Medically Integrated Dispensing Strengthens Oncology Care Through Real-Time EMR Access: Sam Abdelghany, PharmD, BCOP, MHA

Medically integrated dispensing (MID) in an oncology setting allows clinicians to treat patients in real-time based on patient electronic medical records (EMR) within a hospital setting. Treating patients while in the hospital helps ensure patients are receiving the care they need as opposed to receiving their medication from an external, third-party pharmacy.

Panelists at the Boston Regional Institute for Value-Based Medicine, held on February 6, discussed the advantages of MIDs in an oncology environment and their potential when translated across hospital systems. One of the panelists, Osama (Sam) Abdelghany, PharmD, BCOP, MHA, executive director of oncology pharmacy at Smilow Cancer Hospital at Yale-New Haven Health, addressed the strengths and limitations of expanding MID models in an interview with The American Journal of Managed Care®.

There are 3 pillars required for seamless implementation of MIDs, Abdelghany said. They are system-wide use of a standard EMR, signature of care, and cohesive staff training.

“All those 3 aspects have to be operating under a strong leadership that has a dyad between the medical leadership and pharmacy, because you need a strong alignment to identify priorities,” he said.

However, there are major hurdles to realizing MIDs’ value to hospital systems, many of which are external or related to payers and pharmacy benefit managers. Abdelghany said one of the biggest issues pharmacists encounter is being locked out of payer networks, thus limiting their ability to dispense medications.

Additionally, when pharmacists are “locked out” and unable to deliver care under a fee-for-service model, they are not compensated for the clinical work and time they put in to enhance patient outcomes.

“There's also a misalignment between what we do today and just the reimbursement model,” Abdelghany said. “We need to shift from what we do today, the fee-for-service product, to a different way that aligns all of us to a value-based arrangement in the future.”