Five DELTA Rx interns had the opportunity to complete an entrepreneurial-oriented experience this past summer for the DELTA Rx Summer Internship Program. This is the first summer that we have had summer internships "back to normal" since the pandemic. The mission of the DELTA Rx internship program is to allow pharmacy students to participate in activites that revolve around innovation and entrepreneurship prepare them for their future careers. Learn more about their personalized experiences and how it impacted them:
This past summer, I had the opportunity to complete my DELTA RX internship at NuCara Pharmacy with Dr. Brett Barker. NuCara Pharmacy offers a variety of services to its customers, including home medical equipment, immunizations, compounding, infusion centers, and more. NuCara Pharmacies are primarily located in rural parts of Iowa, allowing them to be more accessible to patients and provide invaluable personable experiences.
My main project for the summer was to implement point-of-care testing (POCT) in the pharmacies. I initially began working with many pharmacy managers to see how comfortable they felt with the POCT process, and based on that, I wrote a standard of practice (SOP) for the POCT process. The SOP included information regarding setting up the machine, how to troubleshoot, best practice tips, pricing, and the legalities. After writing the SOP, I took time to visit several NuCara pharmacies across Iowa to make sure that their systems were working and to answer any questions that they had. The main obstacle to overcome in this project was to motivate the pharmacies to learn how to run a test and to promote the tests at their pharmacies. I tried to overcome this concern by staying in contact with each pharmacy and discoursing through any issues they were having. By the end of the internship, I was able to get the POCT process up and running at eight different pharmacies.
A side project that I was able to be a part of towards the end of my internship was the Iowa Quality Initiative, in collaboration with CPESN and Seguridad Inc. This project focused on the quality-of-care pharmacies provided to their patients and tried to increase it. By the end of the project, each pharmacy will be able to know its quality based on measures developed for pharmacy performance. I assisted in the data collection process. This entailed me extracting data from all the Iowa Nu Cara pharmacies and uploading them to the Seguridad system. Implementing the POCT process allowed NuCara pharmacies to provide a higher quality of service to their patients. This project gave me experience of analyzing data that many pharmacy managers look at.
Additionally, during my internship, I got the opportunity to work with the Iowa Pharmacy Association. I attended IPA events and got to sit in on many meetings with the IPA board, IPA committee meetings, and the Iowa Insurance Department. This part of the experience was unexpected, but a very valuable part of it. I was able to understand more about the policy process and make life-long connections. I also got the opportunity to write three articles for the IPA Journal about various legislative topics.
Overall, this experience allowed me to develop my business leadership skills and learn more about pharmacy at a corporate level. I was able to learn how to take an idea and implement it in multiple pharmacies. My main project gave me hands on experience on how to problem solve when issues arise. This internship experience allowed me to develop new skills and sharpen the skills that I already developed. I am thankful to DELTA Rx and NuCara Pharmacy for giving me an opportunity to be a part of this learning opportunity.
Eagle Grove Pharmacy (EGP) was the location where I completed my DELTARX summer internship. EGP is a family owned and operated independent pharmacy located in the upper center of rural Iowa. EGP provides supreme service to thousands of small-town Iowans—from dispensing medications and fitting diabetic shoes, to compounding hormones and lollipops. On top of various specialty pharmacy offerings such as compounding, diabetic shoes and medication therapy management, they provide medication bubble packing and med synchronization as well. EGP strives to render the upmost of care towards all patients that walk through their doors, every day of the week.
Through my past experience as a retail pharmacy intern for two years, I have grown interested in the inner workings of Direct and Indirect Remuneration (DIR) fees. As a result, my project over the profitability of their medication bubble packing and secondary project on impact of DIR fees upon EGP intrigued me greatly. DIR fees have permanently changed the landscape of community pharmacy since they were released in 2006 with the formation of Medicare Part D and their STARS program. My initial with the bubble packing is still under development, as many payers will delay and retroactively DIR fee prescriptions at the claim level—up to 6 months of delay.
My second project with the impact of DIR fees on EGP is seen within my poster, looking at the impact of DIR fees on EGP since 2016. This project required contacting payers, our contracted payer service, and taking a dive into their DIR fees to uncover the effect of them over time. Both projects elucidated the importance and severity of DIRs fees and their odious effect on the pharmacy from a financial perspective.
My experience at Eagle Grove Pharmacy was eye-opening to the abilities and time that independent pharmacies hold versus chain-retail pharmacies. EGP helped me develop a greater sense for the standards of patient care that is expected of independent retail pharmacies; patients choose EGP over other pharmacies just for that reason. My favorite part of the internship was learning all about compounding from Denise, Meleah, and Barb.
