GOOD NEIGHBOR PHARMACY/THOMAS J. LONG SCHOOL OF PHARMACY AND HEALTH SCIENCES

ENTREPRENEURIAL PHARMACY PRACTICE PROGRAM BOARD OF GOVERNORS August 22, 2013

Our Mission...

To create practitioners who lead by taking calculated risks, show courage under fi re, demonstrate perseverance, and are agents of change so that they may address healthcare challenges.

To create new paradigms and innovative solutions and systems to enhance patient care.

Meet i ng A gendaThursday, August 22, 2013 • DeRosa University Center • Room 211A/211B

Time Agenda Item Presenter9:00 a.m. Light Breakfast/Snack Served

9:30 a.m. Opening Remarks, Introductions, Purpose of Event and Goals All

10:00 a.m. Entrepreneurial Program - Re-cap of last year All

10:15 a.m. Entrepreneurial Program - Current Status David Collum

10:45 a.m. E-Mentoring Program All

11:00 a.m. Views and Governance from the Board (open dialogue) Board of Governors

11:30 a.m. Students of PRAC 136 - Spring 2013

12:00 p.m. Lunch - River Room

1:15 p.m. Dean Oppenheimer and Asst. Dean Nancy DeGuire Phil Oppenheimer and Nancy Deguire

1:45 p.m. AmerisourceBergen Mike Quick and Jeff Sharkey

2:15 p.m. Short Break

2:45 p.m. Research Projects - Collaborate with CPhA / student involvement/

real dispensing date/ publication

Entrepreneurial Program - Future Direction - Specialty, Biosimilars/

SB493, Hospice

David Collum

3:15 p.m. Re-cap Action Items

3:45 p.m. Closing - Future Meeting/ Closing comments by Dean

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Mission, Roles and Responsibilities of Members

Program Mission: To create practitioners who lead by taking calculated risks, show courage under fire, demonstrate perseverance, and are agents of change so that they may address healthcare challenges. To create new paradigms and innovative solutions and systems to enhance patient care.

Board of Governors Mission: To contribute to the development, administration, and management of the Entrepreneurial Pharmacy Practice Program.

Criteria and Qualifications of Members: Board members should demonstrate interest in furthering the mission, vision, values and self-sustainability of the program. Board members may be current or past pharmacy owners, own or be employed by a pharmacy-affiliated company , or donors to the Entrepreneurial Pharmacy Practice Program. Prospective Board members will be interviewed by the Board Chairperson/Faculty Chair and must agree to participate fully in all components of the program.

Roles and Responsibilities of Board Members: Board members will serve two-year terms. If desired, members may serve additional consecutive terms. If a member leaves the Board, he or she must take a minimum of one year off before rejoining. Board members are expected to attend meetings in March, July and October. If attendance in person is not possible, video or telephone conferencing will be available. Additional telephone and web conferences may also be scheduled as needed.. Travel costs are the responsibility of the Board member.

Board members will assist the Chairperson with program curriculum development, including providing innovative ideas and securing referrals for guest lecturers and topics. Members will assist in student and grant recipient selection. Board members will be asked to serve as Mentors in the Entrepreneurial Pharmacy Practice Network.

Board members will be expected to assist the Board Chairperson in identifying and recruiting new Board members. They will also be asked to identify methods of creating a sustainable flow of income to the program through prospective donor identification and cultivation.

Code of Conduct for Board Members: During their terms of office, members of the Board of Governors shall carry out their functions with integrity, independence, good faith, and in the best interest of the program. They shall act responsibly and fairly with care, diligence, loyalty and prudence. They shall carry out their duties in a manner that maintains confidence in the program. Board members shall respect the confidentiality of the information received in the performance of their duties as well as the confidentiality of the deliberations in which they participate. They shall not use proprietary information obtained as a Board member for the personal benefit or advantage of themselves or of any family member, friend, or organization. Board members shall make every reasonable effort to avoid real or perceived conflicts of interest and shall make a full written disclosure of such and make every attempt

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to resolve the conflict in the best interests of the program. Members will conduct themselves in a respectful manner and treat fellow Board members, faculty, staff and students in a courteous manner.

After leaving the Board, former members shall respect the confidentiality of the proprietary information obtained and the deliberations in which they participated during their service.

Committees/Sub-Committees/Standing Committees: Committees and sub-committees may be formed, and the formation of standing committees may result from these.

Reports: Periodic reports of the Board’s activities shall be made by the Faculty Chair at least three times per year to coincide with Board meetings and on as-needed basis. Reports shall be provided to the Dean of the Thomas J. Long School of Pharmacy and Health Sciences, benefactors of the Program, and others as deemed appropriate by the Dean and the Faculty Chair. Minutes: The Board Chairperson shall determine the method for recording, review, approval, distribution and storage of meeting minutes.

Role of Board Chairperson/Faculty Chair: Faculty Chair will spend three days per week on campus at the Thomas J. Long School of Pharmacy and Health Sciences and will be available on an as-needed basis. The Faculty Chair is an appointed one year renewable non-tenured position with reimbursement for expenses incurred while traveling on University business.

GOOD NEIGHBOR PHARMACY/THOMAS J. LONG SCHOOL OF PHARMACY AND HEALTH SCIENCES

ENTREPRENEURIAL PHARMACY PRACTICE PROGRAM BOARD OF GOVERNORS August 22, 2013

Shaping the future of healthcare...

Contributing to the development, administration, and management of the Entrepreneurial Pharmacy Practice Program.

Demonstrating an interest in furthering the mission, vision, values and self-sustainability of the program.

En t r ep r eneu r S t uden t P r o f i l e : A l e x Van Zu iden

Vision of a PharmacyI could see my pharmacy in the future being in either a rural setting or an urban setting, but it would have a different focus to it depending on where it is. In a rural setting, I want to create a more traditional pharmacy. It would be a community center and have a soda fountain feel, but serve coffee instead of ice cream. I could see myself building up a compounding lab in such a setting. Depending on the market for it and of course if I could build the space. I would hope to be near the center of town on a busy street. I would love to be able to display and sell local products and bring pride to the community.

In a more urban setting, I imagine I would not be able to get as much space, so I would work in a more combined setting with doctors and specialize in medications. In that setting, I would also look into implementing 340B. I could see myself serving many of the LTC facilities in the city. In either situation, I’d like to provide as many clinical services to my patients as possible, including provider status, have available MTM services, as well as do immunizations.

I expect that my team in the pharmacy participate in generating new ideas on how to best run the pharmacy, giving feedback without having to worry about what someone was to think of them. The number one thing that would differentiate myself from my competitors would be the customer service that I can provide.

an innoVatiVe Pain management ProgramIf I am to give a new pain management recommendation, I first must know what the pain is classified as, since there are different treatment options for physical versus psychological pain. Since there are “numerous” conditions, the problem may be quite complex and may need an equally thorough treatment plan. I would want to know

the reasoning behind why the doctor said that the patient’s life was threatened without continued use of marijuana, whether in this statement the doctor was considering the possibility of addiction or a lack of appetite which could both be associated with the use of marijuana. I would also like to know what options the doctor has tried previously in the past and why they didn’t work. Likely, the reason that the other medications didn’t work would be due to their side effects.

Knowing that the patient appreciates natural medicines and natural approaches, I would recommend non-pharmacological approaches to the pain depending on the severity the patient truly has. Although there is no scientific evidence for them, a homeopathic medicine may act as a placebo and help the patient feel less pain. If it is a physical pain, such as rheumatoid arthritis, he may try capsaicin cream on the areas that are causing pain. If it is a problem that could be added by anti-inflammatory medications, there are several diets that may help (which emphasize eating foods that are naturally anti-inflammatory while avoiding foods that may cause inflammation) in addition to a small dose of NSAID or other natural anti-inflammatory medication, such as tumeric. In addition to these medicines, lifestyle changes like taking up restorative yoga, meditation, or regular massages may help. The patient may also look into such procedures as chiropractic adjustments and acupuncture which may help to alleviate some pain

Ultimately, the patient will likely use a unique combination of above therapies and a traditional pain relief medication, such as an NSAID. The goal would be to improve the patient’s quality of life while acknowledging a desire to stay away from traditional medications. Although other patients may find the same treatment helpful for their pain, it would probably not be something that could be used among a large group of patients since there are often more effective, cheaper products out there for those seeking pain relief.

alex’s View on innoVation and health careIf something already exists in the market, it is no longer innovative by another company unless the new company does something to improve the service/item. For example, medication deliveries is not an innovative activity, but if a large retail store were to implement a personal delivery service, I imagine it would be called innovative for the simple fact that medication deliveries were not done to that scale before. Many consumers do not know what smaller scale health care organizations are doing, but if a large scale health care organization did them, they would make sure that everyone knew- likely through advertisements and press conferences. In that case, others would perceive the company as being innovative, when in fact they are not. As a potential small business owner, I see nothing wrong with this kind of implementation, in most cases, programs must be adjusted to work in a different situation so there is a level of innovation needed, although not as extensive as creating something from nothing.

En t r ep r eneu r S t uden t P r o f i l e : Be l i nda Chu

Vision of a Pharmacy• Itwillbelocatedinaurbanlocation

• Becauseeventhereismorecompetition,therewillalwaysbeenoughpatientsanditgivestheopportunitytospecializethepharmacy• Ialwaysentertainedtheideaofhavingapharmacyinthecity,therewillbeamorediversepatientpopulationandIfeelmoreopportunitiestopartnerwithdoctorsorother

local pharmacies• Dependingontheareaofthelocation,therecanalsobeplentyofplacestoparticipateincommunityeventsbeabletoobtainrelationswiththelocals• Havingmypharmacyinthecitywouldalsomakeadvertisingaloteasier

• Moreshopstoputfliersintogetyournameoutintothecommunity• Inthecity,therecouldberadiostationsthatcouldextendtheirtoreachtoevenmorepeople• Otherexamples:newspapers,magazines,etc.

• Ifitwaslocatedinaurbanlocation,therewillbemoreopportunitytohavemoreoutreachopportunitiesandbeabletohelpavarietyofpatients• Eventhoughtheremightbemorecompetitioninanurbanarea,therearemorespecialtypharmacieswhichcouldbe

beneficial to patients attending health fairs • Itwillbepartofaclinic

• Byhavingaclinicassociatedwiththepharmacy,thepatientcanretrievetheirmedicationsimmediately• Asopposedtootherlocations,thepatientwillhavetheuniqueopportunitytoattendtheirdoctor’sappointmentandpick

up their medication without having the hassle of driving to another location to pick up their meds.• Thisisespeciallyimportantforacutepatientswhomayneedtotaketheirmedicationsimmediatelytotreatwhatever

indication they may have• Thisalsosavesthedoctorfromhandlingtheconsultationservicessincethepharmacististheprescriptionexpert

• Some patients get annoyed if we ask if they would like a consultation when they have already received one from the doctor

• I would be interested in partnering with other doctor offices and if it was a specialty clinic, then I would have direct access to my clientele• Withsomuchcompetitionfromlargepharmacychains,thebestwayIfeeltoovercomethisistoprovideaspecialized

practice and services that normal community pharmacies may not have• Forexample,ifmyclinicwasadiabeticclinic,therecouldbepatienteducationopportunitiesavailabletoimproveoverall

patient health• Becausetheclientelewouldbemorelimited,youwillbemoreaccessibleasapharmacyforpatients

• thequalityofconsultationswillbeimprovedinthesensethatyou’llbefollowingthepatienttotheirhealthgoalsandbethereeverystepoftheway• Ihaven’tdecidedmynicheyet

• Itwouldhavetodependonmylocationandthepatientpopulation• Moreresearchisrequiredbeforedecidingonwhatkindofspecializingwouldbeappropriateformypharmacy

an innoVatiVe Pain management ProgramPatients Monson and Raich have to come to my pharmacy as their pharmacist for help with pain management and pain relief and general guidance on how to improve their quality of life. Their doctor recommended them to come to my pharmacy to find out about alternate methods of treatment since they have banned from the usage of marijuana therapy. Both patients are under a lot of pain and have resorted to marijuana therapy after trying a multitude of pain medications that just wasn’t as effective and which they were allergic too. Providing an alternative pain management therapy is necessary due to the state laws regarding medical marijuana. Untreated acute pain can lead to physiologic symptoms associated with chronic sympathetic nervous system discharge. Resulting in symptoms such as tachycardia, tachypnea, pallor and diaphoresis. These are the steps that I will use to assess the severity of their pain and some alternate therapies for pain management.

Before recommending any form of treatment, I would like to receive a detailed list of the all the medications that the patients have previously been on before resorting to marijuana. The doctor may have not tried all the medications available and as a pharmacist, I could give him advice regarding that. It is important to have this information so that their won’t be any repeated therapy and narrow down what can be used for the patient.

The first thing I would like to recommend is to try R.I.C.E. therapy which stands for Rest, Ice, Compression, and Elevation. This therapy is commonly used to reduce pain and swelling from a sports or activity injury and since these patients have both been injured from a car accident, there probably are some muscle strains, pulled muscles, over extended ligaments and etc. Since there is no medical record available for consultation, I will ask the patient how severe their injuries are and if they are in the recovering phase, then if they follow the steps R.I.C.E. therapy, then they will see improvement in the pain and inflammation of their injuries.

Cryotherapy, a form of cold compression therapy, involves usage of ice to lower the temperature of the injured tissue in an acute injury which is common in orthopedic medicine. Reducing the temperature will also help maintain the stability of the cells of the muscle tissue. Statis compression used in conjunction with the cryotherapy is to increase external pressure which prevents the formation and swelling in the site of injury.

I would also recommend music therapy for these patients. Since they will be taken off long term marijuana usage, they will be at risk for withdrawal symptoms such as anxiety, depression, and seizures. Therefore it is important for these patients to surround themselves in a calm environment. Music therapy is also a powerful and physically noninvasive medium. And through testing and research amongst different populations of test subjects, unique outcomes are possible when interventions are directed to reduce pain, anxiety, and depression.

En t r ep r eneu r S t uden t P r o f i l e : Ch r i s F ong

Vision of a PharmacyMy vision of the ideal Pharmacy is a retail pharmacy somewhere in the heart of San Francisco. Location wise, this would be great because San Francisco is very populous, and many people live in downtown San Francisco. The long term goal would be to expand my store, eventually creating a chain of retail stores located within Northern California. In order to be a successful retail store though, much hard work and dedication is required.

If I was the manager of the store, I am responsible for everything that goes on in the Pharmacy. That includes the overhead, employee issues and personal problems, ordering medications, coming up with novel ways to draw in customers, and much more. To me, the most important part about owning your own pharmacy is having a solid and growing customer base. I would therefore have to come up with ideas and selling points to draw in customers.

Because the majority of patients are elderly, I want to make things easy on them. For example, I might set up a refill request program online so they can refill their prescriptions in the comfort of their own home. I would also incorporate a drive-thru so patients don’t have to come into the store, and can just stay in their car to pick up their meds. I would also have a number of different screenings available at the pharmacy. If feasible, I would have blood pressure screenings, bone mineral density screenings, and blood glucose screenings. This would also allow valuable one on one time with the patient. Creating a bond and connection with the patient is essential if you want the patient to keep coming back.

I would incorporate some sort of prescriptions savings club to draw customers in. For example, I might create a savings card they can buy for 40 dollars a year, and they can use that to save money on their medications. The savings amount would vary according to each medication. Since infants and toddlers usually take antibiotics when they are ill, I would add an additional flavoring syrup if they wanted to add it to the medication for maybe $2. This would allow greater patient compliance with the medicine, and also increases the chance the patient will come back to the pharmacy.

The ultimate goal would be to fill about 400-500 prescriptions a day. This would mean hiring the necessary amount of techs and pharmacists that can cover that workload. If possible, I might add a graveyard shift because there are always cases of special emergencies and patients being released from the hospital late at night. Depending on the success of my pharmacy in San Francisco, I might branch out to other parts of the bay area eventually.

Pharmacy is all about the health and well-being of the patient. I would stress to my employees that the customer is not always right, but the customer is always the customer. They are the reason why my Pharmacy even exists. As a pharmacist, it is my duty to provide them with the best care that I possibly can in the most convenient and easy way possible.

an innoVatiVe Pain management ProgramThe Gonzales vs Raich case was a very important case for the field of pharmacy. It is a very controversial case because it has to do with a patient’s life or death. Thedecisionofthiscaseliterallycouldhavedeterminedwhetherthepatientlivedordied,sincesheclaimedthemarijuanawashelpkeepingheralive.However,there are other alternatives to deal with the pain. Raich had numerous health conditions and needed the marijuana to keep her alive, while Monson suffered fromchronicpainfromacaraccident.Monsonusedthemarijuanatorelievepainaroundherspine.Oneideainmy“laboratoryofinnovation”wouldbetouseice/heattherapy.Forexample,ImighttellhertouseatopicalIcy/Hotpatchtorelievethepainaroundthespine.Theiceservicestonumbthepainfulspot,andthe heat services to relax the pain away. Since Raich’s doctor claimed that she was allergic to numerous prescription medicines, I would recommend an Icy/Patch sleeve or cream, or something topical.

