Offering medical, surgical, and radiation oncology, the Hallmark Health Hematology and Oncology Center provides local access to personalized, comprehensive, high-quality cancer care. Located in Stoneham, Massachusetts, about 7 miles north of Boston, the center is part of Hallmark Health System, which also includes 2 community hospitals, Lawrence Memorial Hospital of Medford and Melrose-Wakefield Hospital.
The center also houses an onsite oncology pharmacy. Being positioned on the same floor as the treatment area places the pharmacists right where they need to be. “As in any oncology practice, we are fully available for any kind of consults,” Michelle Corrado, PharmD, System Director of Pharmacy Services, told The Oncology Pharmacist. “We are regularly requested by patients…if they have any questions about their regimen or side effects, the pharmacist will typically go out to the infusion room and sit and talk with patients and their families, answering any questions they might have.”
This ease of communication extends beyond patient consults. Proximity to team members increases the frequency of face-to-face conversations and enhances personalization of cancer care, according to Corrado. “Many interdependencies are needed among physicians, nurses, and pharmacists to get the right treatment for the right patient; and you really need to know that patient. You need to know that he or she was hospitalized last week. You need to know how his or her labs are trending. You need to know that he or she vomited for 3 days the last time.” This degree of information is not always available when pharmacists work remotely. “Sometimes it is just a casual conversation. I really have seen that the level of information you get about the patient increases exponentially by being integrated into the practice,” she said. And this dedication has its rewards. Patients regularly compliment the center, specifically the pharmacy.
Behind the Scenes
What many patients don’t know is that their high-quality care stems from a lot of hard work. As in many oncology pharmacies, pharmacists at Hallmark Health head up the Risk Evaluation and Mitigation Strategies (REMS), including oncology and nononcology REMS programs. For the center, that represents between 6 and 12 programs for such agents as epoetin alfa, darbepoetin alfa, natalizumab, and denosumab, each requiring the verification of lab values and documentation.
Pharmacists also are the point people for the center’s computer-based orderentry system (IntelliDose, IntrinsiQ), building any new protocols instituted by the center, including supporting literature, into the system. Add in their use of the existing pharmacy information system (MT Software, MediTech) and the just-implemented electronic health record system (Centricity, GE Healthcare), and the center’s pharmacists are coordinating a good amount of hightech. Plus, they currently are implementing a bar-coding system as an additional source of quality assurance.
Pharmacy also handles pharmaceutical purchasing and contracting. As the system director, Corrado is responsible for contracting, and Hallmark Health has a buyer. However, “the oncology pharmacy coordinator is responsible for all the inventory [at the center].” The center keeps a very tight inventory margin, which requires close communication with the team. “What patients are coming in. What treatments we need to handle,” she explained.
In addition, there is the business plan for the upcoming year. Corrado and the center’s oncology pharmacy coordinator will work with the director and the health system’s finance and compliance officers to “make sure that we are offering the right therapies for our community, and that goes into the expansion of the nononcology infusions,” as the center currently acts as an infusion center for multiple sclerosis treatments, osteoporosis, as well as various neurologic conditions, she said.
