While the previous Tip described some nuances between various practice models in pharmacy, yet another concept has been described as “virtual ward”. A virtual ward provides multi-disciplinary case management services to people who have been identified, using a predictive model, as high risks for future emergency hospitalization. Virtual wards use the systems, staffing, and daily routine of a hospital ward to deliver preventive care to patients in their own home.
Kirkcaldy et al describe the integration of a medicines management service into a virtual ward.1 They conducted interviews of pharmacists and technicians having experience with the service. There were three themes uncovered. One was ‘Impact on Patients and Carers”, which included improved patient communication and medicines optimization. The second theme was “team working” in noting how the information to all interdisciplinary team members “made sense” once it was shared and that education of the patient became more cogent and systematic. The third was “Issues and Challenges”, a theme that included issues such as not always having the patient’s medical records readily available, that patient expectations were very high when notified of the virtual ward service, and distressful situations experienced during home visits, along with the extremely complex nature of some of the patients’ conditions and medication regimens. The researchers provided a framework from the results of the interviews into a plan for sustained implementation; however, as this study was carried out in Great Britain with government sponsorship of the program, an evaluation of potential reimbursement models would be necessary here in the U.S.
Pharmacy managers and leaders will have to continue to demonstrate value in pharmacists’ expertise and services. This requires understanding not only of what pharmacists bring to the table, but what other health professionals bring to the table so that the services provided can be complementary rather than competitive and be part of a bundled package that can be sustained over long periods and be held accountable in hopes of saving the health care system money while garnering new revenue streams for value-added services.
Additional information about Implementing Value-Added Pharmacy Services and Managing and Creating Value can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.
1Kirkcaldy A, Jack BA, Cope LC. Health care professionals’ perceptions of a community based “virtual