Another non-prescription recommendation I would make to the patient is to get physical therapy. Although physical therapy can be expensive and can last awhile, it is vastly underrated and can benefit the patient enormously. The physical therapist would probably massage the painful area, and use techniques to help relieve the pain. Another way physical therapy helps is by using electrical stimulation. The electrical stimulation would help to reduce the swelling and inflammation around the painful area. I might incorporate a massage station/chiropractic station right near my pharmacy. Chiropractic techniques are extremely useful for back pain and muscle spasms. Because the patient is suffering from back and spinal pain, a technique called “spinal manipulative therapy” can be used.Inthistechnique,thechiropractoruseshisorherhandstomanipulate,massage,andstimulatethespineandotherpainfulareasaroundthespine.Havinga chiropractor station at my pharmacy would probably be the most beneficial treatment especially because the patient is suffering from spinal pain. Since the patient is allergic to most medications, this is probably the way to go.

Some other small things I would recommend would be to maybe take a yoga class, and take time out of the day to breathe and relax. This will help to relieve muscle tension hopefully, and help with the pain. Although marijuana was the patients’ main form of pain therapy, there are definitely other useful alternatives to deal with the pain. I might also recommend acupuncture as a possible solution as well. As a pharmacist, I am responsible for giving patients’ advice and help to relieve their pain. It is my duty to do all that is in my power to help the patient live better, and feel better.

En t r ep r eneu r S t uden t P r o f i l e : Ch r i s P ham

Vision of a PharmacyMy vision for a pharmacy I may own in the future is very loose, but I am interested in possibly managing my own independent pharmacy someday. I feel that I would like to be in an urban or suburban area when I grow older so the pharmacy I manage should be in an urban area. I always envisioned independent pharmacies as free standing entities, but in an urban area with a lot of competition from other pharmacies, I think being part of a clinic or partnering up would help in getting customers and patients to utilize the services the pharmacy can provide. I think it makes things a lot more convenient for the patient if the pharmacy was a part of a clinic; it would be easier to advertise or promote any clinical services the pharmacy could provide.

I definitely want the pharmacy to provide a wide array of clinical and MTM services since it seems these services will be the norm in the future. I want immunization services and lab work to be something regularly done at the pharmacy. Depending on my interests, expertise, or needs of the local population there could be other services I want to push for a certain condition or group. An example can be AIDS patients and trying to provide services special to their needs. I would imagine an urban or sub-urban area with have large populations and therefore a lot of children so specializing in pediatric care can also be an option. If the pharmacy was close to long-term care center then specializing in geriatric care would be a better idea. Another niche service I am really interested in and would like to provide is a compounding service. Compounding seems like a great way to better serve the needs of your patients by changing formulations into something better for them.

an innoVatiVe Pain management ProgramA list of the medication that was used will be important because there may be some kind of drug class or specific kind that was not considered by the physician that would not cause any problems to the patient. A description of

what exactly is causing the pain will also be of importance, because figuring out what kind of damage the patient suffered and what kind of nerves or organs were affected will aid in any possible drug or pain management selection.

I do not know much therapeutics regarding pain currently either but, if not many drugs have worked there are some alternative or complementary therapies that may work or help. Pain has a psychological element and being in pain constantly can induce stress and make the pain even worse. There are some non-pharmacologic interventions that may help a little bit in the management of chronic pain from a more psychological angle.

Onealternativemethodcanbesoundtherapy,thereissomeevidencethatthiscanhelpinrelievingchronicpainastheremaypossiblybeamechanismthatacts on neurons. The patient simply sits on some equipment made specifically for this kind of therapy and feels the vibrations of sound or music through their body.Otherrequirementsareaquietisolatedroomwithgoodlighting.

My pharmacy is going to be combined with a clinic so perhaps the clinic can provide a sound proof room for this kind of therapy. For this reason it may be easy for my pharmacy to use this therapy in other patients as well due to the ease of location and how sound therapy can be generalized to many different kinds of chronic pain. I am not sure if this will completely get rid of the pain, but if no drugs are working so far adding something else along the patient’s normal pharmacologic therapy may help.

Another non-pharmacologic therapy could be cognitive-behavioral therapy, which has three components: patient education, behavioral skill training, and cognitive-skill training. Relaxation exercises are taught and patients learn how to monitor triggers to pain and stress and subsequently how handle their response to those symptoms. Ultimately patients learn how their thoughts contribute to the symptoms and learn how to change these thoughts. CBT can be administered in one-on-one sessions in person, group, telephone, or internet, making it very versatile. This kind of therapy is also the most commonly used behavioral medicine approach for chronic pain patients, so this can be generalized to other patients besides the new incoming patients.

En t r ep r eneu r S t uden t P r o f i l e : De r r i ck Chan

Vision of a PharmacyI have worked in a compounding pharmacy in the heart of the Sunset district of San Francisco for a few years. The pharmacist that took me under his wings will probably retire in a few years as he is approaching 80 years old. Ideally I would like to purchase his pharmacy with the established patient base. The location is ideal because the neighborhood is a great supporter of local businesses and receives patients from UCSF and local practices. The pharmacy is also on a busy intersection with multiple bus lines, restaurants, banks, and schools. The pros of the pharmacy is apparent, but there is also a large area of potential improvements. The building is old,withpoorlightingswhichcastsaslightlyuninvitingvibe.Withownership,Iwillrenovatethepharmacytoattract more customers and build a clean room for the compounding aspect of the pharmacy. I will also extend my compounding services to veterinary medication.

In addition to compounding, I will also incorporate medication management therapy, immunization, and delivery services. Especially with the increase amount of elderly population, I will target my practice toward geriatric care management also. It is in the best interest for elderly patients maintain their independence for as long as possible. Therefore, my practice will include planning and coordinating care to assist elderly patients and their family members to maintain the patient’s quality of life. Medical supplies like wheel chairs, walkers, prosthetics, etc is not widely available to the public. If the calculated risk is ideal for having these available, the service will definitely drawmorebusinessandpublicitytomypharmacy.Otherservicesthatwillincreasetraffictomypharmacywillinclude hosting CE events and community health fairs.

Although owning a pharmacy have always been my dream, I have also envisioned myself working in a hospital setting. In order to make both these dreams come true simultaneously, I would need to partner up with four to five colleagues to buy out that pharmacy in San Francisco. I will work at a hospital four day out of the week with ten

hourshiftsformaintainthefull-timestatus.Similarlymycolleagueswilldothesamewiththeirfulltimepositionelsewhere.Withproperschedulingwewilleachworkatourpharmacyforonetotwodaysaweek.Ofcoursethisplanwillinvolvetremendousplanningandcoordination,butcanbeplausiblewithhardworkanddedication.

After the end of my career in a hospital setting, I can imagine spending my retirement maintaining my own pharmacy. I would definitely hire a full time pharmacist, but I will also manage the pharmacy with more owner oriented tasks.

an innoVatiVe Pain management ProgramMy newly acquired patients, Monson and Raich present a very complex case of seeking the appropriate treatment to alleviate their pain by incorporating alternative measures to replace marijuana usage. As a compounding pharmacy, I will be able to design a drug product that will act locally to treat the area of pain.Thisshouldminimizethepotentialadverseeffectsthatwouldoccurifmedicationwastakenorallyorifalargedoseisinthesystemiccirculation.Weighingin fact that these patients are heavily dependent on medically assisted pain relief, I do not envision a complete cure of the patients’ conditions. Rather better management of pain, mental health, and physical health can be achieved at my pharmacy.

To aid the patients from their mental dependence on marijuana, my pharmacy will also provide services including psychiatric therapy as well as hypnosis. If withdrawal symptoms are severe, physiological dependence could worsen the patient condition. Therefore tapering off of marijuana may be appropriate after doctor’sconsent.Oncethepatientsarementallystrongenoughtofaceandcombattheircondition,physicalstrengthenthroughphysicaltherapy,chiropractictherapy, and massage therapy can be attempted. Close assessment and monitoring of the patients progression will help determine appropriate long term therapy. Not only do their painful conditions hamper their everyday lifestyle, but it also affects their family members. For benefit of the patients as well as the family’s own understanding of the intricate situation, it would be ideally to get family members more involved with the treatment plan. My pharmacy will host family workshops to educate them with things that they can do to assist the patient including simple massages, application of medicated cream/ointments, and especially the patient’s nutritional plan. Because of the complexity of Monson and Raich’s cases, extreme and uncommon measures should be considered if othermethodshavefailed.Othertreatmentsthatcanbefacilitatedbymypharmacyincludeacupuncture,spinalcordstimulation,herbalsupplement,andmusictherapy.

Due the intricacy of the patient’s condition and the limitations controlled by the federal law, all possible treatments will be exhausted until the proper regimen is fitting for the patient. Unfortunately, there is a chance that absolutely none of the alternative treatment plans will control the patient’s condition. At that point the ultimate risk and benefit outcome must be considered for resorting back to the use of cannabis. A possible option is to get the approval of allowing the patient to use a controlled amount of cannabis only at the pharmacy. The drawback of the proposal is inconvenience and pain flares when the pharmacy is closed. To combat the inconvenience, my pharmacy can develop a separate department that specifically performs in home services with on call needs.

En t r ep r eneu r S t uden t P r o f i l e : E d wa r d Sung

Vision of a PharmacyMy vision of a pharmacy would be in an urban area with a dense population with similarities to a city such as San Francisco. The size of the pharmacy would be on the smaller side and would most likely be located near some type of facility geared toward geriatric care. Because of the population density of a large city and the inconvenience of getting around, delivery services would play a significant role in the business model of my pharmacy.

Iwouldfocusmostofmyresourcesinhiringdriverstodeliverthedrugstothegeriatriccarefacilities.Withsomanycustomers condensed into a smaller area, it will be an efficient strategy to offer delivery services to these patients when considering the cost of gas and wages. The walk-in customer would also receive optimal service with a staff trained towards providing friendly customer service.

If a partnership were to be undertaken, I would have it constructed so that one individual takes care of the delivery services and the other the walk-in services. Both would share the responsibility of finances and drug stocking equally.

an innoVatiVe Pain management ProgramFirst and foremost, I would look at the patients medication history and make sure that they have truly exhausted all possible medication therapy choices before recommending anything else.

From here, we could move to different forms of pain management such as massage therapy, acupuncture, TENS, lasertherapy,andevenhypnosis.Ofcoursethesemethodswilllikelynotbecoveredbymostinsurancecompanies

so it would prices and money would be something to discuss with the patients before undertaking these alternatives.

If all else fails, because treatment with marijuana was so successful in each of these patients, I would recommend continued use of the product. In order to remain compliant with California law, I would seek out a reputable and legitimate medical marijuana dispensary in the area and, working in conjunction with a trusted physician, recommend the patients to retrieve their marijuana from these dispensaries instead of cultivating the product on their own. This would be the easiest solution I could see to the problem but a more radical approach would be to seek out a manufacturer that made some sort

oflegalTHCpillthattakesitseffectthroughoralingestioninsteadofinhalation.Iwouldobtainsmallquantitiesofthepillsandgivethemtothepatientstotryout. In the end, my main concern would be the well being of the patients and getting their pain under control.

These recommendations wouldn’t be made to any patient who complains of pain but those who have gone through extensive trials of medications without any success.

En t r ep r eneu r S t uden t P r o f i l e : E i l b r a Younan

Vision of a PharmacyIn a couple years down the road, I plan to open my own, independent pharmacy in Turlock. The main reason that I would like to have my own pharmacy is provide better assistance to the Assyrian community in the town. A quick fact about the town is that the population of Turlock is about 70,000 and approximately 30,000 are Assyrian in which many of whom do not speak English. This is a barrier that needs to be fixed in order to reach out to everyone and assist them in every way possible. Not only educating the patients about their medications such as providing them with information about drug interaction and side-effects, but ultimately being a friend where they can count on to get well and to stay healthy.

My vision is to open this pharmacy near the hospital, Emanuel Medical Center, because it is in the middle of the town where everyone could have access. I plan to partner up with my cousin who currently is a pharmacist and through our services, I believe we can reach out to a lot of patients.

At the same time, I want to implement a program where I could hold public announcements about the dangers of not vaccinating children at a young age and the devastating impact it could have on the community. For others, language and cost are some barriers that exclude their children from being immunized. This public health issue should be resolved, and parents need to be aware that when they chose not to vaccinate their children they not only make a decision for their child, but ultimately they make a decision for their entire community. For my project proposal, I plan to create flyers, as well as CD-roms for the non-English speaking populations where they could be played at schools, television/radio-stations, churches, as well as Day-Care Centers. In addition, I would like to hold vaccination workshops educating and immunizing the underprivileged because everyone including children need to have their vaccination schedules completed.

an innoVatiVe Pain management ProgramThe use of marijuana for pain management is illegal in most states, and many patients are not aware that there are multiple therapies to treat their excruciating pain rather than illegally buying or growing marijuana. For instance, innovative techniques such as spinal injections, acupuncture, and chiropractic treatment and massage are some ways that patients can take advantage to relieve their pain rather than masking the pain indefinitely with dangerous and illegal drugs. A popular treatment that many patients consider is spinal injection therapies with steroid medications to relieve their lower back pain. In this procedure the patients are sedated and with the use of x-ray

guided procedures, and with one treatment the patient’s pain is treated for the remainder of their life. First, the patients are laid on their stomach and a local anesthetic is injected. Then an epidural needle is injected to the epidural space.

Another option that is popular among these patient populations would be acupuncture. This procedure reduces pain by increasing the release of endorphin. In this treatment, several thin needles are inserted in the area of the patient’s pain. So, by placing the needles at the pain area the body is unblocking blockages that cause that pain and helps the flow of energy move properly. In this procedure the patient’s do not feel pain except a slight poke on the specific area. During thetreatment,thepatientscouldhavenumbnessfeeling,oratinglysensation.Otherthanthis,thetreatmentispainfree.

A third alternative would be simply going in to see chiropractic and receiving several massage treatments. During these treatment sessions, the chiropractic adjusts the patient’s spinal cord with several massage sessions. This is a non-surgical treatment that reduces stress and back tension by increasing the blood flow throughout the patient’s body.

En t r ep r eneu r S t uden t P r o f i l e : I r ene And r ada

Vision of a PharmacyWhenIthinkaboutwhatIwantformyfuturepharmacy,Ienvisionapharmacythatspecializeswithallergies.Beingallergictomanythings,Ihavegonethroughthetroubleandhassle of trying to find places like restaurants, grocery stores, and other places that really cater to my allergy-specific needs. As for the specific type of community, I would probably start with something urban to try to reach a bigger amount of people to find the specific niche of people with allergies. At this pharmacy, it would be very patient specific and would cater to each individual’s specific needs.

The services that I would provide would include the regular filling of prescriptions but would really be detailed in obtaining medicinal allergies, food allergies, seasonal allergies, and their reactions. This would be sure that we can really give something completelysafetothepatient.Additionally,IwouldcarryOTCmedicationsthatwouldspecifyiftherewereanyofthecommonallergens present in an item. Since I became gluten-free, I learned that some cough drops do in fact have gluten and went through the struggle of finding something that would not give me an allergic reaction when I already feel sick. Sometimes when youaresick,youjustwanttofindthethingsaseasilyasyoucantogohomeandrest.WiththeOTC,Ialsowouldprovidemanyoptions for specific products needed for allergies like hydrocortisone cream, Benadryl spray, antihistamines, lactaid, eye drops, probiotics and would research other products that could be used to help with allergies. A wide-array of vitamin supplements would be needed to supplement those who do have food allergies. I also intend to have dietician or nutritionist who would be able to consult someone with a food allergy especially if they do end up with some disease states like hyperlipidemia, hypertension,ordiabetes.Withallergies,tryingtoeatrighttotreatthesediseasescouldgetverydifficultandsometimesit’seasiest to come find someone that would know what to substitute for certain foods if you do end up being allergic.

Aside from the pharmacy, I do intend to carry other items that someone with allergies may need like tissues, a lunch box, nice carry bag for the epipen/any medications needed to carry with you at all times, hypoallergenic pillow cases, lotions/shampoos/soaps/deodorants that are without some of the most common allergens in it. I would also sell allergy-safe baby products and have allergy specific bracelets/identifiers that can be made for children who do go to school and might have allergies so that the care-giver/teacher would know about the conditions of the child. Each staff member would also be informed of the different possible allergies to make the patient feel at home. I plan to carry any items that a person with allergies would really need to live comfortably.

