you a quick heads up as well for the Quality corner show is our first episode in 2023. You'll remember in past years, our meeting or podcast cadence was was stated as a weekly podcast. But we're looking to change things up and make sure that we're providing a consistent podcast approach.

00:36:45:15 - 00:37:07:24
Speaker 3
So we're going to be moving or switching up our recordings and our release of episodes where we're going to be releasing two episodes a month, really more of a focus, making sure that we have high quality guest, high quality content and we're able to provide that consistently. So normally this is the part of the episode where I would say, You'll hear us next week, but that is not the case.

00:37:07:24 - 00:37:38:18
Speaker 3
You'll hear from us probably in roughly about two weeks from when this episode gets released on on the timing of it. So make sure that you still subscribe, that you still check out our episodes on Buzz Sprout on any of the major podcast aggregators. And if you have questions or comments or feedback for our team, if you're someone that would like to appear and talk about a topic that relates to health care, health care, quality, value based care, new clinical guidelines for how pharmacies can change their workflow and take a more data centered approach.

00:37:38:18 - 00:37:59:11
Speaker 3
We would love to hear from you. You can contact us at info at pharmacyquality.com or you can contact us via our social media profiles. We are on both LinkedIn and Twitter currently, so find us there and engage in the comments or the replies on those posts with our audience. We love to get new topics and to hear what others in this industry, what they would like to hear about.

00:37:59:11 - 00:38:07:22
Speaker 3
So that's all that we have for today. Again, you'll hear from us in a couple of weeks. But before we go, we've got one final message from the PXP team.

00:38:07:22 - 00:38:28:18
Speaker 2
The pharmacy Quality Solutions. Probably Financial has a request for you. Our goal is to spread the word about how quality measurement can help improve health outcomes. And we need your help in sharing this podcast to friends and colleagues in the health care industry. We also want you to provide feedback, ask those questions and suggest health topics you'd like to see covered.

00:38:29:12 - 00:38:51:18
Speaker 2
If you are a health expert and you want to contribute to the show or even talk on the show, please contact us. You can email info at pharmacyquality.com. Let us know what is on your mind, what we can address so that you are fully informed. We want you to be able to provide the best care for your patients and members and we wish all of you listeners out there well.