Gina Schnathorst (Host): Welcome to the Iowa Specialty Hospitals and Clinics ISH DISH podcast; practical health advice from Iowa Specialty Hospital experts. We want to connect the members of our communities with the latest healthcare information that's understandable, relatable, and useful to your daily life.

Today we are going to dish on everything pharmacy. Drugs! We're going to talk about drugs today! No, just kidding. Actually, in the studio with me today, I have Trish Hoffman. How are ya?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Good. How are you?

Good

Host: Good! I'm so happy you're here!

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Thank you. I'm happy to be here.

Host: We get such plethora of guests on the show, and every time is different, and the information is great. So, you are our main ISH retail pharmacist and our pharmacy supervisor. So, you have a big hat.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Yes.

Host: When did you start working with us?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: So, I originally started working at Iowa Specialty in 2016. I started as a staff pharmacist on the inpatient side. Worked in that position for about four and a half years. We relocated briefly for about nine months for my husband's job, and then I ended up coming back, yep, in 2021 and then that is when I started the retail pharmacy side.

Host: Okay and we had some construction and new, I don't know, gosh, when was that now? It's been

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: We moved back into the original pharmacy location in 2021. It was shortly after I came back. Yeah.

Host: So anybody who hasn't been there for a while, a few years, it looks completely different. Yeah,

Yes. Definitely a huge upgrade.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: We get that a lot. Well, this looks different than the last time I was here.

Host: And now I can't even barely remember what it looked like before,

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Right.

Host: Yeah, it is cool. So, just tell me a little bit about what you do, any new services that the pharmacy provides. To the layperson who comes up and gets their meds, we have no idea what's going on behind the scenes. So, I mean I was gonna ask you about what your typical day looks like. So maybe we'll just start there and then we'll just see where it

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: any new

Host: goes.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Well typically, as far as the retail side, come in, kind of get the computer system up and going before we open. A lot of what the pharmacist does is... obviously verify prescriptions and counsel patients, but there's also inventory management. Any other questions from other departments. We work with nursing and the clinic a lot, even the hospitalists when someone's being discharged. We also fill medication boxes for patients in the assisted living and independent living.

Host: And then do we have somebody that makes those deliveries?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Yes, if they're at the assisted living or independent living, we deliver those every Friday afternoon, and they start on Sundays, so that way they do that. We do monthlies for assisted living, and then weeklies for the patients that do their own

Host: medications.

And this is at the Meadows.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: This is at the Meadows.

Host: Independent that are attached to our hospital. Yes. Another great perk!

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: We do also have a couple patients that we fill boxes for that live at home. So, that's a service we offer there.

Host: It seems like when I come to the pharmacy to get a script or whatever I need, you're on the phone a lot.

So what is that all about?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: So, sometimes it's with the clinic.

Host: Okay.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Sometimes it's with an insurance company, sometimes it's with a doctor's office, or even another pharmacy, transferring prescriptions in. Sometimes, a lot of it is electronic now. Things get faxed, but every now and then that doesn't work, or it's something you need right away. So, we just give the pharmacy a call and do it pharmacist to pharmacist.

Host: Okay, not that you're always on the phone but like this girl is fielding some questions.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Well and then you'll have patients call in with a question, and so then that is deferred to the pharmacist out there, so.

Host: Right. Yeah, that's a lot.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: I do spend a lot of time on the phone.

Host: Good. So, do we have any new services or anything brand new that maybe the public would not know about?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: We don't necessarily have anything brand new, but I did want to just reiterate that we have automatic refills. That's something that refills your prescription automatically every one month, three months, however often you get it.

Host: And how would somebody sign up for that or...

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: All they have to do is just give the pharmacy a call or when they're in, just let us know. We also have a program that goes along with that, but it's called MedSync. And what it does is take all your medications and line them up, so you're not making multiple trips to the pharmacy.

Host: I'm gonna make a note of that right now This is me writing that down. MedSync.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Yes, and automatic refills.