Since I am targeting a specific niche, the pharmacy would really be impeccably clean for those allergic to dust and the staff would be informed not to wear any strong fragrance for the patients as well. I would want it to have a very neat appearance to appeal to those with allergies and their families.

I would try to partner up with a local allergy doctor within the area just as a way to get patients as well since we would be able to help them with their allergies. This would be a very mutually beneficial relationship as any other our customers could also be sent to them. If they do bring a list of what they are allergic too, the staff would be able to help them pick out products for them. I also would partner up with some grocery stores/bakeries like whole foods and Kara’s cupcakes that do cater to people with allergies. This would also include restaurants that are friendly and patient in dealing with customers with allergies.

an innoVatiVe Pain management ProgramIf my independent pharmacy had two new patients, Monson and Raich who needed marijuana, I would first assess their pain to really evaluate the doctor claim for them to “absolutely need” the marijuana and if their lives were really threatened without it. This would include classifying the pain as well as exacerbating factors and times of pain. In treating an intense pain, I would like to combine different types of treatment to really attack the problem at all different angles. That is also the reason why I would do much research of the patient to see all the different aspects of their pains. To start off treatment, I would really like to add as much nondrug treatments as I possibly can like maybe ice packs, heating pads, yoga, stretching, or meditation. I may even try to find some teas or herbs that might help with pain relief. Maybe a warm bath could help with the pain as well.

In addition, I would want a complete drug list of all the prescription pain relievers they have tried and reasons for why the patient feels that these not work. I would try many strong pain kills like morphine or vicodin to give in addition to the nondrug therapy measures. I would also try combining different pain relievers together if that would hopefully create an additive effect to help with pain treatment. Furthermore, when finding about the problems with the pain I could maybe add additional medications like muscle relaxants, sedatives, or anti-psychotics based on the actual cause of the pain.

I’d also collaborate with doctors that specialize in pain to come up with a proper treatment for the patients. If this does not actually help with Monson and Raich’s pain, I would also try to add a psychiatrist and physical therapist. Maybe the psychiatrist can help their mind with the pain depending of if the reason for the pain is rooted mentally. If the pain is rooted due to a physical problem, the physical therapist may be able to help alleviate the cause of the problem. My main concern would definitely be treating the pain by attacking the cause and making sure all different types of pain being felt could be alleviated to a comfortable level of pain.

Another option I would try is a drug that has some components of marijuana but is still legal like Marinol. If even the Marinol would be unable to alleviate the pain, I would admit the patients to a hospital to try some IV therapy analgesia. I would definitely start off with a patient controlled analgesia (PCA) since the patients are alert and able to press the button when they feel pain. This way we can evaluate the pain as well as give a more potent and fast acting pain reliever. If we are able to come up with an IV therapy that brings their pain down to a tolerable level then we can evaluate to see what dose they need or if they would need to come in for IV treatment maybe once a month or week dependent on how much analgesia/pain relief is truly needed.

En t r ep r eneu r S t uden t P r o f i l e : L ana Ngu yen

Vision of a PharmacyOurHealthWellnessCenterlocatesinoneoftheliveliestpartofamediumsizedcitysimilar.IthasthediversitymirrorthatofLosAngelesandrelaxingbeachatmosphere of San Diego, somewhere the weather is nice enough where people love walking their pets, kids playing at the parks, and outdoor malls. Although this may seem a bit farfetched regarding the financial resources but it could as well be in an area similar to that of Long Beach or Santa Monica city in Southern California. The PharmacyiscenteroftheWellnesscenter,withflowershoptotheleft,bakerytotheright,andfitnesscentertothebackofthepharmacy.Creativebakerswhousehigh quality ingredients are welcome to rent the bakery. The flower shop would be rent out as well. I do hope to have a botanical mixture in the flower shop. The fitness center is a simple large gym space where I hope to have daily instructors to provide different health classes including yoga, tai chi, Zumba, martial arts, meditation, cooking and art lessons. Pharmacy hours would be 7 days a week from 9am till 7pm. The flower shop, bakery, and fitness areas may have various hours depending on demand.

I would run the pharmacy and hopefully have a decent sized staff with similar values and vision. The pharmacy will incorporate many modern technologies and equipment. In addition to the services commonly present in a traditional community pharmacy, my pharmacy would provide health screenings including blood pressure, diabetes, cholesterol, anemia, bone mineral density, memory decline, and fall risk. The pharmacy will also have an area for referral services, Medicare part D enrollment services, and MTM sessions. All the pharmacists would be certified to provide immunizations. The pharmacy will have a diverse group of staff members who view their jobs as more than just a job, but a career that promotes healthy living and friendships. I hope to have continually growing prescriptions so speed is veryimportant.Wewillalsohavemembershiprewardscards.However,therewillalwaysbeatleast1teammemberattheconsultationareareadytoaddressthenecessarypatientcare.Ourpharmacistsrotateevery2hoursateachspecificstation.There will also be a kids’ corner with some toys and learning materials. The interior decorations for the pharmacy would include environmental friendly materials, some handmade pieces, and art displays, including those belong to local artists in the community. Some of the art pieces would be up for sale and there will be one lucky guest each month to win an art piece. The pharmacy will also have a small area to display fundraising materials from different organizations/charity groups from the community as well as relief services.

In the first few years, a great deal of emphasis will be put on advertising and branding the pharmacy through various medium to drive business. During that time I also plan on working as a PIC then will appoint a trusted staff member to be the PIC. I willhavemoretimetooverseetheentireWellnesscentermoreclosely.Idohopetohavesomefamilymemberstohelpoutand/or be a part of the center. That would fulfill one of my biggest goals—to have a family/relative owned wellness center.

lana’s eleVator sPeechHi,mynameisLanafromLivingWellpharmacy.• Ihavethehonortomanagesomemedicationtherapiesforanumberofyouremployeesandtheyseemtoappreciateagoodvarietyofservicesweoffer.• Tonameafew,weoffermedicationtherapymanagement(MTM),on-callNurseAidavailable24hours/day,vaccinations,personalizedtherapeuticlifestyle

planning and assessments, home delivery, Insurance plan finder assistance, and patient referrals to notable physicians.• Ifyouhappentobelookingforapharmacythatoffersacomprehensivewellnesscareforyouremployeespleasegivemeacallandwecanchataboutallthe

specialservicesourpharmacyoffer.(Handhim/hermybusinesscard).• Itisnicetomeetyouheretodayandlet’shaveagreattime(attheevent).

an innoVatiVe Pain management ProgramCurrent standards of pain management offer many options for patient with chronic pain. It is best to have an individualized treatment regimen for each patient using a combination of methods including drugs, physical therapy, behavioral medicine, neuromodulation, interventional, and surgery. After careful medical review of Monson and Raich’s medical conditions, past medical histories, current laboratory results, physical assessments, and personal preferences, I may be able to manage the condition with the most optimal therapeutic regimen.

Before I explore different therapeutic options, I would need to know the cause of their pains, current diagnosis, and the regimens their doctors have tried on. After I received the information, I would do thorough medication therapy management to see if they were optimal treatments for the patients’ conditions. Medication related errors,asseenthroughtheFDA’smedwatchprogram,areoneoftheleadingcausedeathandsuboptimalmedicalmanagement.Withtheplethoraoftreatmentoptions available, there may be a better protocol their doctors have not tried.

For either neuropathic or nociceptive pain, patients are often started on non-opioid analgesics including Acetaminophen and NSAIDS. For more aggressive medical therapy,availableoptionsincludemanyOpioids,antidepressantsforneuropathicpains,anticonvulsants,Ziconotide,benzodiazepines,antispasmodics,topicalagents, botulinum toxin, and etc.. Drugs from these classes have very good clinical data and response to them may vary with individuals. There are also a wide variety of nondrug therapies these patients may benefit from including Cognifitve-behavioral therapy, biofeedback, spinal manipulation, and neuromodulation such as TENS, spinal cord stimulation, deep brain stimulation, interventional approaches and surgical procedures. After careful examination of each of the patient’s health status, especially pain description. I would use some combination of pharmacologic and non-pharmacologic therapies above to manage the pain.

En t r ep r eneu r S t uden t P r o f i l e : Robe r t L ee

Vision of a Pharmacy• Myfirststepistostartdoingsomeresearchonwhichpharmacyonthemarkethasasteady,highvolume,andhigh

potential for outcome. • Iwilllookintotheirlocation,thenumberofpharmaciesthatarearoundit,itscustomerbase,yearlyoutput,and

output history. • Lookingatmyoptions,Iplantoinvestinoneofthepharmaciesandstartmybusinessfromthere.

• IalsoneedtolookintofindingadistributorwhereIcangetagoodpriceforitsdrugs.Eitherteamupwithotherpharmacies to increase our buying power or set some sort of deal with the company.

• Withthepharmacyinhand,Iplantoreachouttodifferentgeriatricsites,hospitals,compoundingsites,etctobuildacontract and start doing business with them. • ThisiswhereIwanttofocusoninbringinginmostofmyincome.Byworkingtowardstobeingthesolesupplierto

these sites, I plan to use this money for further investments. • KeepinmindthatIwillstillbeservingmypatients.However,asIcontinuetofurthermybusiness,Iplantomoveaway

from this and focus more in doing business with different facilities. • Aftermakingenoughmoney,Iplanoninvestinginmorepharmacies,butthesepharmacieswillfocusmoreinservingto

geriatric, hospitals, and compounding sites.• Afterallmyloansandbillshavebeenpaidoff,Iplantosetupasmallresearchfacility.• Withthisfacility,Iwanttoworktowardscreatingsomethinginnovativethatcanimpacttheworld.Asofnow,Ihaveyetto

know what direction to take, but am still thinking of different ideas.• SomepotentialfieldsIcanfocuson:hypertension,diabetes,andasthma

an innoVatiVe Pain management Program

Situation: Monson and Raich come into my pharmacy looking for pain management options.

My first approach would be to ask them for their evaluation/medication history and the different treatments they have tried to manage their pain.

• Evaluation

• Allergies

• Past/Current Medications

• SocialHistory

• Physical Examination

• Laboratory Test

• Past Assessments

I would then start up a new assessment and write up a list of options/protocols that Monson and Raich can experiment with to see which would best work for them. (Assuming he has taken most prescription pain drugs and nothing has worked for him)

• NonpharmacologicalTreatment

• Acupuncture:Usingneedlestobalanceenergychannelsinthebody

• Acupressure:Acupuncturewithouttheneedles.Usefingers,palms,elbows,feet,devicestoapplypressuretoacupointsonthebody

• Chiropractor:Healingconcernedwiththediagnosis,treatmentandpreventionofdisordersoftheneuromusculoskeletalsystem,andtheeffectsofthesedisordersongeneral health

• Transcutaneouselectricalnervestimulation(TENS):Portabledevicethatattachestoyourskin;itisplacedovertheareaofpain.Usesmild,safeelectricalsignalstohelp control pain .

• Massagetherapy:Helprelaxtightmusclesanddecreasepain.

• PhysicalTherapy:Exercisesthathelpimprovemovementandstrength,andtodecreasepain.

• Spinalcordstimulation(SCS):Electrodeimplantednearthespinalcord.Theelectrodeusesmild,safeelectricalsignalstorelaxthenervesthatcausethepain.

• Marinol:ThiswouldbethebestoptionbecausemarijuanaiscurrentlyworkingforMonsonandRaich.Thiswouldbethelegal“version”ofmarijuana,whichisinatablet form (No smoking involved).

• Mayhelpcontrolorreducepain

• Aromatherapy:Usingscentstorelax,relievestress,anddecreasepain.Usesoils,extracts,orfragrancesfromflowers,herbs,trees

• Guidedimagery:Teachesyoutoputpicturesinyourmindthatwillmakepainlessintense.Helpyoulearnhowtochangethewayyourbodysensesandrespondstopain.

• Laughter:Mayhelpletgoofstress,anger,fear,depression.ReminderthatMonsonandRaich’spainmaybeasecondarysymptom(suchasfromstress,depression,disease, etc.).

• Music:Helpincreaseenergylevelsandimproveyourmood.Helpreducepainbytriggeringthereleaseofendorphins.

• Hypnosis:Helpsdirectyourattentiontosomethingotherthanpain.

Because it seems as if the pain medications are not working, I would like to suggest these options in addition to the medications. If he has tried all these options and still complains of having pain, further analysis needs to be done because it might be stemming from a bigger problem. I would ask the patient do get more testing done to find the main source, and focus on treating that.

En t r ep r eneu r S t uden t P r o f i l e : S o N ing ( Sunny ) L ee

Vision of a PharmacyMypharmacywilljoinacooperativenetworksuchasGoodNeighborPharmacyorRxHealthMartinordertoincreasebargainpowerwhenitcomestodealingwith insurance companies, wholesalers, or manufacturers. I will most likely hire a pharmacy manager or PBM to help me manage the financial aspect of the pharmacy, especially inventory wise. To start the pharmacy, I will also hire a part-time pharmacist who can split working hours with me, two technicians, and one cashier, and have the pharmacy open six days a week.

The services that the pharmacy offer will include the typical prescription filling, dispensing, counseling, over-the-counter remedies, as well as vaccinations, MTM services, and compounding services. Specifically, I will again look for contracting or advertising opportunities at the long term care center or senior apartments to offer annual flu vaccine services as well as MTM services for residents at the facilities in addition to accepting walk-ins of individuals from the general public at the pharmacy. The compounding services are targeting more on individuals who have special needs, who have pets, or can even be offered to the clinic nearby if the facility does not have the service itself.

Oncethebusinessisontrack,Iwouldalsoliketomakemypharmacyavailableasapracticesiteforpharmacyinterns so they can have the chance to learn how to run their own pharmacies if that is something they are interested in.

an innoVatiVe Pain management ProgramBased on the information provided, it seems like the first thing that needs to be done is an interview with thephysician.Weneedtohavethephysicianclarifywhat kind of medical conditions Raich is suffering from, especially what might be the cause of her pain, as well as get a current medication list and allergy history of her. This will give us a better idea as far as whether Raich has been receiving adequate drug therapy for her medical conditions since if she has not, taking care of this problem will be the first priority of all. If she has been receiving adequate drug therapy for her medical conditions, then we will need to ask the physician how many medications the physician he has actually tried on Raich and exactly what they are.

Wewillthenalsohavetohaveaninterviewwiththepatientforathoroughmedicationreviewaswellaspainlevelassessmenttoseeexactlyhowwellthedrugsthe physician had tried on her.

However,ifdrugtherapyhasalreadybeenoptimizedandithasbeendeterminedthatsheisstillinneedofmoreaggressivetherapiestotreatherpain,thenwewill probably need to consult with other healthcare professionals to seek for possible pain treatments. A few people that I would want to reach out to would be chiropractors, physical therapists, Chinese medical doctors, and psychologists. In addition, depending on what caused the pain, I would also want to reach out to people who may have experiences in dealing with the pain as well. For example, if Raich’s pain was a long term effect due to prior sports injury, I would try to talk to a sports coach or athletes since they may very likely know what the best way is to handle the situation. If the pain or medical condition is rare, I would also look for resources or scientific studies to see if there are any new therapeutic options in the U.S. or even other countries that would be able to help her

En t r ep r eneu r S t uden t P r o f i l e : Sus an Deng

Vision of a PharmacyFor my pharmacy, I would like it to be located in an urban area where there are many retirees and seniors. I want my pharmacy to be located in a medium to high income community with lots of foot traffic because my pharmacy will carry other types of merchandise like expensive gifts and jewelry. My pharmacy would be a free standing store.

I would also like my pharmacy to be a joint partnership. I would like to have someone else who is passionate about independent pharmacy help me manage it and invest in it. I would also like to have another person’s input into the pharmacy and someone to bounce ideas off of.

The population that I want to serve would be mainly seniors. In addition to filling prescriptions, I would also have several other services focused on the senior community like Medicare Part D reviews, medication therapy management reviews, immunizations, and other health screenings like blood pressure, blood sugar, cholesterol, and bone density. Every week, there will be one day where a certain screening service will be offered. The screening services will be rotated throughout the weeks, so if a patient wants a certain screening, they can just come on a specified day. I also want to offer compounding services to customize medications for patients like hormone therapy, suspensions, creams, and other formulations. Compounds are not limited to people, pets are welcome as well.

an innoVatiVe Pain management ProgramMy innovative idea to address Monson and Raich’s pain management problem is to apply a step-wise approach. First, I would review their past and current therapies to see if that information can point to a future direction for effective treatment. If that does not lead to a solution, I would search for alternatives to mainstream pain management like acupuncture. Lastly, if other pain alternatives are not effective, I would research new medications and clinical trials to recommend.

