Establishing Clinical Pharmacy Services With Prescribing Privileges in a Federally Qualified Health Center Primary Care Clinic.

OBJECTIVES: To describe the process and cost of establishing clinical pharmacy services with prescribing privileges in a federally qualified health center (FQHC) primary care clinic.

SETTING: The primary care clinic was located in a low-income area of Southern California and served patients with Medicaid and Medicare. The primary care clinic had preventive medicine and family medicine physicians, a family medicine residency program, behavioral health services, and a registered dietician.

PRACTICE INNOVATION: New clinical pharmacy services were established at this FQHC primary care clinic. The medication assistance program was a stepping stone to establish rapport with the physicians. Credentialing and privileging was implemented for clinical pharmacists. An open protocol collaborative practice agreement was developed to allow clinical pharmacists to manage ambulatory patients.

RESULTS: From August 2014 to June 2015, the clinical pharmacist interacted with 392 patients and spent 336 hours educating patients and providing disease state management. The pharmacist also provided consults to residents and providers. Diabetic patients made up 76% of all clinical pharmacy encounters. There were 86 face-to-face clinical pharmacy appointments with the pharmacist. The average time for clinical pharmacy appointments was 77 minutes.

CONCLUSION: By describing ways to develop rapport with providers, how to credential and privilege pharmacists, and explain resources and costs of setting up a service, the hope is that more clinical pharmacists will be able to incorporate into independent or FQHC primary care clinics for improved management of ambulatory patients.