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Profile of an Innovator: Josh Feldmann 

Josh Feldmann, PharmD
Pharmacy Manager
Taylor Pharmacy, a Mercy Family Pharmacy

Mercy Family Pharmacies in northeast Iowa developed a successful model of patient care services through the Iowa Pharmaceutical Case Management (PCM) program. PCM is an Iowa Medicaid funded program that compensates community pharmacists and physicians for drug therapy problem services provided to eligible patients. Pharmacists meet with patients for comprehensive medication reviews, drug therapy problem resolution sessions, problem follow-ups, and preventive care appointments. Recommendations are then relayed to the physician for approval. Approximately 400 Iowa PCM eligible patients receive care by one of Mercy’s eight pharmacists, and they boast a 95% response rate from physicians on interventions with 85% acceptance. Josh Feldman, manager of Taylor Pharmacy, a Mercy Family Pharmacy, leads the team in participation with PCM and marketing to private pay organizations.

Josh graduated from University of Iowa in 1997 and went to work for the Federal Bureau of Prisons. After two years with the Bureau, he decided to return to the University of Iowa to further his education through the Doctor of Pharmacy program. Since completing that training Josh has been employed by a network of pharmacies which were purchased by the Mercy Health System. While Josh has been personally responsible for around 250 of the PCM eligible patients receiving care through Mercy Family Pharmacies, the pharmacists have individual areas of expertise and patient load is dispersed accordingly. Josh specializes in the needs of psychiatric patients, while his other colleges focus in the areas of cardiovascular disease, diabetes and women’s health issues. Their practice is successful not only in the large number of patients they care for and the high physician response rate but also in the quality of patient care they provide. Eighty-two percent of Iowa PCM patients diagnosed with high blood pressure and cared for by Mercy Family pharmacists are at their blood pressure goal. Of their patients with high cholesterol, eighty-five percent are at their LDL goal.

As a preceptor for pharmacy students, Dr. Feldman’s goal is to create a model to implement in other pharmacies. He wants to help students gather business sense and think about generating revenue in their practices. Personally, he plans to develop a business based solely on pharmacist consulting services. In the past two years he has developed a co-marketing relationship with an area occupational health organization and is providing health screenings to area employers. He hopes that will lead to private payors of case management services by pharmacists.

Entrepreneurial Leadership Analysis:

How did Josh, and the other pharmacists at Mercy Family Pharmacies, determine the necessary resources?

Utilizing the manpower the pharmacies already have with their staff pharmacists, resident, pharmacy students, and support staff, the team planned their schedule to allow work on PCM patients when dispensing requirements are lowest. After more than a year utilizing paper charts for PCM patients the pharmacists approached Outcomes Pharmaceutical Health Care to develop a web-based documentation and management system for their patient care files. Utilization of the current web-based system then identified potential areas for alteration and the system continues. Necessity has been the driver in this system for delivery of Pharmaceutical Case Management services.

How is the progress managed?
Josh tracks both the response rate of physicians and the acceptance rate of there interventions. While many of the physicians readily respond and approve the interventions by this team of pharmacists there are some who are still resistant. Josh continues to notify even the unresponsive physicians of his services and recommendations in hopes that familiarity will lead to acceptance.