INNOVATIVE PRACTICE FORM

Name: Donald K. Zettervall

Address: 41 Briarwood Drive, Old Saybrook, CT 06475

PHONE: 860-388-5973 NO FAX

E-mail/Information service:

Briefly describe innovation

Diabetes Counseling. In this pharmacy the patient is the head of the team. The pharmacy is a private office suite and sells no products. In the beginning counseling was done as diabetes classes. The patient would go through four classes for a set fee. They saw a need for individual counseling so for the last three years patients have been counseled one on one by appointment. The pharmacist encourages family and friends to come to counseling and support the patient. They currently counsel patients with type I or II diabetes including information on tight control where possible. The patients usually come by referral from the physician. The patient allows the pharmacy to obtain all medical records from third party and the physician. During the first visit, the pharmacist and patient establish rapport and the pharmacist thoroughly explains the disease, diet, exercise, and medications. This visit usually lasts around two hours. Follow up visits last 45 minutes to an hour. Patients usually come 3-4 times but some come on a routine basis. The physciain allows the pharmacists to make all management decisions including dose changes. The pharmacists say that the patients have responded well and regard the counseling as money well spent. They offer a 24 hour support via call forwarding from the pharmacy to the pharmacist's home. Documentation of home counseling is done via modem linked to the pharmacy computer.

Both Donald and his partner will be speaking at the National Conference on Diabetes in New Orleans on August 22-25, 1996 (4 days--students and pharmacists welcome).

Method of Reimbursement

Payor(s): mostly the patient--have some third party, are working to incresase thrid party and HMO's--will probably have BCBS--is a slow process

Reimbursement rate: 4 classes = set fee

first visit = $150-$200

Follow up = $60

Is documentation required? Yes The pharmacist charts the entire visit. BGL records sent in graphic to MD. Two glucose monitors that download into patient files. Send written report to MD (this is well liked by MD)

Specialized training required?Yes Six years ago, two pharmacists were AADE certified. This requires a documented 2000 hours direct patient contact, can use clinical practice. Must be recertified every five years. They are certified diabetes educators with the National Board.

Software/instrumentation required? No  Donald Zetterval tailors the programs to the pharmacy's needs. Develops new programs on his own. Currently have Lifescan monitors and are licensed to operate a hemoglobin A1C machine which they are looking to purchase.