First of all, I would perform a medication review on all the drugs that Monson and Raich are taking

and have taken in the past. I would also look at the drugs along with their health conditions. Raich’s doctor claims that she is allergic to dozens of prescription medications, but I would like to look into it deeper to see whether it is a side effect or a real allergy. I also want to ask her what specific disease state she suffers from in the hopes of find a better alternative treatment. In Monson’s case, I would see what she tried in the past and then start her on other pain medications that she has not tried before. I want to perform a comprehensive review with both patients as well as communicate with their respective healthcare providers to make sure all their medications are working efficiently and effectively.

Secondly, if the problem is not resolved from the medication review, I would try holistic or alternative medicine. Alternative management for pain includes but is not limited to acupressure, chiropractors, yoga, and aromatherapy. Monson’s pain is due to a car accident and muscle spasms around her spine, therefore I believe acupuncture or chiropractic treatment may be beneficial in treating nerve pain.

Finally, if their pain is still not resolved, I would look up new drugs or clinical trials where Raich and Monson might be able to enroll in. I would do adequate research on the clinical trials to make sure they are safe before recommending them to patients. New drugs can be more effective and have different mechanisms than the current drugs on the market making these alternatives more promising.

En t r ep r eneu r S t uden t P r o f i l e : Van Duong

Vision of a Pharmacy Imagine a pharmacy that upon entering, is warm and welcoming with a large waiting area complete with a comfortable couch and coffee bar for patients to enjoy during their wait. The pharmacy shall be named “Golden Times” and centered in an urban town with a large aging population including veterans.

My vision for a pharmacy will be a dynamic pharmacy that encompasses several different services for my clientele. It will be a community pharmacy that caters to the geriatric population, particularly those in senior homes. It will dispense weekly trays to patients at nursing homes as well as regular prescriptions for those who wish to fill here. I will have drivers working to complete delivery services as well as a drive-thru service for the convenience of patients.

A clinic will be attached to the pharmacy so that patients could come and be monitored for their chronic diseases such as diabetes, hypertension, and high cholesterol. There should also be available clinic area for patients to monitor general vitals once a month for their visits where we can keep track of and provide education services for, recommending them to see doctors where needed. Pharmacists will provide MTM and Medicare Part D services.

Next to the waiting room, it will open into a coffee shop where young students can utilize to study. The coffee shop also serves as a conference room for holding staff meeting and guests for teaching continuing education courses for local nurses. It can also be used for the community to host their meetings. There will also be a drive through for medications which aligns up with the coffee drive through so patient can get their medications and coffee in one stop!

This pharmacy can also venture into hospice businesses in the community to help serve the organization and increase script counts.

I would establish my clientele by working directly with nursing home administrators to get their patients on a subscrip-tion base medication. I would also offer free coffee or beverage for patients picking up at least two medications. I would also work with local doctors and get to know them to establish good relationships so that patient issues can be dealt with swiftly. In addition to this, I would work with a local pharmacy school organization to host a health fair for transpar-ency in the community and to be known to locals. As a modern approach to marketing, I would update the profiles of the pharmacy online and promote free coffee deals through newspaper ads and the internet media.

I plan on going into this venture alone with my spouse who I hope will also be a pharmacist so we can share the work-load and management of the business.

Van’s eleVator sPeechHihowareyou?I’mVan,ownerofVanPharmacyintown.Ihearyouremployersareabitconfusedastowheretheygettheirmedications.Haveyouheardofourservices?It’swonderful,anditcouldreallybenefityourcompanyandemployees.Wehaveservicesthatcouldreducesickdaysofyouremployeesandgetthemproperly treated with the medications they need in a timely manner—something you won’t find through mail order. Some of your employees already use us, and theyloveit.We’requiteflexibleandwillingtoadapttoyourcompany’sspecificneeds.Whydon’twehaveameetingoveradrinkwhenyou’refree?Here’smybusiness card and a brochure about our services. I’ll look forward to getting in touch with you soon.

an innoVatiVe Pain management ProgramIf Monson and Raich came to my pharmacy for pain management, I would try my absolute best to assist them. First, I would gather all of the information needed including a list of their past medications used, strengths, and all known allergies. From there, I would look into several alternatives.

I would first recommend what is legal and suggest using different opioid substances such as morphine, oxycodone, hydromorphone, and fentanyl patches. If the legal options are truly exhausted, this issue may be an opportunity waiting to happen! It appears that the federal government has an issue with homegrown marijuanaplants,butwhatisthemarijuanawasgrownbyapharmacythatisalreadyfederallyregulated?Usingtheideaofcombinatorialplay,Iwouldintegratethe idea of growing medicinal marijuana together with the establishment of pharmacists as medicine dispensers and have a separate entity in my pharmacy for growing marijuana.Monson and Raich bring up the potential for creating an innovative plan to grow and market marijuana grown from the pharmacy following all federal regulations and guidelines.

Workingwiththefederalofficialswouldbenecessaryinthisplan.Ifthegovernmentisverystrict,Icanperhapshavearoomwherepatientsaremonitoredduringtheir use of smoking the marijuana and only allowed to take in as much as necessary to test how much they actually need. I would certainly try this idea out on first Monson and Raich, and if the trial went successfully with all profit margins being worthwhile, I would expand to offer this to other patients in the community for pain management.

En t r ep r eneu r S t uden t P r o f i l e : V i r g i n i a Tan

Vision of a PharmacyMy pharmacy would be in a community setting. Urban settings are too crowded. A pharmacy there would have lots of potential business but it would also come with high expenses to buy and maintain the property and also most likely, angrier and more rushed customers. Rural would be too out of the way for an independent pharmacy. Business would be slow unless I was a large facility for compounding or long term care that doesn’t depend on patients coming directly to the pharmacy.

A free standing pharmacy would be nice because it would draw the eye and it would be well known for one thing. But I rather like the idea of a combination grocery store and pharmacy. I interned at Savemart last semester and I thought that the work environment was good and the customer base was decent but since it was a grocery store first, many people did not go there for the pharmacy. I think there is a lot of potential in this area because everyone needs to shop for food, but the problem with their system was that they did not push the pharmacy out as a large money maker, so instead of being a highlight in the store, it was pushed into an obscure corner. I would like to have a pharmacy known equally for both so that the message gets through that food and medicine are connected in good overall health and that this store provides convenience and service to its customers. I was part of a Target business plan competition here at school and they asked us to come up with an idea to bettertheirpharmacy.OurideaforthecompetitionwastomakeTargetastandoutcompanyinthecommunityby having them hold health fairs, one day a month by pairing with a different organization each month to bring education and awareness for a specific disease state (heart, breast cancer, etc). I would want to do this for my own pharmacy, but the difference would be that Target is already a very large and established company that could make this happen. As an independent pharmacy, this might prove to be very difficult and not as successful until the business is larger.

an innoVatiVe Pain management ProgramIn this situation, the patient’s life is at risk if they do not take something to relieve the pain. This means that the situation cannot be left untreated and something must be given to alleviate the pain. The doctor has tried dozens and numerous prescriptions to treat the pain but none have worked. The term dozens and numerous is very general, and it does not include the type of pain reliever given, dosing, or if there were any combination treatments. In many cases, it is a combination of treatments that works best to relive pain. A simple example would be for the common cold. Although the cold virus

must run its course and there is not much to directly treat that, the symptoms of the cold are the most bothersome. Those can be relieved by a combination of drugs(maybe for sinus relief or cough) but there are also recommendations to increase rest, intake of fluids, to prop up pillows while sleeping, and basically common sense advice that can help relieve symptoms without a prescription.

For this case, we don’t not know what type of pain the patient is in, which area, or the degree of pain, but there are still things we can do to treat general pain. Ice and heat is a common way to relieve pain and is quite effective at some levels. Physical therapy or massage also might be an option depending on the area of pain. Rest might also be an obvious but important recommendation since what the patient might be doing might be aggravating the painful area. The doctor should also disclose what types of medications were given to the patient and it should be checked to see if they were the proper medication for that type of pain. If the proper drug is used and is somewhat effective, then perhaps the patient can use a single or combination of drugs with non-drug measures to relive most of the pain.

En t r ep r eneu r S tuden t P r o f i l e : Wayne Chen

Vision of a PharmacyMy ideal pharmacy would be one that encompasses an entire health center. It would be in an urban environment, where many young professionals and students are, like San Diego, San Francisco, or LA. The people here are likely extremely busy, and can really benefit from having all the resources in one place. For many working people, the idea of staying healthy simultaneously putting much of their work into their jobs is unrealistic. The idea behind my pharmacy is that it is a lot more than just receiving medications, and there would be a huge focus on preventative care, that can help everyone lead more productive lives.

Withmanyyoungadults,thereisn’tlikelytobetoomanychronicproblems,andmanyoftheproblemscanbepreventedfromworseningwiththerightlifestylechanges.Onebigelementwouldbeagym.However,thefocuswillnotbeonhowyoulookoreven how much you can lift, it will be based on personal preference but use numbers like BMI to help record progress. A long withthegymwouldbeanutritionbar,withfoodanddrinksthatcanmeetanindividual’sspecificneeds.Workoutsupplementscan also be sold, but it will be more important to keep the focus on actual health, and not just the appearance.

Inadditiontophysicalwellnessfromthegym,ahugeemphasiswillbeplacedonthementalwellness.Here,alotofcounselingwill take place, especially useful for those that are on any depression medications. This will serve to treat the underlying problems,ratherthanjustbeamedicationforaproblem.Otherconsultationservicescanalsobeobtainedhere,asthiscanbe a highlight of patient and people interaction.

Whileitseemslikethepharmacyisjusttargetingpeoplewhoarenotunderserved,orarelikelytoberelativelyhealthyinthe first place, there will be a huge emphasis to use parts of the profits to help the social wellness of the community. It will help keep the medications cheaper for customers, and health fairs will be organized under the pharmacy’s name in an effort to educate and bring heath care to the community. This allows people who become members to know that they are directly making an impact on the community. Another way to help the community really build up, is events and activities that help get people together. Basketball tournaments with assigned teams, and activities that can really bring people together so that they can have fun and be motivated to stay healthy.

Building a membership base while the people are younger will be a of great importance. First, it allows people to get the most cost effective health care (preventative care) which will save them tons of money later on. Also by building memberships and profiles, you can build a sense of community, and it can really benefit anyone that joins.

Ultimately, the idea here is to get the young adults thinking about it early so that much of the healthcare costs are lowered in the future, and so that people can develop good habits early on. The pharmacy seeks to make being healthy fashionable, and allows for young adults to have everything they need in one place for themselves, and even get cheapermedicationfortheireldersinthesamespot.Whilethefinancialsarecertainlyahugebarriertofigureout,Iwouldverymuchliketomakethisadreamcometrue.

an innoVatiVe Pain management ProgramOurpatient,Raich,isexperiencingchronicpainandmusclespasmsthatareendangeringherlife.Itappearsthatconventionalmethodsofrelievingchronicpainandmusclespasms are not working for her. This is not surprising as many drugs neuropathic drugs tend to vary a lot through each patient, and using combinations of them usually result in more side effects.

For non-pharmacological ways that our pharmacy can help, we offer physical therapy. This can help solve the source of the problem, and break out of the muscle spasms, which may even be part of the cause of the chronic pain. It also saves the patient from needing to experience any side effects that inevitably come from drugs. Sometimes, medication is not necessarily the answer.

However,ifphysicaltherapydoesnotwork,anewalternativethatshecancertainlytakeistogetaprescriptionforMarinol.Icaneducatethepatientthattheingredientisverysimilartotheactiveingredientinmarijuana.However,sinceitistakenorally,theeffectswouldbeslightlydifferent,andtheabsorptionwouldbeaswell.Whensmokingmarijuana, it is inhaled into the lungs, and goes directly into the blood stream. Because it by passes the first pass effect, or the metabolism from the liver, the effects are more immediate and potent. This can potentially lead to more side effects. Marinol however, is ingested, and is not fully absorbed. It would be the equivalent of baking marijuana into food, however it is in a pill form solubilized by sesame oil. The onset of the effects will generally take much longer, usually in a couple of hours.

Thistherapycanbeusedforanyoneelsewho.Whiletheuseandsafetyofmarijuanaishighlycontroversial,therehavebeenmanystudiesdoneregardingtheactiveingredientinit: tetrahydrocannabinol. For legal reasons however, it may be best to try out Marinol as a legal alternative that will have very similar effects because it will have active ingredient initspureform.However,ifthechronicpainandmusclespasmsstillpersisttothelevelwhereitisendangeringherlife,shemayjustneedtocontinueusingmarijuana,asMarinol is not a therapeutic equivalent. It is just a drug with the same active ingredients but taken orally instead of through inhalation.

Thetwotherapiescanalsobeusedinconjunctiontohelpherdealwiththepainassheworksonsolvingthepotentialmainproblemsthroughphysicaltherapy.Whileitisdebatable whether she needs the marijuana or not, most doctors and people would agree that it would be best if we can help her get rid of the source of the pain, rather than treating the pain with medication on a daily basis. This idea applies to most other medications, as well as any other patients experiencing the same issues Raich is experiencing.

GOOD NEIGHBOR PHARMACY/THOMAS J. LONG SCHOOL OF PHARMACY AND HEALTH SCIENCES

ENTREPRENEURIAL PHARMACY PRACTICE PROGRAM BOARD OF GOVERNORS August 22, 2013

Inspiring the next generation...

The entrepreneur is our visionary, the creator in each of us. We’re born with that quality and it defi nes our lives as we respond to what we see, hear, feel, and experience.

It is developed, nurtured, and given space to fl ourish or is squelched, thwarted, without air or stimulation, and dies.

Michael Gerber

V i s i on A P ha r mac y f o r Tomor r ow : Ch i no H i l l s

PrePared by:Irene AndradaAlex Van Zuiden Sunny Lee

Our PharmacyOur pharmacy will be located in Chino Hills, which is a city that is approximately 30-40 minutes away from LA downtown. It is currently a suburban area, but is in the process of developing. We are hoping that this geographical location will give us a steady and decent amount of customer base without too much competition as if we were to open our pharmacy in the inner cities. The fact that there are several senior apartments and facilities within the city will also be one of the major reasons why we choose to open our pharmacy there since we will be looking for opportunities to work closely with these facilities and make that as part of our basic income source.

We bought the pharmacy from an existing independent owner who was looking to retire. We paid $750,000 for the pharmacy. Each member put in $30,000 for the down payment for a total of $90,000 down payment. We borrowed $100,000 from the owner to be received over 5 years. The balance was borrowed from Live Oak Bank, $560,000. Our monthly payment to Live Oak was $11,802 and the monthly

payment to the seller was $1,981. So our total monthly payment came out to $13,783.

Item Buyers Live Oak Seller TOTALAPPRAISAL $2,500 $2,500SBA GTY. FEE $32,000 $32,000LEGAL $5,000 $5,000INVENTORY $300,000 $300,000WORKING CAPITAL $200,500 $200,500PHARMACY $90,000 $560,000 $100,000 $750,000TOTAL $90,000 $1,100,000 $100,000 $ 1,290,000

In terms of demographics, we will most likely have a higher percentage of female and the elderly as patient base since females are in general more concerned and are more likely to work on improving overall health status. In addition, since our pharmacy focuses on holistic care, we would also expect a high percentage (maybe around 80%) of our patients to have some sorts of chronic disease states like diabetes and hypertension that need to be managed.

Our pharmacy will be a holistic health care center focusing on the overall health of the patient population we will serve. To create this vision, we will collaborate with other health care professionals like dieticians and nutritionists just to name a few to better serve the community. Our unique services like delivery, MTM, vaccination, chronic disease management, weight management, and smoking cessation would benefit the patients by having a pharmacy that is convenient and concerned with all aspects of health. We plan to be part of the trend towards preventative health care but will also help with the treatment of disease states. Our ultimate goal would be to create a healthier patient population that would benefit patients by helping them achieve their optimum health.

The challenges that our pharmacy could face would be the competition from the local pharmacies. In the area, there are approximately a Vons, Walgreens, CVS and Costco. Our concern would be creating a patient base to sustain our pharmacy. We would need to acquire some patients from these competitors who could be done by getting a convenient location and having our unique services. Other challenges we could face are the reimbursement issues like with Medi-Cal and the ongoing problems with the economy.

Our VisiOnTwenty years from now, we would hopefully establish a solid patient base and would have a strong enough community presence to adapt and strive among the continuous changes in the pharmacy field. In our area, which has now grown into a much more urban space, has seen a large rise in weight in the community. We are known all around as one of the most knowledgeable resources in weight management. With the laws allowing pharmacies to dispense specialty medications being passed, we saw it as a great opportunity to expand our weight management clinic by being able to offer our patients the specialty medications that will help them with their weight loss goals. We felt that we had the knowledge and the ability to properly use these medications in our community.