Host: You just made my life so much easier, Trish. Okay, what else? Anything?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: We also do offer text and or phone call notifications when prescriptions are ready. So we do usually like to do that with people who are on automatic refills or MedSync just so you know when they're ready. They typically fill about three days ahead of schedule so that you don't worry about running out but it's nice if a new medication is added. We call it short fill but it'll fill enough to your next big fill date, so you're not coming back, you know, some people were coming back three to four times a month just to get their prescriptions.

Host: And I will tell you those text messages are a game changer. Because I always, back in the day felt badly for calling because I thought, well, I don't know when it's ready. And then you would go to the pharmacy. Well, it's not quite ready yet. Okay. Well, I'll just, should I just call? It felt like a pest.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Yeah, no one's ever a pest. Please feel free to call if you need to. The nice thing about the texts also is that you can respond. And we actually message back and forth.

And they also send reminders. So I think it's every two or three days. If you haven't come to get your prescriptions, it sends a reminder.

Host: Yeah. Hello! You still have stuff here.

 So, tell me a little bit about your background and how you came to be a pharmacist.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: So I grew up in northwest Iowa. Forever I was going to be a physical therapist. That's what my, I played sports, I had a few injuries, went to physical therapy, and then in high school I had to do a career paper and we had to choose a few different occupations occupations and you would shadow them. So of course I did physical therapy.

It was actually my track coach who was like, well, did you ever think about pharmacy? And he's like, I know you like math, science, all that stuff. And so I did that as one of my occupations and I ended up loving And so I went to Creighton University in Omaha for my undergrad classes and pharmacy school.

Through pharmacy school, I worked at Hy Vee for retail. And then that's where I started after graduation also, before I transitioned to a closed door long term care pharmacy. So that is, that services nursing homes and assisted living. Everything is delivered, it's a closed door, so patients don't come in to pick things up.

And then we moved to the area in 2016 for my husband's job, and that's how I ended up here at Iowa Specialty.

Host: Wow. So do you miss not doing the physical therapy route, or is this kind of your...

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: No no, this I think this was my calling. And he must have known that.

Host: Right.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Thanks Coach Brosted.

Host: If you're listening, thank you. So, tell me some of the biggest challenges that pharmacists face.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: I would say in recent years, especially ever since COVID hit, drug shortages are huge.

Host: Yeah, I actually had that written down. I was going to ask you about like, how are those even handled?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: You do the best. In the retail pharmacy, our patients might have noticed that their pills might look different almost every time they're picking up. Sometimes you just have to get what brand you can get. We don't like to switch it more than anybody else does, but sometimes that's your only option to have the medication.

So you just kind of have to keep watching. We can put things on back order so that as soon as they're available, they automatically come into us. We don't have to check every single day. But if people have been noticing different looking pills, that's a big thing. And that's also on the hospital side as well. It's across the board, medications.

Host: Do you think there's an end in sight to that?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Oh, I hope so. I thought we kind of would be over it by now. At least, at least better. There's certain medications and things that I've seen. I know some manufacturers were adding more plants in the United States to help ramp up production, so I hope it just keeps going in the right direction. But then, you could have things like a tornado that takes out a big plant and that's one thing that's happened recently, too, so.

Host: Yeah, I talked to one of your techs a week ago and we were discussing the same thing and how you have to just either substitute or maybe if you had a 500 milligram and those aren't available now you have to take two, 250s for example, but you have to be creative.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Yes, you do. Sometimes it's tricky, but usually you can just call the doctor, tell them happening, you know, sometimes we do even call other local pharmacies to see if they have it or can get it. Most times, that's not the case either. We're all in the same boat.

Host: And I have a, this just came to my mind because this is seems to be the hot topic. I'm sure you know what I'm gonna say. Ozempic. Just as the overarching. I know there's a lot of other of these, diabetic slash weight loss medications. Are you seeing an uptick of all of that as well?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Right now we're only dispensing for diabetics. That's the approved indication. That's what insurance companies are allowing. Some do pay for the other, Wegovy, and the ones that are meant for weight loss. But also that helps with the supply. So diabetic patients right now, on Ozempic, Mounjaro, I know some of those they're working on getting that indication for weight loss. And even if it gets the indication, that doesn't necessarily mean insurance companies are going to pay for it either.

