Future Challenges: Changing Health Care Delivery and Advancing Patient Care

Abstract

Our current health care system involves multidisciplinary groups of practitioners who function as freestanding silos and in which a “team” approach means an awareness and tolerance of other disciplines as patients are handed from one practitioner to another. Pharmacy has advanced from clinical pharmacy through pharmaceutical care to the dawning of medication therapy management services. With each step pharmacy has become more focused on direct patient care. As technology and technicians improve the dispensing process and as electronic databases evolve, the pharmacist will increasingly be positioned to be more available and better equipped to provide direct patient care and medication therapy management services. Over the next decade, I see pharmacy and other health care providers moving to an interdisciplinary team approach in which decisions are made by consensus and through which each discipline has an equal opportunity for input.1 To accommodate such a change, I envision a new health care delivery model based on the following components: n Wellness and prevention services as the entry point into the system. n An interdisciplinary delivery model with providers having shared borders (a model in which our professional boundaries become blurred or overlap, and health care professionals share a common knowledge base, a common professional interest, and an instinct to help the patient). n “Physician extenders” providing disease and medication management services using evidenced-based medicine. n Systems that are outcomes driven and outcomes justified. n A broader acceptance and use of complementary and alternative medicine within the delivery model. All of the above components are evolving or already exist in the current environment. The challenge to the system is to integrate them into successful delivery models. The challenge to the pharmacist is to identify, embrace, Future Challenges: Changing Health Care Delivery and Advancing Patient Care and drive their evolving roles within this new health care delivery model.