MARCH 2018 - Pharma-Medic Services' Manager Mark Mercure is at a crossroads. With Manitoba’s regional health authorities’ recent plans to contract the majority of pharmacy services to 100+ nursing homes to only two companies, Mercure and his pharmacy team (along with every other MB consultant pharmacy serving these homes) will be out of work come the summer.
But change and challenge is a constant in the world of pharmacy, believes Mercure, and if his past record is any indication, he’ll find another way to put his skillsets to good use. “Obstacles come up in pharmacy a lot but every time you hit a wall, you have to find an opportunity around it,” he says.
Well before he joined Pharma-Medic Services as pharmacy manager, Mercure had been seeking ways to expand his pharmacy practice to serve his patients better. Back in 2010, recognizing a growing aging demographic in MB, he obtained his certification as a Geriatric Pharmacist, then provided fee-for-service medication reviews to elderly patients as a relief pharmacist. “It was challenging as I wasn’t in the same location every day, but those willing to pay really valued the service,” he says, noting that theses payers were often the patients’ grown children.
Three years later, he joined Pharma-Medic Services, a consulting pharmacy that services five nursing homes (or the equivalent of 597 patients) in Brandon, MB. When the province’s Pharmaceutical Act was introduced in 2014, he obtained his extended practice designation. “With my extended practice, I set out to find applications where they’d be most useful in the nursing home setting,” Mercure says.
Right off the bat, he recognized inefficiencies happening in the admission process of seniors to nursing homes. He offered his services for free to the region for a pilot program. “There were a lot of medication errors happening and I felt pharmacists were better placed than nurses to do difficult medication reconciliations,” he says.
For six months, Mercure used a collaborative practice agreement with two physicians and one nurse practitioner to complete the Home Medication and Initial Orders (HMIO) forms for newly admitted residents. All errors and unintentional or undocumented discrepancies were handled right at the dispensing pharmacy and Mercure
The pilot not only benefited patients with fewer med errors, but the nursing home saved half a day in nurses’ time. Even though the initiative was shelved due to budget constraints, Mercure was not deterred. “In my mind it was a successful project because I proved I could reduce med errors and save costs and I’m that much farther ahead for next time,” he says. “You’re going to fail before you succeed so you have to keep hammering away.”
In facing this latest challenge, Mercure says he’s learned an important lesson. “Don’t rely on government to clear the path for you when it comes to reimbursement,” he says, adding that even with good intentions, the pace of government change is far too slow. “Create the avenue for yourself, and if it’s going to be hard and messy so be it—pharmacists need to take a stand.”