INNOVATIVE PRACTICE FORM

Lou Greenhaw

508 S. Ash

Hillsboro, Kansas

(316) 947-3784

Innovation

Lou Greenhaw of Greenhaw Pharmacy practices in a town of about three thousand. In addition to counseling all new prescriptions, Ms. Greenhaw offers many unique services. The Phen-Fen weight loss program for patients 30% over weight is only one. What is unique about this diet plan is members set their own goals. Each patient meeting those goals rather than their "ideal" body weight measures success. Ms. Greenhaw offers structured counseling for the members once a month. Each patient keeps a diet log and they must come in weekly for blood pressure checks. The program is divided into cycles where the patient receives four weeks of drug therapy, then they must try to maintain their success for four weeks without the drugs. The patient may repeat the cycle if needed, but this is considered a life time program where individuals whom have met their goals are still encouraged to come to the counseling sessions at least once every three months. The program will be two years old in July and with 108 patients, Ms. Greenhaw has hired a full time employee to oversee the program.

Greenhaw Pharmacy also provides patient education and counseling services for asthmatic and diabetic patients. The pharmacists help with peak flow measurements, spacers, and they use placebo inhalers to ensure proper use. The extensive diabetes services include home visits for newly diagnosed patients. The pharmacist spends 45 min. to an hour with the patient in their home, teaching them how to use a Glucometer and administration of insulin if needed. They have a diabetes support group, and because they do not have a dietitian in their town, they help with the important dietary needs of their diabetic patients.

Ms. Greenhaw's pharmacy offers the Medicine on Time blister pack service. This is where all meds to be taken at one time are packaged together in one blister. The patient's name, name of all drugs, the date and time the drugs are to be taken are printed on the back of each dose. They package and deliver this service to the nonadherent, elderly, or anyone requesting it.

Reimbursement

Payers: Mainly patients; third parties are more willing if the services are tied to a product.

Rates: Phen-Fen program - $45/month drugs + services, $10/month without drugs

Medicine on Time - $5/month

Other counseling - around $1/min (?)

Documentation

Most documentation is on patient computer file. Ms. Greenhaw plans to keep future diabetes information on note cards with information such as: last eye and foot exams, HgbA1C values, etc.

Training

Ms. Greenhaw has an asthma certification through Kansas University. This consisted of one month of self-study, during which there were three exams. One week of physician lectures was followed by one lab day working with inhalers, peak flow meters, and pulse ox machines. The clinical requirement was to implement an asthma program with four patients in her current practice and monitor results.

Ms. Greenhaw is currently working on her diabetes certification also through Kansas University and plans to take the national certification exam.

Software/Instrumentation

Patient files are computerized, but the specifics were not mentioned. The only instrumentation located in the pharmacy is the Dynapulse blood pressure screening device.

Interviewed by: Lori Bussey