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Pharmacists & Test Ordering:
Roles and Responsibilities

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Over the past decade, major changes in the healthcare landscape have challenged the profession of pharmacy. The Center for Medicare and Medicaid Services (CMS) is slowly but steadily spreading value-based healthcare service reimbursement, tying quality of care to payment. Outpatient clinics are seeking Patient-Centered Medical Home (PCMH) recognition as a credential for providing high-quality care. Hospitals are penalized financially when certain high-risk patients are readmitted shortly after discharge. Over the next several decades, the number of Americans over the age of 65 years will double from approximately 40 million to 80 million,1 requiring more medications for multiple chronic diseases and more monitoring to ensure treatment safety and efficacy. At the same time, new schools of pharmacy are opening so rapidly that the number of graduates over the next 5 to 10 years will be double that of a decade ago.2 While it may seem that the increasing number of new pharmacists is well-matched with the rising demand for prescription medication, dispensing automation is quickly taking over traditional pharmacist functions. The profession must evolve rapidly – and has the opportunity to do so – by developing programs and collaborations aligned with the clinical and financial risks / incentives of healthcare providers and payers.

Improving healthcare quality and safety outcomes for highrisk patients requires more than basic medication reconciliation and education. Often, clinical tests are needed to verify disease status, establish baseline parameters, or monitor the progress ofmedication therapy. For example, selection of appropriate antihypertensive drug therapy may require at least basic metabolic panel laboratory tests (eg, serum creatinine, electrolytes). As provider status for pharmacists continues to spread among individual states and is considered nationally, pharmacists must be prepared to take responsibility for ordering and managing clinical tests. This issue of The Rx Consultant will present professional standards for pharmacists to follow when using such authority. The best practices shared are based on research, government reports, and decades of combined experience in California and other states. Pharmacists can utilize this information to ensure that tests are ordered only when necessary, and that results are managed appropriately and promptly. Moreover, this information can be used to educate other healthcare professionals, testing organizations (eg, clinical laboratories, imaging centers, pulmonary function test labs), and health plans about the role of pharmacists in ordering and managing tests.


Publication Date: 04/23/2015
Expiration Date: 04/20/2018
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Steven Chen, Pharm.D., FASHP, FCSHP, FNAP; Associate Professor and Chair, Titus Family Department of Clinical Pharmacy and Pharmaceutical Economics & Policy; Hygeia Centennial Chair in Clinical Pharmacy; University of Southern California School of Pharmacy
Michelle K. Lee Chu, PharmD, CDE, BCACP; Ambulatory Care Clinical Pharmacist, University of Southern California School of Pharmacy, Los Angeles, CA.

Disclosure Statement

Dr. Steven Chen and Dr. Michelle Lee Chu report no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Target Audience

This accredited program is targeted to pharmacists .

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Describe the current status of pharmacists as healthcare providers in the US. Discuss the impact of clinical pharmacy services on quality of care and patient safety.
    2. Discuss professional standards or “best-practice” approaches that should be followed by pharmacists in ordering and interpreting tests.
    3. List at least 5 tests that pharmacist providers may appropriately order and interpret. Discuss the indications for each test, and how the results would be used.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-15-004-H01-P

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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