Medco Health Solutions
Forth Worth, TX
The Texas Pharmacy of Medco Health Solutions provides students a truly unique practice setting. Our company has cleaved our mail order dispensing process in two. We have Front End, or cognitive services pharmacies and Back End, or dispensing pharmacies. Our Texas Pharmacy is a Front End pharmacy; that is, we do all of the cognitive services that go into the dispensing of a Rx, then electronically transmit the prescription to a remote dispensing pharmacy for filling, packaging, and shipping to the patient. We have two fully automated dispensing pharmacies (in Las Vegas, Nevada and Willingboro, N.J.) and one manual dispensing pharmacy (in Columbus, Ohio).
Note that Texas law requires all interns to be registered with the Texas State Board of Pharmacy before they can work as an intern in any Texas pharmacy.
Like any pharmacy, at the end of the process, our final product is a prescription in the hands of our patients. We have close to 800 employees and about 230 of them are pharmacists. One way to relate to our size is to think of us as similar to an entire chain of drug stores under one roof. One of the continuing comments we get from students is how much they enjoy being able to interact with so many pharmacists from so many different backgrounds. Another unique feature of our practice setting is that we get Rxs from all 50 states, so students will be exposed to a variety of drugs and pharmacy law that they would not likely see in other practice sites.
Rotation Overview
Day 1 is spent in orientation for this unique practice setting. A copy of the student’s Texas Pharmacy Intern card will be made, and Security will provide the student with an Identification Badge and a personal locker. The Preceptor and student will have a one-on-one conversation to become acquainted, followed by a discussion of PBM’s and Managed Care. The student will then receive an extensive tour of our facility and discussion of our work process. The preceptor and student will have a discussion about proprietary confidentiality and patient confidentiality, sign confidentiality agreements and fill out forms for computer access. The student will attend a New Hire Orientation. This may be scheduled on the student’s first day or, if we have no new hires starting that week, he/she may attend later in the rotation. This will expose the student to topics such as safety, security, ergonomics, and benefits package as part of total compensation, etc.
As we hire new pharmacists or have training classes for existing pharmacists, the student will be included in those classes and receive the same training as our staff pharmacists. Hence, the number and variety of training classes may vary by rotation depending on the types of training we conduct during the four week period.
Standard Assignments
- Students will have the opportunity to observe in all of the areas where our pharmacists work: Order Completion, Quality Team Pharmacist, Doctor Calls, C-II’s, Managed Care, Drug Utilization Review, Clinical Review, Seniors Drug Utilization Review, Pharmacist Lead, and Customer Service.
- Observe and learn the leadership and management skills/techniques necessary to be successful.
- Students will likely get to participate in on-going projects, such as updating the New Drug Bulletin Board and updating the Quality Bulletin Board.
- Students will have the opportunity to participate in the bi-weekly Clinical Conference Calls and conference calls for Drug Information on specialty drugs, such as rare injectables, growth hormones and chemotherapy.
- If we have a training class during their rotation, students will be trained to enter Rxs into our computer system under the supervision of a pharmacist. As with new hire RPhs, there will be a Quality Filter on their work which will send all Rxs that the intern enters to a feedback pharmacist. This pharmacist will coach and mentor the student on any mistakes, error prevention techniques, or violations of company policy or procedures.
- Under the supervision of the preceptor, students will create and present a Technician In-Service training in the form of a Power Point presentation.
- Students will have the opportunity to spend 1-2 days at the Medco Health Regional Call Center in Irving, Texas. This is yet another unique practice setting for pharmacists – the dispensing of information rather than medications. The call center handles patient OBRA counseling by phone, patient questions, and prior authorizations.
- Attend daily Managed Care team meetings to review the team’s goals, efficiency and plans for the day.
- Assist the clinical team with evidence-based research on various disease states and medications.
- Other projects as assigned.
Once they have completed their standard assignments, the student will be allowed input as to how they spend the last part of their rotation. Based on the strengths and weakness of the individual student as well as the interest of the student, the time spent in each assignment will vary. For example, some students may prefer to spend more time in Managed Care rather than Doctor Calls or vice versa. Others may prefer to spend more time in DUR, etc.
Goals/Objectives
- Gain an understanding of the pharmacy operations and pharmacist’s roles/responsibilities within Medco’s pharmacies.
- Gain understanding and experience with the various areas and systems of the pharmacy; especially those where pharmacists are involved in clinical programs and interventions with patients and/or prescribers
- Perform assigned tasks and participate in research or team interventions as appropriate with state law
- Understand the history and evolution of managed care in the U.S.
- Gain understanding of current managed care issues impacting a PBM