The use of specialty weight management drugs is one that we take very seriously and only order when the patient will not benefit from other treatment options. Many of the PBMs that we work with appreciate our documentation and will therefore approve the use of these specialty medications from us for their patients. Other medications that we will be carrying would include “Bio-betters” and “Bio-similars” in order to stay competitive in the market. Since these new classes or drugs work better, it would only be right to have it available for our patients because our ultimate goal is to make sure we provide everything for their best overall health.

Also, the changing times have allowed pharmacists to do “in pharmacy” diagnostic work for routine issues. We will most likely add more CE requirements for the pharmacists on the team to make sure that they feel comfortable and will be able to provide outstanding diagnostic work with patients on routine issues. We would also want to see if there are other ways to improve our patients’ health in general or incorporate other ways of treatments (e.g. Chinese medicine, acupuncture, etc.) to prevent or better manage the routine issues as they occur.

As the city has expanded, we noticed that the patients have become much more fast-paced, needing their medications and the consultation about them quickly. Although we want to spend the maximum time with our patients to make sure that they understand their drug use, we also realize that many of our patients do not have that kind of time. So we came up with a video messaging system that sends consultations, created by us, to the patient at a time that is more convenient. These messages can also be saved electronically so that the patient can go and review it whenever they need to. At this time, we are also working on video conferencing appointments so that our weight and chronic disease clinics can go digital and be more convenient for our patients.

At the WNAC pharmacist’s association event, we will be talking about our pharmacy’s holistic care focus. Our pharmacy maintains that healthcare is about the individual, not just about symptoms or a disease. We pride ourselves on taking care of our patients as a human being: physically, mentally, and emotionally. Therefore, we would share our vision of holistic health care with our new country, which we see as the key to maintaining the healthiest citizens for our new country. We would explain how using this holistic approach is how we have seen such success in our weight management and chronic disease clinics. We would push for our newly formed country to consider ways to create more holistic healthcare, whether that be through universal healthcare or by paying out a better amount to doctors and other healthcare providers who spend the extra time to approach medical problems holistically.

PrePared by:Derrick ChanWayne ChenChris Fong

Our PharmacyOur vision is simple: to provide high quality and safe patient care to the public while demonstrating the ideals of respect, active communication, and professionalism. To carry out our goals we practice promoting an environment that establishes safe, error-free, and cost-effective use of medications. Adequate personnel training is vital in order to minimize mistakes. Mistakes can entail data entry error, incorrect labeling and dosage, and selling the wrong prescription to the wrong patient. Our pharmacy provides second-to-none staff education to reduce these errors.

For our staffing, we plan to have 2 pharmacists, and 2 technicians. With this we can also have up to 4 interns as well, which we plan work out with the pharmacy schools nearby. One pharmacist will focus on the primary services with the OTC and prescription drugs, while the other pharmacist will do specialized services like immunization, compounding, MTM and help with the primary services whenever able. Both technicians will be proficient in compounding. We also plan to keep the current pharmacy name of Reliable Drugs. This way the patients will only need to adjust to a new face inside the pharmacy. This helps keep customer loyalty, and does not alienate the patients who have already been valued customers.

Reliable Drugs was purchased for $700,000, with 15% (or $105,000) as down payment to the former owner. We each had $50,000 of our own money that totals to $150,000. Therefore, we borrowed the balance of $550,000 from Live Oak Bank. In addition $200,000 was borrow from Live Oak bank for operating money. Based on previous years’ financial statement, we can project to repay our loans from Live Oak Bank $100,000 a year while taking in $200,000 as owner’s compensation but with room to grow. Therefore, we project completely repay our loans within 8 years, although adjusting repayments is a possibility.

However, after 2 years, we plan to rebrand ourselves as Swag Rx. this is largely to ensure that we distinguish ourselves from other pharmacies. We do plan to target the younger generations, especially with fitness and supplemental products. This will allow for us to build our brand and serve people of all ages, and expand our business outside of just prescription and OTC drugs.

The location of our pharmacy is at Daly City, California. The traffic coming into the pharmacy consist of 30% Caucasian, 35% Asians, 15% Hispanic, and 20% mixed ethnicity. The community strongly supports local businesses

with about 80% of all businesses in the proximity being owned by local entrepreneurs. The convenient location includes local supermarkets, restaurants, post office, banks, municipal transportation, florist, laundromats, and more importantly physician and dental practices along with a few veterinary hospitals.

The next closest independent pharmacy is about 3 miles away and the next closest chain pharmacy is about 3 miles away also. Although, Kaiser outpatient pharmacy is within 1.5 miles away, this proves to be beneficial rather than competitive because 20% of the prescriptions are directly from Kaiser medical facilities.

Our VisiOnLooking back at our executive summary written 20 years ago as shown above, we have still maintained the same goals and excellence that have allowed us to distinguish ourselves from other pharmacies: providing high quality and safe health care while maintaining respect, communication, and professionalism.

V i s i on A P ha r mac y f o r Tomor r ow : S wag R x

Over the last 20 years, many changes in the world have led to great benefits and advances in the field of pharmacy. Pharmacists can now handle and administer specialty drugs, and can perform “in pharmacy” diagnostic work with patients.

One major topic I will bring to the WNAC Pharmacist’s Association event is the idea that Pharmacists can now diagnose patients. Pharmacy students cover a wide range of subjects in pharmacy school such as biochemistry, pharmacokinetics, and therapeutics. Pharmacists are extremely knowledgeable with medications, how they interact, and how patients respond to them.

Another topic will be introducing a new set of drugs. This third class of drugs will be an intermediate level in between OTC and prescription drugs. This will allow pharmacists to prescribe drugs for intermediate conditions, not severe illnesses. If the doctor’s office is closed and a patient needs medicine, the pharmacist can then prescribe this third set of drug. This will greatly improve the efficacy and time of getting to the drug to the patient, especially in emergency situations. Pharmacists will also be able to send off blood samples of patients. After getting the results, pharmacists can evaluate the lab values, and handle each patient profile individually. Pharmacists being able to diagnose patients and prescribe drugs for intermediate illnesses will greatly expand the future of pharmacy to new heights.

There has also been much advancements in the pharmacogenomics that has allowed the price to drop to a cost that we can get the genetic information of all patients. With the recent discoveries, we can now determine many disease states that a person is likely to get, so that appropriate lifestyle changes can be made to prevent those conditions from happening. With the health care provider status, we can now get reimbursed for those services, in addition to the MTM services that we have been providing for a while.

We also now sell self-diagnostic tools that patients can get, that give us live updates on many of their vital statistics. They are easy to use and are pain free, and help us monitor patients who are at high risk for certain states. This allows us to help with patient compliance as well with certain patients. Because it is updated on their phones, they can also receive live advice if the situation is serious, and certain events like a heart attack can be predicted so that they get help immediately.

With the new technology and laws in hand, we want to empower people into being able to control their health, and get the accessibility to important and relevant information from a professional healthcare provider. We hope to continue another 20 years of success and advancements.

V i s i on A P ha r mac y f o r Tomor r ow : Mode s to

PrePared by:Virginia TanBelinda ChuChris Pham

Our PharmacyThe pharmacy that was recently bought is in Modesto. The city has about 70 pharmacies spread throughout the city (certain sources vary on the exact number going as high as 80 or lower at 60). The pharmacies are not very concentrated in one area, although it seems most of the pharmacies are located in the north side of the city. If we were to buy an existing pharmacy, based on some rough research with google maps, there will be some competing pharmacies within 2 or 3 miles.

“We bought the pharmacy for $900,000, with 10% as down payment to the former owner. We had $90,000 of our own money, and borrowed the balance, or $810,000 from Live Oak Bank. We also borrowed an additional $400,000 from Live Oak Bank for operating money. Our monthly payment on all loans is $15,500.” The pharmacy revenues for the last 3 years averaged $5 million, with a gross profit of 23% and a net profit of 3.75%.

The population was spread out with 54,012 people (26.8%) under the age of 18 [pediatric], and 23,508 people (11.7%) who were 65 years of age or older [geriatric population], the gender percentage distribution is almost 50:50. The estimated population in Modesto in 2011 is 202,751. Unemployment rate in December 2012 was estimated to be 13% which is higher than the national average. Based on 2007 data the city has a large White and Hispanic population, with Multi-Race next. The median household income in 2011 was $44,076. Some key elements that will help differentiate our pharmacy from others will be a medication pick-up service between the pharmacy and senior centers, and active educational outreach presentations throughout the year, once a month, and directed towards a different group of people such as pediatric and adolescent health (schools), companies, senior homes, and doctor offices (prescription information). To incentivize proper medication use and developing good nonpharmacologic habits, we are thinking of setting up a point or game system in which, if patients improve their health, they can get coupons to special exercise classes or something that would promote health. Also another service we are going to provide is compounding. The kind of compounding that we are specializing in will be dermatology, including cosmetics. In an effort to make the store more homely we are considering having a boba milk tea station to bring in a steady flow of customers and new faces.

Challenges that we will have is not having enough to secure and interest a customer base. Our ideas couldn’t be implemented or managed well since we are just testing the waters. There are also plenty of competition from chain pharmacies, especially new ones pop up in the area. The local economy isn’t doing that well and unemployment is also fairly high so people will be less willing to spend their money. We just hope that the new, innovative services that our pharmacy provides will overcome this barrier and encourage customers to buy our products. Reimbursement problems from insurance companies are concerning because of new legislation, but we are hoping that new initiatives will come into place will increase profits from other services (such as BMD, diabetes, and other screenings) that make us more clinical. Our VisiOnThe goal is to expand. Since there are three partners in the beginning we hope to each manage 3 independent pharmacies. Making a total of 9 (more is possible), we are not expecting each store to be incredibly large but they will still offer the same benefits of the original store. We will still be providing health outreach activities in each area we occupy. Once the net worth of each individual pharmacy reaches the value we want them to be, we will sell all of them.

Under the assumption, that California legislature has passed a number of statutes that allow pharmacies to be paid for clinical services, we also will be providing those services in the pharmacy. The point system that we had in place to help increase overall health awareness by creating a prize initiative with free gym classes if they are able to meet their health goal for that month. Twenty years from now, we hope to open our own gym so we no longer have to form any contracts with outsiders.

We are also hoping to create an invention that we mentioned in class and that it sells well. At the very least some regular patients to our stores would have it. The invention was a pillbox that could only be open by some sort of user recognition, such as thumb print. The pillbox can also be programmed to remind patients of when to take their medications and will dispense the correct amount at the right time. The pill box will be loaded with the full amount of drug that each patient buys. This can be done at the pharmacy, to make sure the right amounts are put in and that the box is working properly.

We will expect pharmacogenomics to be an established field of study and will give a presentation on how to make it affordable and accessible. At this time, we expect only people who are well off can only afford these kinds of treatments. Sequencing one’s genome has to be inexpensive and timely. We would be able to personalize medicine, allowing doctors to select the best drug with the least side effects and risks. This would result in less medication overuse and reduced cost.

V i s i on A P ha r mac y f o r Tomor r ow : LONG pha r mac y

PrePared by:Edward SungEilbra YounanRobert Lee

Our PharmacyThe name of our pharmacy is LONG pharmacy (living LONG and healthy lives) located in Stockton, CA. Our pharmacy will be located across the street from a CVS pharmacy (major competitor) on a major intersection in one of the busiest streets in Stockton. We are purchasing an existing pharmacy that was not able to successfully compete with the current major competitor.

With three partners coming into the venture together, we would each invest 50K for a total of 150K of our own money. We bought the pharmacy from the previous owner for 700,000 so we have a borrowed balance of 550,000. We also borrowed an additional 200,000 from Bank of America to build our drive through are and yogurt shop. Our calculated monthly payment on all loans will be roughly 13,000.

The target demographic base of our patient base would be at least 65% geriatric. With rapidly aging US population, more and more geriatric patients are in need of medical care so we thought that targeting the geriatric population would be beneficial for the growth of our pharmacy. Some of the unique pharmacy features we would incorporate include a 3 lane drive through, delivery services, and a joint yogurt business. The incorporation of a 3 lane drive through would predominantly serve the role of quick and easy patient accessibility. This is especially beneficial

to those patients who simply do not have time to physically walk inside the pharmacy to pick up their medications. Because of our pharmacies target on the geriatric population, delivery services will play an essential role in providing drug access to those patients who may have a difficult time physically coming into the pharmacy to pick up their prescriptions. The role of the joint yogurt business is mainly to attract new customers and provide patient’s with something different that most other

pharmacies do not offer. The idea of a joint yogurt business may prove to be particularly valuable in a city such as Stockton with a warmer climate. We also mentioned previously that our pharmacy would be opening up near a CVS pharmacy so these unique features, which are not provided by CVS, may aid us in surpassing our competitors and building a strong presence within the community.

Because we have decided to open up our pharmacy near a CVS pharmacy, the major challenge would be the local competition. With all the different unique services that we will be providing, the maintenance and upkeep costs of our pharmacy may become quite expensive so it will be essential that we can come in and build a strong client relationship with the nearby community immediately while turning a profit. One example of how we may be able to develop a strong presence within the community would be through the use of our yogurt shop. A simple, yet effective idea may be to offer a free yogurt stamp to patients who are compliant with their medications and fill their refills on time. Our VisiOnBeing in business for twenty years, we have finally paid off all our loans and are now making money. We have established a strong relationship with the Stockton community and have had loyal customers for quite a while.

We were planning to open up a new pharmacy in the Lodi area, but decided to change our plans once we heard some of the new events that have occurred. Hearing that California has allowed pharmacists to handle and administer specialty drugs, we have decided to invest in this. We have decided to spend build a new facility for this as an attachment to our current pharmacy. Although we have some money saved up, we will need to borrow some money from the bank to fund this project. With this, we plan to target not only the geriatric and hospital sites in Stockton, but decided to advertise the surrounding cities, such as Lodi, Manteca, Sacramento, and Modesto. To obtain more customers, we will also offer our delivery

services for these sites so that we can start to relationships with our neighboring cities. Although it might take couple years to again pay off our loans, I believe that we will start making a lot of money once we get the ball rolling.

The idea of the Bio-similars has a lot of potential in raking in money, but it is not 100% sure. FDA has said that this “claims” to work better than the original drug, which is not for certain it will. Although this could be a gold mine if it does work, we do not plan on taking this risk, especially because we have already spent a lot of money on our specialty facility. However, we still plan on keeping an eye and researching on its progress to see the response. If we do see a positive trend in the results, we plan on working with another team to start a Bio-similar company up. This is because we do not want to be in too much debt. We already have the loan from the specialty drugs to pay off. As we become close to paying off our debts, we might be interested in starting up our own Bio-similar pharmacy nearby. And of course, this will be based on what we have researched and the results we have seen from other pharmacies conducting this new class of drugs.

The one topic I would like to bring to the WNAC Pharmacist’s Association on maintaining ongoing excellence in pharmacy care is the idea of trust. The foundation of building any type of relationship is trust. By getting to know your patients and taking that extra step to help your patient the best you can, it is then that they start to trust you and respect you as a healthcare professional. They will begin to take your advice and start to make decisions in leading a healthier lifestyle because they know that they are in good hands. Not only will this build long term relationships, but will attract more patients through word of mouth. Patients will start to realize the respect and care we are giving them is also one of the medicines that will help them get better.

PrePared by:Van DuongSusan DengLana Nguyen

Our PharmacyOur vision: To provide outstanding pharmacy services to the surrounding community while catering to patient needs for the benefit of the community.

We strive for our pharmacy to not only supply the community with medications they need, but we also want to educate our patients on their medications and uplift the community’s commitment to health.

Our VisiOn• Bewellestablishedinourchronicdiseasemanagement&screeningservices• Ifallgoeswell,buildsatellitepharmacies• Incorporateotherhealthbusinessventuresintothepharmacy

• ShakeCafé• Fitnesscenter

V i s i on A P ha r mac y f o r Tomor r ow : L i v i ng Be t t e r P ha r mac y

GOOD NEIGHBOR PHARMACY/THOMAS J. LONG SCHOOL OF PHARMACY AND HEALTH SCIENCES

ENTREPRENEURIAL PHARMACY PRACTICE PROGRAM BOARD OF GOVERNORS August 22, 2013

Educating tomorrow’s leaders...

A good education is not so much one which prepares a man to succeed in the world,

as one which enables him to sustain a failure. Bernard Iddings Bell

ENTREPRENEURIAL PHARMACY PRACTICE PROGRAM

PROGRAM REQUIREMENTS

ENTRY INTO THE PROGRAM:

1. Requirements: The student must be a first year student in good academic standing in the Doctor of Pharmacy program

2. Timing: For first year students, entry into the Program will be allowed from the end of the first semester to the end of the third semester in the Doctor of Pharmacy Program.

