INNOVATIVE PRACTICE FORM

Name: Max Ray

Address: University of California at San Diego

Phone #: (619) 543-6190

Briefly Describe Innovation:
Mr. Ray is the Associate Director of the Department of Pharmacy at the Medical Center on the campus of the University of California at San Diego. His educational background includes an M.S. in Pharmacy, a Pharm. D. Degree, and one year of general residency. Past positions include being an ASHP staff member, Director of the Pharmacy Residency Accreditation Board, and Vice President of the California Hospital Pharmacy Association. He credits these positions with giving him insight and perspective into today's health care issues. The focus of his work for the last five years has been in the area of pharmaceutical care. Mr. Ray believes that too many patients are in a position where they are discharged from the hospital, yet require extensive monitoring that may be beyond the scope of many retail practices. Four clinics have been established by Mr. Ray in an attempt to integrate inpatient and ambulatory care. These include a drug referral clinic, an anticoagulant clinic, a congestive heart failure clinic, and a antiretroviral clinic. These clinics are near the hospital and staffed by hospital pharmacists. The pharmacists rotate between inpatient and clinic duties to provide a continuity of care. In the clinics, the pharmacists have the authority to make therapeutic changes according to established protocols. In the future, Mr. Ray hopes to develop an oncology clinic.

Method of Reimbursement:
Payor(s): The clinics are supported by the Medical Center, but they do charge for outpatient visits. The majority of their patients are covered by Medicaid, an HMO, or some other third party plan.

Documentation Required:
The pharmacists in the clinics have access to patient records from the hospital and any changes in therapy or patient condition is noted on the patient's chart. If the patient is readmitted, this information is then readily available to physicians.

Specialized Training:
All staff pharmacists, whether working in the Medical Center or the clinics, have a Pharm. D. and at least one year of general residency. Some of the pharmacist have additional training and board certification depending on which clinic they work with.

Software/instrumentation Required:
All of the clinics are connected to a central database in the Medical Center. In addition to networking with the Medical Center, each clinic can also communicate on-line with the other clinics.

Interviewed by: Greg Knowles