This summer I was fortunate to complete my DeltaRx internship with GRX Holdings. GRX is a company founded in 1983 by Drake alum Greg Johansen and encompasses 23 pharmacies, including Midwest Compounding, Medicap Pharmacy LTC, and Wright Pharmacy. The majority of my time was spent under the regional directors of operations Katie Thaut and Racheal Renfrew as well as the clinical coordinator Megan Myers. There was never a dull moment and I was constantly engaged in activities such as opening a new telepharmacy, attending meetings for potential new clinical services, business development, partnership calls, clinical store reviews, and more. They do a great job of exposing you to as much as possible and I was able to visit over half the stores. Two of my major projects included streamlining CMR services and writing policies and procedures for the newly converted telepharmacy.
Offering MTM services is critical to GRX’s mission of providing our patients with the best care possible. With pharmacies being overwhelmed it can be hard to find time to provide these additional services, especially in one pharmacist stores. Utilizing OutcomesMTM, I created educational materials that included how to prep a CMR guide, common interventions to look for, and patient tips that can be copied and pasted into the CMR. This will allow other staff members to save time for the pharmacist and prep the CMR so it is ready to go for the patient interview. I have continued this project into the fall and helped prepare CMRs for multiple stores.
I was brand new to the concept of telepharmacy and dove right in. The Dallas Center store was in danger of closing and by converting it to a telepharmacy we were able to keep it open and continue providing care to the community. I became familiar with the laws and legislature by writing policies and procedures based on the Iowa Board of Pharmacy's standards. I was present for the board inspection and it was extremely rewarding seeing the time and effort pay off by passing.
This summer was a blast and an opportunity I needed to expand my understanding of pharmacy practice. I met many great people that I can count on to help guide me through my future career. GRX provides you with the perfect balance of structure and freedom to pursue your interests and grow as a professional.
Through the DELTARx Entrepreneurial Leadership Pharmacy Internship, I interned at Walgreens Specialty Community Pharmacy. This site gave me first-hand experience in the current booming section of pharmacy known as specialty pharmacy. The focus of specialty medications is what made this experience unforgettable. Specialty pharmacy focus can be summarized as the management of high cost and or limited distribution medications and the pharmacotherapy of complex disease state(s) (e.g., organ transplants, neurologic disorders).
Success seen at Walgreens Specialty results from the progressive leadership that has developed strong relationships with local clinics, healthcare organizations, and patients around the state of Iowa. My preceptors gave me the opportunity to continue to foster these relationships. A few of the projects I worked on included medication therapy management (MTM), working up patients with viral hepatitis infections, and understanding the relationship between patients, providers, pharma, and our pharmacy. These projects culminated into a capstone project. My capstone project was a data-driven project estimating that over the full month of July 2022, Walgreens’s total patient assistance was approximately $400,000 with an estimated prescription savings of 99%. This information was then created into marketing material for clinics to showcase Walgreens continued expertise and effort in providing affordable specialty medications.
After this internship, my future goals are changing. I am now considering careers within specialty pharmacy and managed care.
This summer I had the privilege to be a part of the DeltaRx internship program and spend 10 weeks at Hartig Drug in Dubuque, Iowa. Hartig Drug is a locally chained pharmacy predominantly found in North-East Iowa but also has several stores in Illinois and Wisconsin. While most of my time was spent at the corporate office located in downtown Dubuque, I got to expand my knowledge of pharmacy by also visiting their long-term care pharmacy as well as their sister company MedOne. During the internship, I was tasked to complete two main projects: developing a continuous quality improvement assessment and profitability analysis for the company.
Since I was unsure of what area of pharmacy to pursue but knew I was interested in the business aspect of healthcare, I decided to apply to the program. Charlie Hartig provided me with unique opportunities to see the behind-the-scenes action for what goes into running a pharmacy effectively. For my first project, I researched, collected, analyzed, and implemented effective strategies the company could do to improve their quality of care. It was crucial to identify recurring trends and isolate the location of the error within the dispensing process. This project was my favorite and allowed me to realize quality patient care is something I am passionate about. Had I not taken the risk to apply for the internship I believe I would not have realized this about myself or would not have realized it this soon in my pharmacy journey.
For my second project, I was able to analyze roughly 5 months’ worth of data from all Hartig Drug pharmacies and compile a list of the bottom 300 unprofitable patients as well as the 100 least profitable drugs. This project challenged me to go outside of my comfort zone and adapt to the challenges that were thrown at me. Even though the challenges I faced were unique to my summer, I found myself feeding into the difficult circumstance and using it as my drive to overcome it. Once the patients and drugs were determined my next task was to find ways to make Hartig Drug more sustainable while maintaining patient care. My suggestions were sent out to each pharmacy with a corresponding patient implementation strategy to help them make the desired change. This project opened my eyes to another way that I can help improve patient care behind the scenes.
I am extremely grateful to DeltaRx for allowing me to not only broaden my understanding of pharmacy but also allowing me to meet such great individuals. Charlie Hartig and his staff were all so welcoming and continued to push me to be my best self. I remember many occurrences when Charlie would take time out of his very busy schedule to sit down with me and simply dissect my thoughts on topics. The knowledge I learned and the leadership experience I have gained at this internship is something you simply cannot receive while in a classroom. I am confident when saying this experience has shaped me into the person I am today and propelled me in the direction of pharmacy I want to pursue.