3. Exceptions: Second year students may apply for entry into the program in the fourth semester. Their application must include any requested documentation on abilities, experiences, long term plans, etc. An interview may be conducted. The entry of those students into the Entrepreneurial Pharmacy Practice Program will be at the sole discretion of the Program Director.

COMPLETION:

A certificate of completion of the Entrepreneurial Pharmacy Practice Program will be awarded when the student meets all of the following requirements.

1. Academic Standards: The student must maintain good academic standing in the Doctor of Pharmacy program throughout the duration of the Entrepreneurial program

2. Required Course: The student must complete PRAC 136 Entrepreneurial Pharmacy Practice (2 units) with a grade of B or better.

3. Elective Course: The student must complete at least 2 units of approved elective course work with a grade of C or better. The following courses are approved to meet this requirement.

PRAC 156 Opportunities in Pharmacy Practice (1 or 2 units) PRAC 193 Independent Study (1-4 units): approved, entrepreneurial focus BUSI 276 Entrepreneurial Management (3 units) BUSI 221 Entrepreneurial Finance (3 units) BUSI 272 Entrepreneurship (3 units) BUSI 282 Entrepreneurial Rapid Growth (3 units) BUSI 293 Special Topics in Entrepreneurship (1-4 units)

4. E-Mentor Requirement a. Meetings: At the start of their second IPPE the student must meet with their e-

mentor at least monthly. b. Assessments: An initial and then follow-up of both the student’s and the

mentor’s perceived assessments competency will be performed using Program

forms and reviewed by the student and the mentor, and then submitted to the Program’s Sakai site for review by the Program Director.

c. Journal: Students must maintain an electronic journal of their interactions, meetings and discussions with their e-mentors and submit the journal to the Program’s Sakai site at the end of each semester.

5. Experiential Requirements a. IPPEs and APPEs: Students must complete at least 3 experiential rotations of

IPPEs and APPEs at approved entrepreneurial sites, including at least one IPPE (PHRM 159 Community II IPPE) and one APPE (PHRM 174 Community Pharmacy APPE). The student must also complete one additional IPPE (PHRM 129 Community I IPPE or PHRM 160 ) or one additional APPE (PHRM 184 or 185 Elective APPE I or II).

b. IPPE Project: During PHRM 159 Community II IPPE, the student, with direction from the preceptor and input from the mentor, must complete a business plan and SWOT analysis on a non-dispensing service that is either existing or to be developed at the practice site in addition to other activities required in PHRM 159. The business plan and SWOT analysis must include calculated break-even point, plans for development and marketing, and an evaluation of sustainability. The IPPE Project must be completed during PHRM 159 and submitted to the Program Sakai site by the student prior to the end of PHRM 159.

c. APPE Project: During PHRM 174 Community Pharmacy APPE, the student must evaluate the overall effects of an established service at the APPE site in addition to other activities required in PHRM 174. This evaluation must include a brief description of the service and its history, an analysis of the impact of the service on patient care, the profitability and sustainability of the service, and the projected ease and difficulty associated with establishing and implementing the service at a different site. The APPE Project must be completed during PHRM 174 and submitted to the Program Sakai site by the student prior to the end of PHRM 174. See below for a description of the APPE Project Presentation.

d. Abilities Assessment: Pre- and post-assessment of the perceived competency of both the student and the preceptor must be performed using Program forms and reviewed by the student and the preceptor during all entrepreneurial IPPEs and APPEs, and then submitted to the Program’s Sakai site for review by the mentor and the Program Director.

6. APPE Project Presentation: A brief, executive summary of the APPE Project will be presented by the student at a meeting of the faculty director and representatives of both the administration and Board of Governors. Presentations or posters of the

project at state and national professional meetings or publication of the project are highly recommended.

7. Documentation: The student must submit all of required documentation using the appropriate forms and methods as described by the Program Director.

8. Professionalism: The student must display professionalism in all course work, experiential settings, and work environments. Any lack of professionalism may result in dismissal from the Entrepreneurial Pharmacy Practice Program at the discretion of the Program Director.

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Thomas J. Long School of Pharmacy & Health Sciences, University of the Pacific Doctor of Pharmacy Curriculum

Approved 6/25/08, Revised 3/17/2009 & 10/10/2012 Semester, Course Number & Course Name Units Unit Totals SEMESTER I 19 PHRM 111 Pharmacy Practice & Professionalism 3 PHRM 112 Dispensing, Compounding & Calculations 3 PHRM 113 Molecular & Cellular Biochemistry 4 PHRM 114 Physical Pharmacy & Dosage Forms 5 PHRM 115 Nonprescription Therapy & Self Care 2 PHRM 118 Practicum I 2

SEMESTER II 18 PHRM 121 Informatics, Statistics & Research Design 3 PHRM 122 Physiology & Pathophysiology I 5 PHRM 123 Physiology & Pathophysiology II 5 PHRM 124 Drug Metabolism & Disposition 3 PHRM 129 Community I IPPE 2

SEMESTER III 16-18 PHRM 134 Pharmacokinetics & Advanced Drug Delivery Systems 4 PHRM 135 Pharmacology & Medicinal Chemistry I 4 PHRM 136 Pharmacology & Medicinal Chemistry II 4 PHRM 138 Practicum II 2 PHRM 139 Geriatrics IPPE # 2

Electives(s) * 0-2 * SEMESTER IV 17-19 PHRM 142 Physiology & Pathophysiology III 5 PHRM 145 Pharmacology & Medicinal Chemistry III 4 PHRM 146 Therapeutics I Neuropsychiatry 4 PHRM 147 Therapeutics II GI/Hepatic/Nutrition 2 PHRM 149 Hospital IPPE # 2

Electives(s) * 0-2 * SEMESTER V 17-19 PHRM 151 Pharmacoeconomics, Benefits & Outcomes 2 PHRM 152 Pharmacy Law & Ethics 4 PHRM 156 Therapeutics III Cardiology 4 PHRM 157 Therapeutics IV Renal/Respiratory 3 PHRM 158 Practicum III 1 PHRM 159 Community II IPPE #,@ 2 PHRM 169 Health Care Outreach IPPE #,$ 1

Electives(s) * 0-2 * SEMESTER VI 14-16 PHRM 161 Pharmacy Management 2 PHRM 165 Therapeutics V Infectious Disease 4 PHRM 166 Therapeutics VI Oncology/Transplantation 3 PHRM 167 Therapeutics VII Endocrine/Musculoskeletal 4 PHRM 168 Practicum IV 1

Electives(s) * 0-2 * SEMESTER VII & VIII 36 PHRM 171 Internal Medicine APPE 6 PHRM 172 Ambulatory Care APPE 6 PHRM 173 Hospital Pharmacy APPE 6 PHRM 174 Community Pharmacy APPE 6 PHRM 184 Elective APPE I 6 PHRM 185 Elective APPE II 6

TOTAL (includes 4 units of electives in Semesters I-VI) 141 APPE = Advanced Pharmacy Practice Experience; IPPE = Introductory Pharmacy Practice Experience * Each student must complete a total of at least 4 units of electives during Semesters I to VI. # IPPE II, III, IV and V may be taken in a different semester than indicated. @ PHRM 160 Practice-Based IPPE may be taken instead of PHRM 159 $ PRAC 143 Health Care Outreach IPPE – Medicare Part D may be taken instead of PHRM 169

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PHRM 111. Pharmacy Practice & Professionalism (3) An introduction to the roles and responsibilities of the pharmacist in general and in various practice settings with a focus on leadership and professional development. Prerequisite: . Admission to the Doctor of Pharmacy Program.

PHRM 112 Dispensing, Compounding and Calculations (3) This course will present mathematical concepts as they apply to the practice of pharmacy. The course will also present information on the techniques needed for the proper compounding and dispensing of medication as well as those techniques needed for communicating effectively with patients and health care professionals. Prerequisite: Admission to the Doctor of Pharmacy program.

PHRM 113 Molecular and Cellular Biochemistry (4 units) A conceptual study of cellular function and control mechanisms at the molecular level. Prerequisite: Admission to the Doctor of Pharmacy program.

PHRM 114 Physical Pharmacy and Dosage Forms (5 units) A study of dosage forms and the relationship between the physicochemical properties of drugs and drug reaction. Prerequisite: Admission to the Doctor of Pharmacy program.

PHRM 115 Nonprescription Therapy and Self Care (2 units) Principles of triage and self care using non-prescription pharmacotherapy and dietary supplements. Prerequisite: Admission to the Doctor of Pharmacy Program.

PHRM 118 Practicum I (2 units) Pharmacy practice skills and knowledge will be developed through completion of self-study modules and guided practice simulations. The practicum experiences relate to effective patient counseling for the most commonly prescribed and select non-prescription medications, smoking cessation products, and immunizations in addition to application of appropriate techniques for measurement of blood pressure, blood glucose and administration of immunizations for adults. Prerequisite: Admission to the Doctor of Pharmacy Program.

PHRM 121 Informatics, Statistics & Research Design (3 units) Students will develop an understanding of the availability, selection and use of electronic and printed sources of medical and pharmacy information. Approaches to effectively responding to drug information questions in addition to analyzing and critiquing medical and pharmacy literature based on knowledge of the essentials of study design and statistics. Students will also understand the research steps prior to and following drug approval by the Food and Drug Administration. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 in the Doctor of Pharmacy program.

PHRM 122 Physiology & Pathophysiology I (5 units) An integrated study of the cellular, anatomical, physiological, and pathophysiological components of the nervous and gastrointestinal systems. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 of the Doctor of Pharmacy program. Concurrent enrollment or prior successful completion of PHRM 123 Physiology & Pathophysiology II.

PHRM 123 Physiology & Pathophysiology II (5 units) An integrated study of the cellular, anatomical, physiological, and pathophysiological components of the pulmonary, cardiovascular and renal systems. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 of the Doctor of Pharmacy program. Concurrent enrollment or prior successful completion of PHRM 123 Physiology & Pathophysiology I.

PHRM 124 Drug Metabolism and Disposition (3 units) A continuation of PHAR 114 (Physical Pharmacy and Dosage Form) utilizing the LADME framework (Liberation, Absorption, Distribution, Metabolism, and Excretion) to understand the biopharmaceutic, biometabolic and pharmacokinetic concepts underlying drug action. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 of the Doctor of Pharmacy program.

PHRM 129 Community I Introductory Pharmacy Practice Experience (2 units) A practice-based introductory experience focusing on the role of the Pharmacist/Pharmacy Intern in a community pharmacy practice. This course is designed to allow students to participate in the delivery of pharmaceutical care. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 of the Doctor of Pharmacy Program Current Pharmacy Intern license

PHRM 134 Pharmacokinetics & Advanced Drug Delivery Systems (4 units) A continuation of PHRM 114 Physical Pharmacy & Dosage Forms and PHRM 124 Drug Metabolism & Disposition utilizing the LADME framework (Liberation, Absorption, Distribution, Metabolism, and Excretion) to understand biopharmaceutic and pharmacokinetic/pharmacodynamic principles governing drug behavior in the body.

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Additionally, the design of modified release drug delivery systems will be covered. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 2 in the Doctor of Pharmacy program

PHRM 135 Pharmacology & Medicinal Chemistry I (4 units) The first course in the Pharmacology and Medicinal Chemistry series, effects of autonomic and central nervous system therapeutic agents and the mechanisms whereby these effects are induced. Drug classes will be presented to illustrate the effects of drug classes in the treatment of diseases. The principles of drug action and receptor theory will also be covered. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 2 in the Doctor of Pharmacy program.

PHRM 136 Pharmacology & Medicinal Chemistry II (4units) The second course in the Pharmacology and Medicinal Chemistry series, effects of antimicrobial, hematologic, and gastrointestinal therapeutic agents and the mechanisms whereby these effects are induced. Drug classes will be presented to illustrate the effects of drug classes in the treatment of diseases. The mechanisms of drug toxicity is also covered. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 to 2 of the Doctor of Pharmacy program

PHRM 138 Practicum II (2 units) Students will develop communication, assessment and documentation abilities to prepare them for didactic courses and practice experience. Students will learn to conduct a patient history, perform basic physical examinations, interpret common clinical laboratory data and diagnostic tests, and document pharmacist directed patient care using standardized approaches. Students will assess simulated patient scenarios using a standardized SOAP (subjective data, objective data, assessment, plan) format. Each student will be expected to demonstrate proficiency in each major ability. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 2 of the Doctor of Pharmacy program

PHRM 139 Geriatrics Introductory Pharmacy Practice Experience (2 units) An introductory practice-based introductory experience focusing on long term care, senior care, and geriatric patients. It is designed as a method to enhance each student’s understanding of the role and responsibilities of pharmacists in the long term care and other geriatric care settings through the provision of pharmaceutical care to patients. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 and 2 of the Doctor of Pharmacy program Current Pharmacy Intern license

PHRM 142 Physiology & Pathophysiology III (5 units) An integrated study of the cellular, anatomical, physiological, and pathophysiological components of the endocrine, immunologic, and hematologic systems and processes involved in autoimmune, oncologic, and infectious diseases. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 to 3 of the Doctor of Pharmacy program

PHRM 145 Pharmacology & Medicinal Chemistry III (4 units) The third course in the Pharmacology and Medicinal Chemistry series, effects of cardiovascular, endocrine, cancer chemotherapy, immunologic therapeutic agents and the mechanisms whereby these effects are induced. Drug classes will be presented to illustrate the effects of drug classes in the treatment of diseases. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 to 3 in the Doctor of Pharmacy Program

PHRM 146 Therapeutics I Neuro-Psychiatry (4 units) Students will develop the abilities to assess and develop patient-specific care plans for patients with specific conditions, diseases, disorders, and drug-induced problems utilizing basic and applied pharmaceutical science abilities. Lectures, readings, and discussion will enable students to develop the abilities to assess, manage, and document simple to complex patients. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 3 in the Doctor of Pharmacy program

PHRM 147 Therapeutics II GI/Hepatic/Nutrition (2 units) Students will develop the abilities to assess and develop patient-specific care plans for patients with gastrointestinal, hepatic, nutrition, and anemia conditions, diseases, disorders, and drug-induced problems utilizing basic and applied pharmaceutical science abilities. Lectures, readings, and discussion will enable students to develop the abilities to assess, manage, and document simple to complex patients. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 3 in the Doctor of Pharmacy program

PHRM 149 Hospital Introductory Pharmacy Practice Experience (units 2) Hospital introductory pharmacy practice experiences are a method to enhance each student’s understanding of

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the role and responsibilities of pharmacists in the institutional setting and to gain experiences with the medication use system and with other health care providers within a hospital. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 and 2 of the Doctor of Pharmacy program. Current Pharmacy Intern license

PHRM 151 Pharmacoeconomics, Benefits & Outcomes (2 units) The description and application of economic-based evaluation methods to pharmaceutical products, treatments and services. This includes understanding principles which will help decision makers maximize clinical and/or humanistic outcomes given economic constraints. Additionally, this course will provide an introduction to managed care and Medicare and its role in US health care delivery. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 4 in the Doctor of Pharmacy program

PHRM 152 Pharmacy Law & Ethics (4 units) Discussions and analysis of federal and state law, regulations, standards of practice, case law and ethics related to pharmacy practice and drug development and distribution. Focus is upon analyzing, understanding and applying these issues through case studies and hypotheticals. Considerable emphasis on professionalism and the historical events that have shaped today’s professional pharmacy practice, as well as the drug development and distribution system. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 4 in the Doctor of Pharmacy program

PHRM 156 Therapeutics III Cardiology (4 units) Students will develop the abilities to assess and develop patient-specific care plans for patients with specific cardiovascular diseases utilizing basic and applied pharmaceutical science abilities. Lectures, readings, and discussion will enable students to develop the abilities to assess, manage, and document simple to complex patients. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 4 in the Doctor of Pharmacy program

PHRM 157 Therapeutics IV Renal/Respiratory (units 3) Students will develop the abilities to assess and develop patient-specific care plans for patients with renal and respiratory diseases. Lectures, readings, and discussion will enable students to develop the abilities to assess, manage, and document simple to complex patients with renal and respiratory-related issues. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 4 in the Doctor of Pharmacy program

PHRM 158 Practicum III (units 1) Problem solving and critical thinking skills will be developed through the discussion and solution of complex cases and problems, with a focus on patients with multiple disorders and patients from various cultures or diverse populations and pediatric and geriatric populations. Problem solving and critical thinking skills will also be developed through the discussion and solution of cases and problems involving the clinical pharmacokinetics of select drugs, including the determination and documentation of initial dosing recommendations, dosage adjustments, drug concentration predictions, and monitoring plans. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 4 of the Doctor of Pharmacy program. Concurrent enrollment or prior successful completion of PHRM 156-157 Therapeutics III-IV.

