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Pharmacy for the Future: 2016 DELTA Rx Summer Interns

This summer, for the eighth year, The DELTA Rx Institute partnered pharmacy students with entrepreneurial pharmacies in their Entrepreneurial Leadership Internship Program. This program allows students to develop and improve their entrepreneurial leadership skills through hands on practice and experience at their pharmacies. By the end of the program, students have a chance to be involved in the process and witness entrepreneurial leadership in a community pharmacy, be prepared for future entrepreneurial leadership positions in community pharmacy, and have exposure with emerging entrepreneurs. Additionally, students are able to give new ideas in developing new innovative programs at their hosting pharmacy.

The experience the interns get is invaluable, helping prepare them for future opportunities. This year’s interns were Elise Damman (’18), Ryan Hannan (’18), and Jacob Schnackenberg (’18).

Ryan Hannan’s Experience

Ryan Hannan is a 2018 PharmD/MBA Candidate within Drake University’s College of Pharmacy and Health Sciences. He was selected as one of three students for DELTA Rx’s summer internship program in 2016. He records his experience as an intern below:

This past summer, I had the honor and privilege to be the summer 2016 DELTA Rx Intern at Right Dose Pharmacy. The purpose of the DELTA Rx summer internship is to foster entrepreneurial skills in students who have ambition and drive to enhance pharmacy practice. Throughout the ten-week internship, students work closely with their mentor to complete a project within the pharmacy and develop a corresponding poster presentation. As a pharmacy and MBA student, I was drawn to this internship to combine the knowledge I have gained in both programs and apply it in a pharmacy setting.

Right Dose Pharmacy is a long-term care pharmacy located in Ankeny, Iowa, and owned by Dr. Rocky Anderson, a noteworthy entrepreneur and pharmacy leader. My preceptor for the experience was Dr. Brad Kline, the Right Dose Pharmacy manager. In addition to Rocky and Brad, I also worked closely with Dr. Julie Kane, the manager of Ankeny Pharmacy. Rocky, Brad, and Julie were all excellent mentors, and I learned from all three of them. Rocky, Brad, and Julie have been working in their respective branches of pharmacy for the majority of their careers, and they shared their passion for independent pharmacy practice.

Over the ten weeks, I was able to partake in daily pharmacy operations and was given the opportunity to use my intern license at its peak to even verify prescriptions. I frequently went with Rocky to group homes for consulting meetings and had the opportunity to attend continuous clinical quality improvement (CQI) meetings to learn about the current issues in long-term care. Since long-term care was an area new to me, I spent some time in the pharmacy working within the daily activities to better understand processes and managerial operations. To maximize my learning experience, I also spent time in Ankeny Pharmacy to gain further understanding about independent community pharmacy. From interviewing new employees to analyzing potential pharmacy acquisitions, I learned something new every day.

The DELTA Rx program consisted of two components: the internship itself and an academic component. The academic component consisted of weekly online modules about business concepts and pharmacy economics. Additionally, all of the DELTA Rx interns and Dr. Erin Ulrich, a Drake professor and DELTA Rx team member, participated in routine conference calls to discuss our projects the material we were learning in our weekly online Developing Your Pharmacy Future modules.

Because there were two pharmacies at the same location, I decided that I would do two projects. My first project initiated from a CQI meeting with one of our clients who was upgrading their medication error reporting system. Since I was taking a class at Drake for my MBA on data analysis, I spent a few days utilizing my new skills to analyze their history of medication errors. After breaking down the data, I went to a group home and watched a medication pass to assess for potential weaknesses in the process. Once I understood their processes and history, we had a meeting with all stakeholders to learn about the software they had purchased. We were charged with designing the interface. Using the trends from their data, I was able to recommend that the system be focused on the six rights of medication administration, principles that all nurses learn during their education. This new classification system was unique in its interface design suited for nurses—the users—rather than the traditional administrators and pharmacy audience.

My second project was to design a new model of service for the community pharmacy. This new model had different tiers of service, starting with no fee and increasing to levels with subscription fees and more service offerings. This project earned me a number of connections through my investigation of various testing device purchases. Throughout the process, I was provided instruction and the opportunity to write a business plan for the implementation of this new model. Example services included medication therapy management, medication synchronization, compliance packaging, and more.

After my summer internship, I was offered to remain on staff at Right Dose Pharmacy as a Pharmacy Intern. My current role involves many similar duties to my summer DELTA Rx internship, and I complete projects on an as needed basis. The medication error reporting system has been completed and is currently in practice at our client’s location. The enhanced pharmacy services model is still in development, and we are planning to gradually bring each component and service live.

