Since 1991, Emergency Center Pharmacist, Les Pieniazek, has found joy in spreading the good name and mission of Texas Children’s. So much so that Les recruited his two daughters and his son-in-law to join our One Amazing Team this year. Read more
Learn more about Eddie’s story and how he provides outstanding service to the patients and families we serve while growing his career at Texas Children’s. Read more
Greetings, team. My highest hopes are that everyone is staying safe as we continue to live within a new world order. My last edition of Hayes on the Health Plan was published in April when life with the coronavirus was brand new. In that post I wrote tips on how to work from home effectively.
Since then, my colleagues and I have written numerous articles about our organization’s efforts to adapt to life with the virus. We have also published stories about departments within Texas Children’s Health Plan that are exceeding expectations in phenomenal ways. Speaking of phenomenal, we think it’s pretty phenomenal that our newest department – only five months old when the virus hit – has continued to grow and thrive in spite of a global pandemic. Today, I want to introduce you to the newly created Department of Pharmacy.
Director Peter Peter recently took the time to answer a few of my questions. His answers give us an inside view into the work his department does to keep members healthy, operations efficient and costs manageable.
Q: What is the role of the Pharmacy Department at Texas Children’s Health Plan?
A: Director of Pharmacy is a new position, as my predecessor was overseeing both Quality and Pharmacy. Historically, pharmacy at the health plan was seen as a clinical role focusing on medication appeals and provider outreaches. Under my leadership, it is more of an operations role. My department is responsible for overseeing pharmacy benefits for all our members. We also oversee Navitus, our pharmacy benefits management company. In addition, we partner with the Medical Policy team to make sure that medications processed through medical benefits are configured in compliance with the Texas Medicaid Providers Policy Manual (TMPPM). In addition to clinical, there are significant compliance, quality, financial, advocacy, and innovation opportunities that exist within the Health Plan, Texas Children’s system and Texas Medicaid. The health plan is in a unique position because of its access to the hospital system, care coordinators, medical data, and community status compared to other managed care organizations.
Q: How big is the Pharmacy Department and what are the roles of the employees?
A: We are a team of two. I started as the Director of Pharmacy in October 2019. Jerry Wong is the Managed Care Pharmacist, and he started June 2020. I am looking to expand the department with several more employees. The specific roles are still being finalized, but will focus on data analysis, project management, interdepartmental coordination, auditing, and clinical program development. I’m also looking to consolidate some tasks that are currently being handled outside of the pharmacy department.
Q: How does the Pharmacy Department work with the Pharmacy Department at the hospital?
A: There are several opportunities to coordinate with our hospital and retail/specialty colleagues on various clinical and quality related projects. Examples include coordination of care, identifying system savings, and prescriber education. This is an area I am looking to sync with more after staffing up the pharmacy department at the health plan.
Q: What successes has the department had in recent months, weeks? Especially in light of the pandemic?
A: We were able to successfully lobby the state to make formulary changes when COVID-19 shut down Texas to allow members expanded access to medications. We also identified opportunities where members were taking a brand-drug when generic alternatives existed. We launched campaigns to notify prescribers of these opportunities, which have already resulted in significant savings for the system.
Q: What is the vision for the department and what is the greatest work ahead of the department?
A: Combining medical and pharmacy data is what Amazon, Walmart, CVS, and other health care organizations are racing to, but what the health plan already has in house. We are ahead in this regard. However, the greatest work ahead of us is focused on alternative payment models where pharmacies can encourage pharmacist-prescriber collaboration, improved care coordination, reduction in adverse medical outcomes, and overall savings. There are also significant opportunities to partner with the Texas Health and Human Services Commission to expand traditional “pharmacist” services and have them more involved as partners in the overall care of the member.
Q: Any fun facts or things that people would be surprised to know about this department?
A: The pharmacy department oversees pharmacy benefits for over 400,000 members enrolled in STAR, STAR Kids, and CHIP across Texas.
In an effort to implement additional measures to help protect our patients, families and staff, Texas Children’s Pharmacy Services is now offering curbside pick-up.