PHRM 159 Community II Introductory Pharmacy Practice Experience (2 units) Community II introductory pharmacy practice experiences are a method to enhance each student’s understanding of the role and responsibilities of pharmacists in the community setting and to gain experiences with the medication use system within a community pharmacy and expand the abilities developed in Community I introductory pharmacy practice experience. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 and 2 of the Doctor of Pharmacy Program. Current Pharmacy Intern license.

PHRM 160 Practice-Based Introductory Pharmacy Practice Experience (2 units) The Practice-Based introductory pharmacy practice experience is another method to enhance each student’s understanding of the role and responsibilities of pharmacists and medication distribution and use process in any one of a variety of pharmacy practice settings. Prerequisite: Successful completion of this course satisfies completion of PHRM 159 Community II Introductory Pharmacy Practice Experience.

PHRM 161 Pharmacy Management (2 units) An analysis of financial management principles applicable to pharmacy practice. An analysis of human resources management applicable to pharmacy practice. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 5 in the Doctor of Pharmacy program

PHRM 165 Therapeutics V Infectious Diseases (4 units) Infectious Disease Therapeutics is an integrated course where students will be taught to bring Medical

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Microbiology, Pharmacology, Physiology, Immunology, Pharmacokinetics, Pharmacodynamics and Chemotherapeutics together in order to care for patients with treatable infectious diseases. Students will develop the ability to assess and develop patient-specific care plans for patients with infectious disease conditions, including prevention and drug-induced problems utilizing applied pharmaceutical science principles and knowledge. Lectures, readings, presentations and discussions will enable students to develop the ability to assess, manage, and document therapeutic care plans of varying complexity for patients with infectious disease Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 5 in the Doctor of Pharmacy program

PHRM 166 Therapeutics VI Oncology/Transplantation (3 units) Students will develop the abilities to assess and develop patient-specific care plans for patients with specific conditions, diseases, disorders of cancers and transplants and drug-induced problems utilizing basic and applied pharmaceutical science abilities. Lectures, readings, and discussion will enable students to develop the abilities to assess, manage, and document simple to complex patients with cancers or transplants. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 5 in the Doctor of Pharmacy program

PHRM 167 Therapeutics VII Endocrine/Musculoskeletal (4 units) Students will develop the abilities to assess and develop patient-specific care plans for patients with endocrine, musculoskeletal, pain, dermatologic, and ophthalmic conditions, diseases, disorders, and drug-induced problems utilizing basic and applied pharmaceutical science abilities. Lectures, readings, and discussion will enable students to develop the abilities to assess, manage, and document simple to complex patients. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 5 in the Doctor of Pharmacy program

PHRM 168 Practicum IV (1 unit) This course is a continuation of Practicum III. Problem solving and critical thinking skills will be developed through the discussion and solution of complex cases and problems, with a focus on patients with multiple disorders and patients from various cultures or diverse populations and pediatric and geriatric populations. Problem solving and critical thinking skills will also be developed through the discussion and solution of cases and problems involving the clinical pharmacokinetics of select drugs, including the determination and documentation of initial dosing recommendations, dosage adjustments, drug concentration predictions, and monitoring plans. Prerequisite: Successful completion of (passing grade in) all required courses in Semesters 1 to 5 of the Doctor of Pharmacy program. Concurrent enrollment or prior successful completion of PHRM 165-167 Therapeutics V-VII.

PHRM 169 Health Care Outreach Introductory Pharmacy Practice Experience (1 unit) Community health care outreach introductory pharmacy practice experiences are a method to enhance each student’s understanding, participation, and commitment to enhancing the health of the public. Groups of students will work with community agencies and organizations in the development, organization, management, implementation, delivery, and assessment of health care outreach activities in local communities. Many of these activities will be managed through professional student organizations. Students will also reflect on their activities to determine the impact of those activities on the public and on themselves. Prerequisite: Successful completion of (passing grade in) all required courses in Semester 1 of the Doctor of Pharmacy program Current Pharmacy Intern license, Current blood bourne pathogen and CPR certifications

PHRM 171 Internal Medicine APPE (6 units) A clinical pharmacy practice rotation at an affiliated health care facility with emphasis on the medical management of disease states, rational drug therapy, and patient monitoring using the pharmaceutical care practice model. Prerequisite: Successful completion of (passing grade in) all required courses and 4 units of elective courses in semesters 1 to 6 of the Doctor of Pharmacy program Satisfy academic standards for entry into advanced pharmacy practice experiences Satisfy the institution’s policies and procedures on healthcare trainee or worker eligibility, such as background

PHRM 172 Ambulatory Care APPE (6 units) A clinical pharmacy practice rotation at an affiliated clerkship site with emphasis on providing pharmaceutical care for ambulatory care patients, including the medical management of disease states, rational drug therapy, and patient monitoring. Prerequisite: Successful completion of (passing grade in) all required courses and 4 units of elective courses in semesters 1 to 6 of the Doctor of Pharmacy program. Satisfy academic standards for entry into advanced pharmacy practice experiences. Satisfy the institution’s policies and procedures on healthcare trainee or worker eligibility, such as background checks and screenings, HIPAA training, etc. Valid pharmacy intern license.

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PHMR 173 Hospital Pharmacy APPE (6 units) A hospital pharmacy practice rotation at an affiliated clerkship site with enhanced experience in selecting drug products, compounding, dispensing, monitoring and evaluation, as well as understanding pharmacy operations and administration, communicating with patients and other health professionals, and providing drug information. Prerequisite: Successful completion of (passing grade in) all required courses and 4 units of elective courses in semesters 1 to 6 of the Doctor of Pharmacy program . Satisfy academic standards for progression into Advanced Pharmacy Practice Experiences. Satisfy the institution’s policies and procedures on healthcare trainee or worker eligibility, such as background checks and screenings, HIPAA training, etc. Valid pharmacy intern license.

PHRM 174 Community Pharmacy APPE (6 units) The Advanced Pharmacy Practice Experience in Community Pharmacy Practice is designed to provide students hands-on experience in selecting drug products, compounding, dispensing, monitoring and evaluating, communicating with patients, communicating with other health professionals, drug information, public health, and pharmacy operations and management. This required experiential learning rotation will allow students to integrate their pharmacy knowledge with patient care skills, further develop effective communication skills, develop pharmacy management skills, and engage in innovative practice experiences when possible. Students will actively participate in the day-to-day activities that comprise the work of a pharmacist practicing in the community setting. In addition, students will have the opportunity to engage in pharmacy practice activities including pharmacy management, medication therapy management and other pharmaceutical care services, and public health promotion and preventive care services. Prerequisite: Successful completion of (passing grade in) all required courses and 4 units of elective courses in semesters 1 to 6 of the Doctor of Pharmacy program. Satisfaction of academic standards for progression into Advanced Pharmacy Practice Experiences. Satisfy the institution’s policies and procedures on healthcare trainee or worker eligibility, such as background checks and screenings, HIPAA training, etc. Valid pharmacy intern license.

PHRM 184 Elective APPE I (6 units) This is the first of two elective advanced pharmacy practice experiences that allow the student to explore and develop abilities in an area of interest within the health care industry. This experience may be in a variety of biomedical settings including patient care, administrative, health care system, public health, governmental agency, professional organization, research, academic, pharmaceutical company, and other biomedical or health related settings. Prerequisite: Successful completion of (passing grade in) all required and 4 units of elective courses in semesters 1 to 6 of the Doctor of Pharmacy program. Satisfy academic standards for progression into Advanced Pharmacy Practice Experiences. Satisfy the institution’s policies and procedures on healthcare trainee or worker eligibility, such as background checks and screenings, HIPAA training, etc. Valid pharmacy intern license.

PHRM 185 Elective APPE II (6 units) This is the second of two elective advanced pharmacy practice experiences that allow the student to explore and develop abilities in an area of interest within the health care industry. This experience may be in a variety of biomedical settings including patient care, administrative, health care system, public health, governmental agency, professional organization, research, academic, pharmaceutical company, and other biomedical or health related settings. Prerequisite: Successful completion of (passing grade in) all required courses and 4 units of elective courses in semesters 1 to 6 of the Doctor of Pharmacy program Satisfy academic standards for progression into Advanced Pharmacy Practice Experiences. Satisfy the institution’s policies and procedures on healthcare trainee or worker eligibility, such as background checks and screenings, HIPAA training, etc. Valid pharmacy intern license.

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates:

Pharmacy Syllabus Template 2013 February

Department / Subject Code: PRAC

Course Number: 136

Semester & Year: Spring 2013

Course Title: Entrepreneurial Pharmacy Practice

Instructor(s) and Contact Information: David Collum, M.S.P., and Guest Presenters dcollum@pacific.edu; 209.946.2073

Location(s): PHS 111 (ex: April 30th PHS 112)

Units: 2

Lecture Hours per Week: 2

Lecture Weeks per /Semester: 14

Total Number of Weeks: 14 weeks (1 semester)

Laboratory Hours per Week: 0

Laboratory Weeks per Semester: 0

Maximum Enrollment per section: 50

Discussion Hours per Week: 0

Discussion Weeks per Semester: 0

Experiential Hours per Week or per Semester: 0

Experiential Weeks per Semester: 0

Course Description:

An overview of entrepreneurship in general, the traits of an entrepreneur, current topics in entrepreneurship with a specific focus on pharmacy practice and patient care programs. This course will teach the participants a comprehensive set of critical skills needed to develop a profitable business project.

Course Prerequisites: Successful completion of (passing grade in) of PHRM 111, Pharmacy Practice and Professionalism.

Preference will be given to students enrolled in the Entrepreneurial Program

Teaching Methodology, Textbook, Teaching& Learning Resources: Lectures; discussions, reading and writing assignments. Email mentoring program, special events and projects. Guest speakers. REQUIRED TEXTS: The Innovator’s DNA Jeff Dyer, Hal Gregersen, and Clayton Christensen, Harvard Business Review Press ISBN # 978-1-4221-3481-8 Blogs, e-journals, and supplemental readings posted on Sakai.

Evaluation Methodology and Grading:

Attendance is expected / X required at all class sessions.

Evaluation Methodology:

The University Honor Code is an essential element in academic integrity. It is a violation of the Honor Code to give or receive information from another student during an examination, to use unauthorized sources during an examination, or to submit all or part of someone else's work or ideas as one's own. If a student violates the Honor Code, the faculty member may refer the matter to the Office of Student and Professional Affairs. If found guilty, the student may be penalized with failure of the assignment or failure of the course. The student may also be reprimanded or suspended from the University. A complete statement of the Honor Code may be found in the Student Handbook, “TIGER LORE”. Attendance is required at all class sessions.

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates:

Pharmacy Syllabus Template 2013 February

Class assignments may be retained by the instructor to assess how the learning objectives of the course are met.

The instructor may be contacted during office hours or ___x_ by email, ___x_ phone, or ___ via Sakai Pagers, cell phones, programmable, alpha-numeric, and/or graphing calculators and any other devices able to hold alpha-numeric content are not allowed in any testing area. No exceptions. Violations will result in a course grade of "F". Weighting of Assignments:

• Mid Semester Project 20% There will be one mid semester project worth 20% • End Semester Project 20% There will be an end semester project worth 20% • Assignments 40% Assignments will be class materials related, and may involve either brief

written submissions, or brief in class presentations. • Note: Assignments and Projects are considered to be “open book”, including notes, readings, and other

resources. Students are encouraged to seek the best resources to substantiate their work.

• Attendance 10% • Class participation 10%

Assignment of Grades:

A 90-100% B 80-89% C 70-79% D 65-69%

F 0-64%

Pagers, cell phones, programmable, alpha-numeric, and/or graphing calculators and any other devices able to hold alpha-numeric content are not allowed in any testing area. No exceptions. Violations will result in a course grade of "F".

Class assignments may be retained by the instructor to assess how the learning objectives of the course are met.

Additional Information:

Contacting the Instructor(s) The instructor may be contacted during office hours or ___x_ by email, ___x_ phone, or ___ via Sakai. Contact information is provided above.

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates:

Pharmacy Syllabus Template 2013 February

Accommodations for Students with Disabilities: Any student who seeks accommodations for a disability must contact the Director of the Office of Services for Students with Disabilities (SSD) for information on the evaluation and accommodation process and requirements. If the Office of Services for Students with Disabilities qualifies the student for accommodations, the student must meet with the course coordinator within the first two weeks of the semester to discuss and agree upon the nature of accommodations for the course, unless accommodations are evaluated and granted during the current semester. Accommodations are not retroactive. The Office of Services for Students with Disabilities is located in the McCaffrey Center, Rm. 137. Phone: 209-946-3221. Email: ssd@pacific.edu. Online: www.pacific.edu/disabilities.

Course Goals:

The goals of this course are to:

1. Provide students with the skills needed to demonstrate innovation and entrepreneurship in pharmacy practice.

2. Enhance student entrepreneur abilities through interactions with an “expert” pharmacy entrepreneur.

Course/Learning Objectives:

At the completion of this course, students will be able to: 1. Describe the characteristics of successful entrepreneurs. 2. Choose the most appropriate methods to monitor the status of pharmacy and healthcare

entrepreneurship. 3. Demonstrate entrepreneurship by assessing opportunities, comparing markets, evaluating channels of

distribution, developing operations plans, and describing effective methods to raise capital, manage legal issues, and build a team. Demonstrate the use of financial and managerial accounting methods when using financial statements by interpreting financial statements, and making appropriate decisions based on them.

The following general categories of Doctor of Pharmacy program performance objectives are met in a meaningful manner by this course.

__ Possess and apply pharmaceutical sciences knowledge x Perform pharmacist directed patient care x Practice in pharmacy and health care environments x Promote public health x Demonstrate professionalism, communication & interaction abilities x Problem solve and continue to learn

The following categories of University Learning Objectives are met in a meaningful manner by this course.

x Major Field Competence x Critical and Creative Thinking x Communication x Collaboration and Leadership __ Intercultural and Global Perspectives __ Ethical Reasoning

x Sustainability

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates:

Pharmacy Syllabus Template 2013 February

Topics, Activities, Tentative Schedule, etc.:

Entrepreneurship: definitions, characteristics of successful entrepreneurs Behavioral Skills for developing entrepreneurial ideas Model for generating innovative and entrepreneurial ideas Business plans, feasibility studies Market Research and Analysis Cash Flow Planning Cash Flow Analysis Income Statements Break-Even Analysis Budgeting and Assumptions Dealing with Banks Loan Proposals Financial Performance Financial Statements Ratio Analysis, Cause and Effect Management Skills, Team Building, and Motivation Human Resources Requirements and Management Business Insurance, Continuity Planning, Risk Management Growth Financing and Control Determining the Best Vendors, Channels of Procurement and Distribution. Operations and Logistics

Workflow Evaluation, Floor Plans and Layout of Businesses

Cost-Volume-Profit Relationships Percent of Sales Financial Gap Analysis Credit and Collections

Legal Issues Facing Small Businesses Branding, Copyright, Patents

Exit Strategies. An updated, detailed schedule will be provided each semester.

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates: Approved by Department: 12/1/2011, By Pharmacy Faculty 2/8/2012

Department: PRAC

Course Number: 136

Semester & Year: Spring 2012

Course Title: Entrepreneurial Pharmacy Practice

Instructor(s) and Contact Information: Dana B. Nelson, Pharm. B.S., M.S., FASCP [email:dnelson1@pacific.edu]

Units: 2

Lecture Hours per Week: 2

Lecture Weeks per /Semester: 12

Total Number of Weeks: 14 weeks (1 semester)

Laboratory Hours per Week: 0

Laboratory Weeks per Semester: 0

Maximum Enrollment per section: 50

Discussion Hours per Week: 0

Discussion Weeks per Semester: 0

Experiential Hours per Week or per Semester: 0

Experiential Weeks per Semester:

Course Description: An overview of entrepreneurship in general, the traits of an entrepreneur, current topics in entrepreneurship with a specific focus on pharmacy practice and patient care programs. This course will teach the participants a comprehensive set of critical skills needed to develop a profitable business project. Course Prerequisites:

Successful completion of (passing grade in) of PHRM 111, Pharmacy Practice and Professionalism. Preference will be given to students enrolled in the Entrepreneurial Program

Teaching Methodology, Textbook, Teaching& Learning Resources: Lectures; discussions, reading and writing assignments. Email mentoring program, special events and projects. Guest speakers. REQUIRED TEXTS: Tzu, Sun/Clavell, James, “The Art of War,” Theophonic Publishers, 2011, ISBN 97817708361 Gallo, Carmine: “The Innovation Secrets of Steve Jobs,” McGraw Hill, 2010, ISBN 978-0-07-174875-9 McGrath/MacMillan: “The Entrepreneurial Mindset: Strategies for Continuously Creating Opportunity in an Age of Uncertainty,” Harvard Business School Press, ISBN 978-0-87584-834-1 Blogs, e-journals, and supplemental readings posted on Sakai.

