PubMed · 8564603
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G H Magnus. 1995-11-01. Preparing for automated dispensing devices.. https://doi.org/10.1093/ajhp%2F52.21.2406
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The status of pharmaceutical services in the Department of Veterans Affairs (VA) is described. The VA health care system is transforming itself from a hospital-based organization into 22 health care networks that emphasize primary and ambulatory care. The impact on VA pharmacy has been substantial. Roles of VA pharmacists and technicians have been enhanced, and a clinical career ladder for pharmacists was created. VA pharmacy officials and leaders from the University of Tennessee College of Pharmacy have been partnering since 1988 in strategic planning to determine how VA pharmacy can do business and serve patients better. Areas targeted for implementation or improvement include staff development, prescribing authority for pharmacists, automation, the physical design of VA pharmacies, residency programs, and a pharmacy benefit management (PBM) product line. The VA PBM is working to enhance the appropriate use of pharmaceuticals in the veteran population, reduce overall health care expenditures, and provide a more consistent quality of care. Specific PBM programs involve the implementation of drug treatment guidelines, a national formulary, and national contracts. There are plans for pharmacoepidemiologic and pharmacoeconomic research in the geriatric veteran population. The VA health care system and its pharmacy service are changing in ways intended to bring about easier access to care, higher quality, and increased responsiveness to patients' needs.
The status of pharmaceutical services in the United States Navy is described. In support of operational forces, pharmacists serve on hospital ships and in tent-based-fleet hospitals. The Navy has a long-term commitment to ensuring that its pharmacists receive postgraduate education and training; each year, pharmacists are selected for specific programs. Pharmacy technicians in the Navy have considerably more responsibility than their civilian counterparts; all complete a 23-week course, and many are board certified. Increasingly, Navy pharmacists provide pharmacokinetic services, counsel patients, serve as an information resource for provides, work in pharmacist-managed clinics, develop clinical pathways, and evaluate drug therapy. Automation and computerization are viewed as answers to challenges created by continued "rightsizing" of the staff and fiscal restraints. A project is under way that will consolidate historical and current patient information for improved clinical decision-making. The scope of Navy pharmacy practice is expanding dramatically.
The status of pharmaceutical services in the United States Air Force medical service is described. Air Force pharmacy is adopting new programs, staffing standards, inventory methods, and roles for pharmacists and technicians. One of the most visible changes is TRICARE, an interservice program that provides improved access to care. Many Air Force medical treatment facilities have been closed; prescription mail-out programs and networks of community pharmacies are filling the gap. The Air Force pharmacy team consists of more than 1300 pharmacists and technicians. Air Force pharmacists are military officers first. Great emphasis is placed on medical readiness training and continuing education. Some Air Force pharmacies are very small outpatient operations filling fewer than 300 prescriptions per day; others fill well over 4000. Many hospitals are being considered for more outpatient-focused operations. Because of anticipated minor reductions in pharmacist staffing, Air Force pharmacists will have to maximize efficiencies to maintain or improve current levels of service. More and better patient information will be provided and distributive processes streamlined. A greater role for technicians is anticipated. The future includes pharmacists serving in a wide variety of leadership and staff positions, improving the use of computers, and incorporating new technologies. Air Force pharmacy is changing to ensure uninterrupted fulfillment of its responsibilities.