Host: Right, So, mean,I there was a huge shortage.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Because of the big uptick, so that's why a lot of these new regulations kind of got put into effect to make sure those patients that are diabetic are able to have access to them.

Host: Right, well that's good. Explain to me what the difference is between a patient comes in and has to be admitted and they need meds versus what you do retail wise. So what is the difference? It seems obvious, but...

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Right, so our medications that we dispense in the retail pharmacy are meant for patients to use at home. So, when they come to the hospital and they're admitted to inpatient, typically the hospital provides the medications and the pharmacists there are involved in verifying all the orders for the inpatients. They also do mixing of the IV medications that are used. We have drug dispensing units located throughout the hospital called Omnicells and that's where sometimes the nursing staff gets the medications for the patients.

Host: Those are kind of high tech aren't they?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: They do all the upkeep and stocking and all that kind of stuff. They do a lot of work behind the scenes so you don't necessarily see them doing it. But I promise you they're doing it.

Host: Right, right. So this Omnicell is, correct me if I'm wrong, kind of like a vending machine for meds?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Kind of. Yeah, you have to sign in and have to have an order in the computer so that you're taking the right medication. There's scanning involved as safety.

Host: And then somebody has to fill that. And whose job is that?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: The technician in the hospital side typically does that, but the pharmacists do it as well. And then they also do discharge counseling. So, they go over the medications before patients are discharged and then if they need to, they come down and get them from our pharmacy or their pharmacy.

Host: Okay.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: But yes, typically our medications are for people at home versus in the hospital.

Host: All right. What hours are you open?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: The retail pharmacy is open 8:30 to 5:30 Monday through Thursday and 9:00 to 5:30 on Friday. And then Saturdays we're open 9:00 to noon. We do have a drive thru window.

Host: That's wonderful. I use it a lot.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: It is open from 9:00 to 5:00. So, and that's just for staffing.

Host: Sure. Okay.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: And that's Monday through Friday that it's open 9:00 to 5:00.

Host: Okay. Anything else that you wanted to highlight for the pharmacy?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: The only other thing I can think of is the inpatient pharmacists also run the INR clinic, which for patients that are on warfarin or Coumadin. It's blood thinner, requires monitoring. They do that one morning a week. They do it Wednesday mornings here and Thursday mornings in Belmond, and patients know their dose right away. They know what their INR was right away, and the pharmacist should make sure they're taken care of.

Host:  That's really

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Yes.

Host: Yeah. And as far as the hospitals are concerned, Clarion and Belmond, Clarion is the one that has the retail pharmacy. Belmond, we do not. It's just inpatient.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: It is just inpatient in Belmond.

Host: Yep. Okay.

Anything else for the good of the group?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: I don't think so. I think we touched on it all.

Host: Covered it all? If anybody has any questions about maybe switching from their current pharmacy and they want to start getting their medication with us, what would be the plan for that?

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: So, they can just give us a call. Phone number is 515-532-2801.. You can just press 4 to talk to somebody in the pharmacy. Let us know what pharmacy and roughly how many medications. And we can get that taken care of for you.

Host: And then you initiate that with that pharmacy I don't have to go into my current pharmacy and say hey I need

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: We will call that pharmacy and get them transferred to us.

Host: Perfect well that seems very painless.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Right. Yes.

Host: All right. Wonderful. Well, thank you so much for being on the podcast today.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Thank you for having me.

Host: If anybody has any questions out there about pharmacy, any kind of different meds, maybe you're person who had have a substitution, don't hesitate to call. These guys are so friendly and so open to communication and they want to help. So absolutely give them a call. 515-532-2801 if you have any questions. All right. Thank you so much for being on today.

Trish Hoffman, ISH Pharmacist, Retail Pharmacy Supervisor: Thank you.

Host: Thank you for listening to Iowa Specialty Hospitals and Clinics ISH Dish podcast. For more information on the topics we discussed today, visit us on the web at iowaspecialtyhospital.com. There, you can read a transcript of today's episode or previously aired episodes, as well as get the latest news from Iowa Specialty Hospitals and Clinics and explore all of the services that we offer. For the ISH Dish podcast, I'm Gina. Thanks for tuning in.