INNOVATIVE PRACTICE FORM

Name MIDDLEBURG PHARMACY AND DIABETIC CARE, INC.
JOHN W. OWEN, SR., R.Ph., SENIOR PHARMACIST, PRESIDENT/CEO
Address 2710 GERVAIS STREET COLUMBIA, SC 29204
Phone # (803) 254-1441
FAX # (803) 256-0504
E-mail/Information service NONE

Briefly describe innovation

Practice deals mainly with complete diabetes care- education, treatment, and management. The pharmacist and patient form a team, in which the patient is established as the head of the team and the pharmacist and other health care professionals involved are the coaches. All team members work together to aid the patient in the management of diabetes. Patient's are referred to the pharmacy through their primary care physician or diabetes educators in local hospitals. They are seen on an appointment based system. In the initial visit, the pharmacist and patient discuss the disease and outline a management plan (home glucose monitoring, diet, exercise, medications and follow-up visits) that is tailored to meet the patient's current status and needs. This initial visit is very comprehensive and generally requires about two hours. The patient is also asked to return in seven to ten days for a follow-up visit. The pharmacist uses this visit to assess the patient's testing technique (clearing up any confusion regarding procedure) and to determine if the patient is having any problems with other aspects of the management program. Many patients return prior to the next visit with their physician to obtain a print out to take with them (many of the home glucose meters can be linked up to a computer program which prints out the patient glucose data in various forms, allowing the physician a visual indicator of the status of the patient since the last visit). Some patients return routinely.
Education, treatment and management is also available for hypertension and hypercholesterolemia. Drug therapy and drug utilization evaluations are available as well. In addition, specialized and general Rx compounding is provided. In the near future, comprehensive asthma care will also be included in the practice. Mr. Owen says that he is in the process of forming a pharmacist consulting team that will not only provide services within the pharmacy but also home consultations. This is in response to the practice recently becoming the first CARE POINT licensee in the central SC area. The CARE POINT COGNI- CARE system provides a completely computerized pharmaceutical care system for patients who become a member of the program.

Method of Reimbursement

Payor(s): patient pays for most cognitive services, deductible requirements and co-pay - third party and HMO's generally pay for home glucose monitor and supplies. Will bill Medicare, Medicaid and private insurance (assignment accepted) and Champus. Not electronic yet (except for Rxs) but has the capability to set up.

Reimbursement rate: 1. Diabetes education on correct and proper home glucose meter operation and use- $10.00 per training session (30min); payable by patient.
2. Disease state personal evaluation for education and consult (30 min.)- $25.00- payable by patient
3. Drug Therapy and drug utilization evaluation- $15.00 (15 min.)- payable by patient
4. Follow-up visit - $10.00 (10 min.)- payable by patient
5. Drug therapy recommendation and consult w/physician ; depends on complexity and time to write consult- up to $50.00- payable by patient
6. Downloading and print out of data for several glucose meters- initial is free, then $1.00 per report (several reports can be generated) .

Is documentation required? Yes
Uses S.O.A.P. Forms and diabetes training forms

Specialized training required? Yes
12 hours graduate work in developing community practices for specialized services; training in diabetes, hypertension and asthma through CE programs, seminars, home study and professional pharmacy education. Presently seeking certification as a Diabetes Educator through AADE.

Software/instrumentation required? Yes
CARE POINT COGNI- CARE system; LIFESCAN's "In Touch" patient education, glucose meter downloading and management program; BOEHRINGER MANNHEIM's DIAGNOSTICS down loading and management program for ACCU-CHEK/ADVANTAGE; MEDI-SENSE's down loading and management for PRECISION QID; CLINICAL PHARMACOLOGY by Gold Standard; DYNA PULSE blood pressure management system; NUTRITION CONCEPTS dietary management program; MAYO CLINIC ATLAS patient education series; several others on order

Interviewed by: Tara Owen