All Texas Children’s patients are eligible for this prescription service and can pick up refills and new prescriptions at the following locations:
Texas Children’s Medical Center Pharmacy
6651 Main St.
(valet drive at corner of Southgate and Main)
Hours: 9 a.m. to 5 p.m. Monday through Sunday
The Center for Children and Women at Southwest Houston Pharmacy
9700 Bissonnet St.
(Look for parking spaces designated for curbside pick-up. Pharmacists bring prescriptions to families while they are sitting in their cars)
Hours: 9 a.m. to 7 p.m. Monday through Friday
The Center for Children and Women at Greenspoint Pharmacy
700 N. Sam Houston Pkwy. W.
(Look for parking spaces designated for curbside pick-up. Pharmacists bring prescriptions to families while they are sitting in their cars)
Hours: 9 a.m. to 7 p.m. Monday through Friday
The patient family contacts one of the three participating pharmacies to request curbside pick-up. When the patient family arrives at the pick-up location, they will:
A member of the pharmacy team will deliver the prescription to the patient family’s vehicle and provide instructions on how to contact the pharmacy team with any future questions. Please note, only credit/debit card payments are accepted for curbside pick-up at this time.
Launched last week, several families have used the curb-side service and have expressed their gratitude for Texas Children’s commitment to their safety. Pharmacy staff is proactively calling families that have not yet picked up their prescriptions. During one of those calls, a family with 13 prescription refills told the technician they were thinking of requesting a transfer to another pharmacy because they did not want to come into the hospital during this pandemic, said Director of Community & Ambulatory Pharmacy Services Yemi Abudu. When they learned about our curbside service they were elated and scheduled to pick their prescriptions up the next day.
Abudu said families can continue to come into to the pharmacy if they wish, but now have the option to pick it up curbside, especially if they do not have any other reason to come into the hospital.
“This is an innovative way to keep our business going and to meet the ongoing needs of our patients and families,” she said. “We are pleased to be able to offer this to them during this unprecedented time of need.”
Did you know that the pharmacy department dispenses over 300,000 doses of medication each month? With each dose, pharmacy personnel work with other members of the health care team to ensure the five rights of medication safety:
Right patient, Right medication, Right route, Right dose and Right time
Pharmacy would like to add one more right.
Right there when you need us, easy to reach and ready to help. Pharmacy can be right there whenever you need them to answer medication questions, educate patients and provide expertise in patient care.
Pharmacy Week is October 20 to 26. Join us in celebrating all that our Texas Children’s Pharmacy department does to ensure safe and effective medication use for our patients when they need it most!
The Centers for Children and Women at Texas Children’s recently received community pharmacy practice accreditation from the Center for Pharmacy Practice Accreditation (CPPA). This accreditation demonstrates Texas Children’s ongoing commitment to high quality care and patient safety.
With approximately 33,000 community pharmacies located across the United States, The Centers in Greenspoint and Southwest are the first in Texas to gain this esteemed accreditation.
“Gaining this voluntary accreditation is an important way for us to show our investment in continuous improvement of our pharmacy practice,” said Yen Phan, pharmacy manager at The Centers for Children and Women. “Our team worked very hard to meet the rigorous CPPA requirements for accreditation, and we will continue to focus our efforts on providing exceptional patient-centered care.”
The CPPA, a non-profit organization, recognizes pharmacy practices that foster medication safety and effectiveness, ensure continuous quality improvement and facilitate desired patient health outcomes.
The Centers at Greenspoint and Southwest implemented several initiatives to meet the CPPA standards for community pharmacy accreditation including creating a Quality Committee that provides an organized forum to review quality metrics and develop solutions to prevent potential medication errors. The Quality Committee also assessed overall performance and identified areas in need of quality improvement.
“The surveyors were very impressed with our best practices and model of care,” Phan said. “Our hope is that our best practices can serve as a benchmark for other community pharmacies to replicate.”