Post-internship, I am working to develop an app to allow our clients to request refills from Right Dose Pharmacy by scanning prescription label barcodes. This app would be deployed on iPod Touch devices that would also hold the potential for other resources, such as apps for communication to the pharmacy, basic medication references, and calculators. This project has required me to learn the skills of mobile device management, volume purchasing, working with contractors, and break-even analysis. Because of its nature, the app project has extended my expertise beyond pharmacy and into the world of health information technology.

Throughout my time at Right Dose and Ankeny Pharmacy, I have learned a diverse array of new information and skills. Connection with patients, simplified pursuit of new ideas, and a flexible work environment all are benefits of an independent or small chain pharmacy. The DELTA Rx focus for entrepreneurial skill development was prominent, and I discovered the realm where pharmacy, management, and information systems cross over. Because of this, I am pursuing a rotation and potentially a residency in pharmacy information and data analysis and am excited to see what the future holds. 

Jacob Schnackenberg’s Experience

Jacob Schnackenberg is a 2018 PharmD/MBA Candidate at Drake University. He was selected as one of DELTA Rx’s three summer interns for 2016 and completed an internship with NuCara Pharmacy at locations throughout Iowa and Illinois. Read Jacob’s reflection on his experience below:

 “Entrepreneurial opportunities are everywhere in the field of pharmacy, and through my internship with NuCara and the DELTA Rx Institute, I was put in various positions to see some of these opportunities first hand. Throughout the entirety of the internship, I was put into environments that were challenging, but most importantly, rewarding.

During the thirteen-week summer internship, I had the privilege to work under Brett Barker, Vice President of Operations for NuCara Management Group. Brett is a visionary leader in the state of Iowa and in the pharmacy profession. He is heavily involved in telepharmacy, the Iowa CPESN, Drake University, and the University of Iowa, among other notable commitments. Every week, Brett placed me into unforgettable experiences that I would have never otherwise experienced.

NuCara’s success thus far as an independent pharmacy has definitely been earned. From the time and care given to every patient, to supplier contracting and strategic ordering, they stay true to their mission of being “…passionately committed…[to] excellence, innovation, and creativity for the benefit of our patients.” NuCara’s well-deserved reputation for innovation is exemplified in the opening of the second telepharmacy in the state of Iowa, a pilot in the small community of Zearing. The integration of technology with the practice of pharmacy is one that resonates with my entrepreneurial ideals and is what ultimately attracted me to the internship.

Performing monthly inspections of telepharmacies across the state of Iowa, learning about and presenting on the topics of CMS star ratings, PrescribeWellness, EQuIPP, the Iowa CPESN, reimbursements, adherence, and DIR fees all are tasks I had during the internship. All these topics are major buzzwords in the field of pharmacy, but surprisingly they are not taught in the pharmacy curriculum. This ultimately provided me insight into what is going on within the profession at a corporate level that I otherwise would not have experienced.

The knowledge I gained, specifically, from understanding adherence measures and the pay for performance model, was the spark for my internship project, the NuRewards+ loyalty card. The NuRewards+ loyalty card was designed to incentivize patients for completing specific ‘opportunities’, the majority of which are intended to increase patient medication adherence. Highlighting current programs NuCara offers such as medication synchronization and compliance packaging, as well as rewarding those already adherent to their chronic medications, are examples of a few of these ‘opportunities’.

From pitching the idea to the CEO to finally rolling out the program in select stores, execution of the rewards program was much more demanding than I initially had thought. I’ve not only gained knowledge and a deeper understanding of where the profession is headed from this experience, but I have also learned that it takes an army behind an entrepreneur to have success—even for something as ‘simple’ as a rewards program. From collaborating with the graphic designer to working with the printing company to getting feedback from company personnel, if there is one overwhelming theme, it was that the bridges that are built between different parties along the way are extremely valuable. 

 I am a believer that there is much room for innovation, for technology, and for better patient care in the profession of pharmacy, and most importantly, there is so much more to pharmacy than simply being a drug expert. I am excited for when the time comes for job interviews and to be able to incorporate real life experiences from this internship into my responses to interview questions. From meeting with the Illinois Board of Pharmacy, to working with the specialty pharmacy within NuCara on getting URAC accredited, to speaking with Humana and questioning the intentions of their pharmacy quality network, the professional experiences throughout the internship have personally shaped my views and values for the profession.

I would like to thank Brett Barker, Vice President of Operations, for his time, energy, encouragement, and friendship this summer. Thank you also to the staff at NuCara Management group in Conrad, Iowa, as well as all of the NuCara pharmacies in Iowa, Illinois, and North Dakota that I have had the pleasure of spending time in.

I would also like to extend my thanks to Dr. Erin Ulrich, the DELTA Rx Institute, Dr. Tom Swartwood, Dr. Renae Chesnut, and Drake University College of Pharmacy and Health Sciences for this invaluable opportunity and experience. I can confidently say that experiences like this build passion for the next generation of pharmacists to see the opportunity within the field, and strive for advancing the profession of pharmacy.