I knew this rotation was going to be challenging…

amanda-brenneke-photo“Mama always said life was like a box of chocolates. You never know what you’re gonna get.” I’m sure most of you know and recognize this famous quote from the film Forrest Gump. What I didn’t know about this quote is how it would exemplify my June advanced pharmacy practice rotation experience in Jefferson City. When choosing this site for one of my nine rotations, I thought this might be a chance to learn about association work, policy, and non-traditional pharmacy career paths. Little did I know that I would learn so much more in my short one-month experience, than I could have imagined. I value my time spent at this rotation because I do not think that I could have learned the majority of what I did here at any of my other scheduled sites or most of the other offered rotations.

My primary location for June was at G.L.O. and Associates, a pharmacy consulting business that works closely with the Missouri Pharmacy Association as well as Missouri Medicaid (MO Healthnet). I knew this rotation was going to be challenging and full of information when I was handed a three page document of mostly unfamiliar acronyms on the very first day. From there I was oriented to the tremendous load of projects that were underway, learning that juggling isn’t just for circus acts. As the days passed, I found myself immersed in various projects across the spectrum from reading legislature to helping implement new state wide projects. Through various conference calls and meetings I started to pick up the lingo (after asking the meaning of additional acronyms used of course) and began feeling more comfortable in this very foreign to me, government based world.

I was fortunate enough to be able to attend a couple of really insightful meetings including the Drug Prior Authorization Committee Meeting, Community Health Center Pharmacy Integration Meeting, and the Chronic Pain Management Show-Me Echo sessions. While at the Drug Prior Authorization Committee Meeting for Missouri Medicaid, I sat with the voting members of the committee and was able to observe first-hand how preferred drugs and drug edits are changed and adapted into policy. This meeting really showed me all of the thought and time put into those rejections that I am so use to getting at my retail pharmacy job and made me think about the big picture on a state level. The Community Health Center Pharmacy Integration Meeting was even more eye opening for me. Dr. Steven Chen a faculty pharmacist from the University of Southern California spoke about the ways he has been able to integrate pharmacy into health centers using a large grant. I also heard from Missouri health care providers about all of the ways they are currently utilizing pharmacists in their clinics. Finally, observing the Chronic Pain Management Echo was like watching a futuristic collaboration, except that it is happening right now! The Echo program uses telehealth technology so that participants can video chat in real time with one another. Providers from rural areas are able to participate using any electronic device (computer, tablet, cell phone) and collaborate with others as well as an expert panel associated with the University of Missouri.

Perhaps my favorite project to watch grow and assist with has been the Polypharmacy Risk Reduction Program, fondly referred to as PPRR. This program utilizes a group of dedicated Missouri pharmacists to review current Medicaid patients’ medications. Here’s how it works: high risk patients will be identified and assigned to participating pharmacists across the state; those pharmacists review claims data to access therapy and provide recommendations to the patient’s provider. Theoretically, this program will hopefully produce better out-comes for MO Healthnet patients as well as save tax payer money.

This rotation has been so rewarding for me and I plan to recommend it to younger students when I get back to Kansas City. I have gained a very valuable understanding of so many different aspects of pharmacy and many things that cannot be taught in school which I believe will be very important to understand in my pharmacy career. It has been a truly great month in Jefferson City and I am grateful to have spent a month with G.L.O. and Associates and the Missouri Pharmacy Association.

Amanda Brenneke
University of Missouri-Kansas City
2017 Pharm.D Candidate

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