For more information about the CPPA accreditation process, visit www.pharmacypracticeaccredit.org
For more information about The Center for Children and Women, visit www.jointhecenter.org
Texas Children’s Specialty Pharmacy program has received accreditation from the Utilization Review Accreditation Commission (URAC) and Accreditation Commission for Health Care (ACHC). This accreditation helps the Specialty Pharmacy position itself and demonstrate its value in delivering specialized clinical services.
“This is a remarkable accomplishment and will allow us the opportunity to gain access to care for patients with commercial payers,” said Jeff Wagner, Director of Pharmacy.
Texas Children’s Specialty Pharmacy opened in September of 2016, and was established to handle convenient plan of care management, and other services specific to patients with serious illnesses.
The pharmacy is an outpatient service, available to any eligible patients at Texas Children’s Main Campus and West Campus. More specifically, to patients and international patients who are seen by Texas Children’s providers and who have Medicaid/Medicare, TCH Health Plan, and CHIP as their health plan. It allows families to fill their specialty medications (and other retail medications) at the hospital, through free mail delivery, or in-person pick-up which is solely located at the Mark Wallace Tower Outpatient Pharmacy.
“Many of the patients in our care face challenges in medication access in the community,” said Wagner. “Ultimately, we are ideally positioned to address this gap in access and care with the Specialty Pharmacy.”
To differentiate from other pharmacies, there are Specialty Pharmacists embedded within Texas Children’s Hospital outpatient clinics to counsel patients taking specialty medications. They also provide ongoing monitoring of their specialty therapy and coordinate pharmacotherapy needs with physician/clinic teams. There is also a call center that provides proactive refill management for specialty pharmacy patients.
Recently the pharmacy staff created a patient satisfaction survey that resulted in positive data that reaffirms how the Specialty Pharmacy continues to be efficient and accessible, all while meeting patient needs in the most effective way possible.
“I love having the medications delivered to our home,” said one survey participant. “It just makes things simpler when I forget to pick my meds up or just can’t go get them.”
Along with productivity and being able to provide the necessary medications, patients also expressed the high level of professionalism and customer service that comes from the staff throughout the department.
“I have a great team of passionate people who strive to provide the best care possible for our patients! They are a joy to work with on a daily basis, said Stephen Davis, Specialty Pharmacy Manager. “They challenge and inspire me at the same time. I provide support, guidance, and leadership to my team. I empower them to make informed decisions and assist them with troubleshooting and problem-solving.”
Texas Children’s Specialty Pharmacy has expanded into almost a dozen clinics since it opened and has positively impacted hundreds of patients in that short time.
“The Specialty Pharmacy has supported Texas Children’s Hospital’s mission, and the impact this service has had over 1,000 patients is breathtaking,” said Wagner. “The engagement of families in the planning of these services, and the feedback we have received to date has been absolutely remarkable.”
The accreditation covers all clinics supported by Texas Children’s Specialty Pharmacy and is a major ingredient in its success moving forward. The pharmacy will have to be reaccredited again in another three years.
“Accreditation will help in our ability to offer this service to all patients of Texas Children’s Hospital, and even beyond,” Wagner said. “The ultimate goal is to be able to offer Specialty Pharmacy Services for all patients, regardless of payer.”
As of 2018, the pharmacy has currently rolled out into the following 11 clinics within Main Campus:
Dermatology
Endocrine
Gastroenterology
Hematology
Neurology
Oncology
Prader-Willi
Pulmonary
Renal
Rheumatology
Transplant
As well as the following four clinics within West Campus:
Cancer Center
Endocrine
Gastroenterology
Rheumatology
In 2018, Texas Children’s Specialty Pharmacy will expand services to include the Complex Care clinic and the Allergy and Immunology clinic. Texas Children’s Hospital The Woodlands will receive specialty pharmacy services during the summer of 2018. The Specialty Pharmacy is currently working towards acquiring additional contracts in order to serve more patients with commercial insurance.
“In order to ensure that Texas Children’s Specialty Pharmacy is able to continue to serve our patients, we are actively working towards acquiring additional space in order to support the anticipated growth,” said Davis. “In the future, I envision Texas Children’s Specialty Pharmacy providing mail-order service to all patients within the state of Texas and outside the state of Texas.”