Over the last 10 to 15 years, the practice of outsourcing certain services has grown exponentially within the hospital pharmacy marketplace. At the same time, health care’s use of modern communication technology also has grown at a blistering pace, and pharmacists are now able to conduct much of their business via email, computer interface, and other hardware and software configurations. Initiatives such as CPOE, BCMA, EHR, and eMAR all depend heavily on the clarity and veracity of electronic communications to ensure best practices. Unfortunately, one of the natural results of this dependency is a concurrent decline in face-to-face, personal interaction.
Without a doubt, the sophistication of modern pharmacy technology has enabled numerous improvements to medication tracking, preparation, and administration functions, and practitioners can perform data mining and analytics on myriad work processes, as well as catalogue performance metrics for easy reference. This instant access to information now applies not only to internal interactions, but also to relationships with outside suppliers and service partners. However, as we have seen all too clearly in the recent past, depending solely on quality assurance and policy and procedure information supplied by entities outside the hospital’s walls does not guarantee the soundness of pharmacy practices nor the safety of hospital patients.
Whenever a story comes out about the negative ramifications of health care practices, we hope that experience will be used to bring about positive change. We have seen this in the experiences of early champions of USP Chapter <797>, who were met with initial skepticism, yet those tenets have now become almost universally accepted. As outsourcing has become a vital and ingrained practice in modern pharmacy practice, we must not lose sight of fundamental business practices that have proven their mettle.
If your pharmacy has come to rely on an outside entity to manage some internal process, such as the outsourced preparation of PN (see page 12) or environmental monitoring (see page 2), perhaps now is the time to meet directly with representatives of those entities, tour their facilities, and see for yourself what those operations look like. All the quality metrics in the world cannot replace the instincts, judgment, education, and experience of your own two eyes.
All the best,
R. Mitchell Halvorsen