Program overview

Department of Pharmacy

The Geisinger Ambulatory Clinical Pharmacy program has more than 90 ambulatory clinical pharmacists managing patients’ medications for over 20 medical conditions. Pharmacists are incorporated into both Geisinger-owned patient-centered medical home (PCMH) and accountable care organization (ACO) sites within four practice models: primary care disease management, specialty medicine disease management, and home-based care and pharmacy telemanagement. The Medication Therapy Disease Management program was named the recipient of the American Society of Health-System Pharmacists (ASHP) Award of Excellence for 2016 and a finalist in Medication Safety for chronic pain management.

Primary care pharmacists are embedded in family practice and internal medicine sites across the health system. This practice model is based on a concept of comprehensive, high-value, office-based visits to achieve ongoing management and patient ownership of chronic disease patients at primary care sites. These pharmacists help to improve medication-related patient outcomes and assist primary care providers in decreasing healthcare costs and meeting quality benchmarks. Under collaborative practice agreements with providers, the pharmacists perform comprehensive medication reviews and medication reconciliation, identify and resolve medication-related problems, manage chronic disease states through evaluation of the safety and effectiveness of medication regimens (including titration and monitoring toward targeted patient outcomes), design patient-centered, cost-effective medication regimens, optimize polypharmacy and provide education to patients and providers.

Pharmacy students from a variety of regional schools of pharmacy complete experiential education rotations at our hospital and clinics as part of their core rotations.

Residency requirements

As a PGY1 pharmacy resident in an ambulatory setting, you will be responsible for providing safe, efficacious and cost-effective drug therapy for all patients. You’ll work in a multidisciplinary practice and collaborate with all team members using collaborative practice agreements. Once you’re competent in specific disease states, you will provide face-to-face and one-on-one phone-based medication management for patients with chronic diseases. You’ll communicate with all healthcare professionals and patients regularly concerning medical care and quality of life, emphasizing the monitoring and documentation of specific pharmacotherapy outcomes. Beyond your patient care activities, you’ll assist healthcare personnel with in-depth drug information.

With a focus on primary care, you’re responsible for Medication Therapy Disease Management (MTDM) activities related to things including anticoagulation therapy, diabetes (including insulin pump management), hypertension, dyslipidemia, asthma, heart failure, osteoporosis and COPD. By communicating with the patient, you’ll identify, resolve and prevent medication-related problems. You’ll assess each patient’s medications for indication, effectiveness, safety and adherence issues and order lab tests in the assessment process. And you will follow up with the patient to titrate/manage/monitor their medication therapy and ensure positive outcomes.

Core longitudinal experiences 

• Medication therapy disease management (primary care)
  • Residents will be expected to establish a patient panel and care for patients over time
  • Disease states include: anticoagulation, asthma, COPD, diabetes, dyslipidemia, heart failure, hypertension, osteoporosis and smoking cessation 
• Pain management
• Cardiology
• Pharmacy administration and management

Focused rotations

• Orientation
• Anticoagulation
• Transitions of care
• Elective(s) tailored to resident interest — possibilities include:
  • Advanced pain management
  • Outpatient geriatrics
  • Advanced cardiology
  • Outpatient hematology/oncology — infusion, oral chemotherapy or combined experience

Additional longitudinal experiences

• Leadership and teaching
• Staffing (community pharmacy, telepharmacy, on-call)
• Major research project
• Drug information

Program requirements

• Completion of all R1 goals/objectives with a status of achieved by the end of residency
• Completion of MTDM disease state certification exams by program deadline
• Completion of major project, which includes meeting all project deadlines and submission of written manuscript of completed project to GC-West RAC and platform presentation at Eastern States
• Completion of Medication Use Evaluation, which includes meeting all project deadlines and submission/presentation to MTDM leadership and a poster presentation at a national meeting (e.g. the American Society of Health-System Pharmacists conference)
• Completion of a drug review and a class review, which includes meeting all project deadline and submission/presentation to Geisinger Health Plan
• Ambulatory clinical pharmacy presentations and active participation in medical home and provider meetings at primary care sites