ASHP survey of ambulatory care responsibilities of pharmacists in integrated health systems--1997.

Abstract

The results of a national survey of the ambulatory care functions of pharmacists in integrated health systems, including managed care organizations, are reported. Persons responsible for ambulatory care pharmaceutical services in 392 integrated health systems nationwide were interviewed by telephone and asked about their systems' organizational characteristics, information systems, pharmacist functions, and performance measures. Respondents reported a range of health-system components, including acute care hospitals, home health services, managed care products, and ambulatory care centers. Approximately 27% of respondents reported that their health system had an electronic medical records system, and 23% reported having one for ambulatory patients. Approximately 49% of respondents indicated that their system had an interdisciplinary care team for ambulatory patients that included a pharmacist. Overall, distributive functions consumed the largest portion (45%) of pharmacists' time, followed by clinical (30%) and administrative (21%) activities. The percentages of time spent on the different functions varied by geographic region and type of health system. Tracking adverse drug reactions, monitoring medication compliance, using pharmacoeconomic data for formulary decision-making, conducting medication management programs, and patient counseling were routinely provided as part of ambulatory care pharmaceutical services by 75% or more of health systems. Financial performance and patient satisfaction were the most frequently used performance-evaluation measures. Overall, pharmacists providing ambulatory care services in integrated health systems spent about 45% of their time on distributive, 30% on clinical, and 21% on administrative functions.