Evaluation Methodology:

The University Honor Code is an essential element in academic integrity. It is a violation of the Honor Code to give or receive information from another student during an examination, to use unauthorized sources during an examination, or to submit all or part of someone else's work or ideas as one's own. If a student violates the Honor Code, the faculty member may refer the matter to the Office of Student and Professional Affairs. If found guilty, the student may be penalized with failure of the assignment or failure of the course. The student may also be reprimanded or suspended from the University. A complete statement of the Honor Code may be found in the Student Handbook, “TIGER LORE”. Attendance is required at all class sessions. Class assignments may be retained by the instructor to assess how the learning objectives of the course are met. The instructor may be contacted during office hours or ___x_ by email, ____ phone, or _x__ via Sakai Pagers, cell phones, programmable, alpha-numeric, and/or graphing calculators and any other devices able to

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates: Approved by Department: 12/1/2011, By Pharmacy Faculty 2/8/2012

hold alpha-numeric content are not allowed in any testing area. No exceptions. Violations will result in a course grade of "F". Weighting of Assignments:

Examinations/Quizzes 40% There will be one midterm exam worth 20% and two quizzes each worth 10%

Projects, Presentations 40% There will be one individual project/presentation worth 15% early in the class and one group project/presentation at the culmination worth 25% See the attached rubrics for business plan presentations and oral presentations. Attendance 10% Class participation 5% Mentor/Mentee Participation 5% Assignment of Grades:

A 90-100% B 80-89% C 70-79% D 65-69% F 0-64%

Course Goals:

The goals of this course are to: 1. Provide students with the skills needed to demonstrate innovation and entrepreneurship in

pharmacy practice. 2. Enhance student entrepreneur abilities through interactions with an “expert” pharmacy

entrepreneur.

Course/Learning Objectives:

At the completion of this course, students will be able to: 1. Describe the characteristics of successful entrepreneurs. 2. Choose the most appropriate methods to monitor the status of pharmacy and healthcare

entrepreneurship. 3. Demonstrate entrepreneurship by assessing opportunities, comparing markets, evaluating channels of

distribution, developing operations plans, and describing effective methods to raise capital, manage legal issues, and build a team.

4. Demonstrate the use of financial and managerial accounting methods when using financial statements by interpreting financial statements, and making appropriate decisions based on them.

Topics, Activities, Tentative Schedule, etc.:

Entrepreneurship: definitions, characteristics of successful entrepreneurs Generational Awareness and Sharing of Knowledge Financial Performance Financial Statements Ratio Analysis, Cause and Effect Cost-Volume-Profit Relationships Income Statements Break-Even Analysis Cash Flow Planning Cash Flow Analysis Budgeting and Assumptions Growth Financing and Control

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates: Approved by Department: 12/1/2011, By Pharmacy Faculty 2/8/2012

Percent of Sales Financial Gap Analysis Dealing with Banks Loan Proposals Credit and Collections Business plans, feasibility studies Legal Issues Facing Small Businesses Business Insurance, Continuity Planning, Risk Management Branding Market Research and Analysis Operations and Logistics Management Skills, Team Building, and Motivation Human Resources Requirements and Management Determining the Best Vendors, Channels of Procurement and Distribution. Workflow Evaluation, Floor Plans and Layout of Businesses

Exit Strategies.

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences

Course Approval & Revision Dates: Approved 9/25/08, Revised 10/21/08

Department: PHRM

Course Number: 161

Semester & Year: Spring

Course Title: Pharmacy Management and Finance

Instructor(s): Peter E. Hilsenrath, Ph.D., Joseph A. Woelfel, Ph.D., R.Ph., FASCP (Course Coordinator)

Units: 2

Lecture Hours per Week: 2

Lecture Weeks per /Semester: 12

Total Number of Weeks: 14 weeks (1 semester)

Laboratory Hours per Week: 0

Laboratory Weeks per Semester: 0

Maximum Enrollment per section: 225

Discussion Hours per Week: 0-2

Discussion Weeks per Semester: 6-8

Experiential Hours per Week or per Semester: 0

Experiential Weeks per Semester: 0

Course Description: An analysis of human resource management and financial management principles applicable to pharmacy practice. Course Prerequisites:

Successful completion of (passing grade in) all required courses in Semesters 1 to 5 in the Doctor of Pharmacy program

Teaching Methodology, Textbook, Teaching& Learning Resources: Lectures; discussions, reading and writing assignments.

REQUIRED TEXTS: Desselle & Zgarrick, "Pharmacy Management: Essentials for All Practice Settings,” 3rd edition (ISBN: 978-0071494366) (online: AccessPharmacy)

Warholak & Nau, “Quality and Safety in Pharmacy Practice,” (2010) (online: AccessPharmacy)

Cohen “Medication Errors,” (2007) (online: APhA PharmacyLibrary)

Evaluation Methodology: The University Honor Code is an essential element in academic integrity. It is a violation of the Honor Code to give or receive information from another student during an examination, to use unauthorized sources during an examination, or to submit all or part of someone else's work or ideas as one's own. If a student violates the Honor Code, the faculty member may refer the matter to the Office of Student and Professional Affairs. If found guilty, the student may be penalized with failure of the assignment or failure of the course. The student may also be reprimanded or suspended from the University. A complete statement of the Honor Code may be found in the Student Handbook, “TIGER LORE”. Accommodations for Students with Disabilities: Any student who seeks accommodations for a disability must contact the Director of the Office of Services for Students with Disabilities (SSD) for information on the evaluation and accommodation process and requirements. If the Office of Services for Students with Disabilities qualifies the student for accommodations, the student must meet with the course coordinator within the first two weeks of the semester to discuss and agree upon the nature of accommodations for the course, unless accommodations are evaluated and granted during the current semester. Accommodations are not retroactive. The Office of Services for Students with Disabilities is located in the

COURSE SYLLABUS

McCaffrey Center, Rm. 137. Phone: 209-946-3221. Email: ssd@pacific.edu. Online: www.pacific.edu/disabilities

Attendance is expected at all class sessions. Class assignments may be retained by the instructor to assess how the learning objectives of the course are met.

The instructors may be contacted during office hours or by email philsenrath@pacific.edu or phone 209.946.2642 and jwoelfel@pacific.edu 209 946 2374.

Pagers, cell phones, programmable, alpha-numeric, and/or graphing calculators and any other devices able to hold alpha-numeric content are not allowed in any testing area. No exceptions. Violations will result in a course grade of "F".

Weighting of Assignments:

Midterm Examination 35% Final Examination 35% Assignments 30%

Assignment of Grades:

A 90-100% B 80-89% C 70-79% D 65-69% F 0-64%

Any concern regarding grades (quizzes, midterm and/or final) must be resolved within 5 days of the assignment/quiz/exam.

The following general categories of Doctor of Pharmacy program performance objectives are met in a meaningful manner by this course. X Possess and apply pharmaceutical sciences knowledge X Perform pharmacist directed patient care X Practice in pharmacy and health care environments X Promote public health X Demonstrate professionalism, communication & interaction abilities X Problem solve and continue to learn The following categories of University Learning Objectives are met in a meaningful manner by this course. X Major Field Competence X Critical and Creative Thinking X Communication X Collaboration and Leadership X Intercultural and Global Perspectives X Ethical Reasoning X Sustainability

Course Goals: The goals of this course are to:

1. Demonstrate understanding of basic principles of human resources management, patient safety, quality management and organizational management.

2. Understand basic financial management principles that are relevant for pharmacists. 3. Demonstrate critical thinking and problem solving skills.

COURSE SYLLABUS Course Objectives:

At the completion of this course, students will be able to: 1. Understand and apply important concepts of organizational management including patient safety, quality management, organizational g

setting, and mission, vision, value concepts. 2. Discuss human resource theories and practices, labor law and professional development. 3. Describe how to attract and retain employees, involve employees in organizational-departmental goals and conduct objective

performance reviews. 4. Compare a balance sheet, income statement and capital statement. 5. Perform financial statement analysis and its application to day-to-day personal and business finance. 6. Compare planning and budgeting concepts and their application to capital & operational budgets. 7. Identify and apply inventory control techniques, including group purchasing, organization participation, just-in-time inventory, and con

substances diversion control. 8. Perform break-even analysis and differential analysis and their application to pharmacy services.

Discuss capital investment decision-making and cash flow theories. 9. Discuss entrepreneurship.

Topics, Activities, Tentative Schedule, etc.: Instructors: Peter E. Hilsenrath, Ph.D. (philsenrath@pacific.edu); Joseph A. Woelfel, RPh, MS, Ph.D., FASCP (course coordinator) (jwoelfel@pacific.edu)

Lecture Location: PHS 115 Wednesday 10AM – 12 Noon Discussion Location: PHS 115 Thursday 10AM – 12 Noon – will be scheduled

as needed to augment lecture presentations and content Reading Code:

Desselle & Zgarrick, "Pharmacy Management: Essentials for All Practice Settings,” 3rd edition (ISBN: 978-0071494366) (online: AccessPharmacy); Warholak & Nau, “Quality and Safety in Pharmacy Practice,” (2010) (online: AccessPharmacy); Cohen “Medication Errors,” (2007) (online: APhA PharmacyLibrary)

Week Date Required Reading*

Lectures

1 4/24

D Ch. 3 Introduction and Personal Finance (Hilsenrath)

2 5/1

D Ch. 17

Khan videos1,2,3,4 posted Sakai (not required)

Financial Reporting: Income Statements, Balance Sheets, Cash Flow (Hilsenrath)

3 5/8 D Ch. 30 Entrepreneurship & Innovation in Pharmacy Practice (Collum)

4 5/15 D Ch. 17 Financial Statement Analysis Ratio Analysis: Profitability, Performance, Solvency, Liquidity (Hilsenrath)

5 5/22 Carroll Ch. 8,9 posted on Sakai, D 19 Managerial Accounting: Break Even Analysis,

Differential Analysis (Hilsenrath)

6 5/29 D Ch. 20 Financial Management and Health Insurance (Hilsenrath)

7 6/3 - 6/7 MIDTERMS

8 6/12 D Ch. 4,11 Organizational Management, Strategic Planning,

People, Communication (Woelfel)

9 6/19 D Ch. 12, 13, 15 How to Manage, ABC's, Empowerment, Customer Service, Performance (Woelfel)

COURSE SYLLABUS

10 6/26 D Ch. 27, 28, 29

C Ch. 5, 21 Risk, Risk Management, Patient Safety & EHR in Pharmacy Practice (Woelfel)

11 7/3 D Ch. 8 W Ch. 7,8 Continuous Quality Improvement in Pharmacy Practice

(Woelfel)

12 7/10

D Ch. 18

Budgets and the Management Dashboard (Woelfel)

13 7/17 D Ch. 23 Controlling Inventory and Diversion (Woelfel)

14 7/25 – 7/31 FINALS

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates: Revised 5/21/2010, Approved by Pharmacy Faculty 7/22/2010

Department:

PRAC Course Number:

156 Semester & Year:

Course Title:

Opportunities in Pharmacy Practice Instructor(s):

Ed Sherman Units:

1 to 2 Lecture Hours per Week:

0-2 Lecture Weeks per /Semester:

Up to 13 Total Number of Weeks:

14 weeks (1 semester) Laboratory Hours per Week:

0 Laboratory Weeks per Semester:

0 Maximum Enrollment per section:

30 Discussion Hours per Week:

0-2 Discussion Weeks per Semester:

Up to 13 Experiential Hours per Week or per Semester:

0 Experiential Weeks per Semester:

0 Course Description:

This course is designed to provide the students the personal and business tools to make the transition from the academic environment to the daily practice of pharmacy now and in the future, with an emphasis on entrepreneurship.

Course Prerequisites: Doctor of Pharmacy student

Teaching Methodology, Textbook, Teaching& Learning Resources: All students must attend all class sessions and participate in class oral discussions Oral presentations (article presentations) • Students taking the course for one unit will be required to give one oral presentation with documentation

dealing with the Profession and / or Business of Pharmacy during the semester. • Students taking the course for 2 units will be required to present 2 oral presentations during the semester. All students must complete and present a business plan. • Students taking the course for one unit can present as teams, with up to 4 members per team. • Students taking the course for 2 units can have no more than 2 members on Business Plan team. Lecture on being emotionally, professionally and financially successful in a current pharmacy practice. We will discuss what pharmacists will be doing in the future and how we can lead the way for the changes that are coming. Students will have the opportunity to interact with guest speakers on business and professional issues.

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates: Revised 5/21/2010, Approved by Pharmacy Faculty 7/22/2010

Evaluation Methodology:

The University Honor Code is an essential element in academic integrity. It is a violation of the Honor Code to give or receive information from another student during an examination, to use unauthorized sources during an examination, or to submit all or part of someone else's work or ideas as one's own. If a student violates the Honor Code, the faculty member may refer the matter to the Office of Student and Professional Affairs. If found guilty, the student may be penalized with failure of the assignment or failure of the course. The student may also be reprimanded or suspended from the University. A complete statement of the Honor Code may be found in the Student Handbook, “TIGER LORE”. Attendance is required at all class sessions. Class assignments may be retained by the instructor to assess how the learning objectives of the course are met. The instructor may be contacted during office hours or by email. Weighting of Assignments:

Class discussions 25% Article presentations 25% Business Plan 50% Attendance is required at each course session

Assignment of Grades:

Pass Must attend each session of the course Actively participate in discussions (70% or higher) Presentations completed on time and competently (70% or higher) Complete and present an appropriate business plan (70% or higher)

No Credit Failure to satisfactorily complete any of the above requirements (at a level less than 70%)

Pagers, cell phones, programmable, alpha-numeric, and/or graphing calculators and any other devices able to hold alpha-numeric content are not allowed in any testing area. No exceptions. Violations will result in a course grade of "F".

Course Goals:

The goals of this course are to: 1. To provide the tools and logic skills to help students ascertain their career path and goals. 2. To acquaint the student with an overview of the structure or the profession in today’s and tomorrows

world. 3. To acquaint the student with the various opportunies available to them in the profession now and in the

future. 4. To acquaint the student with the business dynamics affecting the workplace structure and culture. 5. To acquaint the student with intrapreneur and entrepreneur mechanics in relation to traditional and

non-traditional pharmacy roles. 6. To equip student with the ability to effectively and confidently communicate their ideas with dialogue

that will create a successful career path.

COURSE SYLLABUS

University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences Course Approval & Revision Dates: Revised 5/21/2010, Approved by Pharmacy Faculty 7/22/2010

Course Objectives:

At the completion of this course, students will be able to: 1. Identify personal qualities and attributes affecting career choices. 2. Understanding of the entrepreneur and intrapreneur concepts. 3. Identify career options current and future. 4. Understand and recognize motivational theories affecting the daily and long term pharmacy practice. 5. Construct a future pharmacy practice paradigm of innovative practices 6. Describe, understand and design pharmacy marketing techniques. 7. Understand and identify tools for professional and economic success as related to personal and ethical

success. 8. Describe the elements of effective communication 9. Describe elements of managerial structure. 10. Describe elements necessary to effectively participate in the pharmacy business culture.

Topics, Activities, Tentative Schedule, etc.: 1. Where am I and where am I going a self analysis. 2 Business structure.

A. Chain B. Independent C. On line D. Hospital E. Industrial F. Others

3. Entrepreneurship and intrapreneurship. 4. Coloring outside the lines

A. Innovative professional and business practices for the future of pharmacy B. Safety zone (security, paycheck) vs. outside the line (risk takers)

5. Marketing techniques Realistic goals, not limits, and how to attain them

6. Communication A. Techniques and management of staff. B. Dealing with patients and payers C. Communicating with other professions

7. Guest speakers and class participation groups.

An updated, detailed schedule will be provided each semester.

GOOD NEIGHBOR PHARMACY/THOMAS J. LONG SCHOOL OF PHARMACY AND HEALTH SCIENCES

ENTREPRENEURIAL PHARMACY PRACTICE PROGRAM BOARD OF GOVERNORS August 22, 2013

Providing a guided mentoring relationship...

The primary goal of the Ementor is to help the mentee develop a distinct competitive advantage facilitated by the sharing of the ementor’s business experience and knowledge.

A career-oriented program designed to help students enrolled in the Entrepreneurial Pharmacy Practice Program gain valuable information about the actual working environment of a pharmacy.

Criteria and Responsibilities of Ementors

The primary goal of the Ementor is to help the mentee develop a distinct competitive advantage facilitated by the sharing of the ementor’s business experience and knowledge.

Ementoring is a means of providing a guided mentoring relationship using online software or email. The ementoring program is a career-oriented program designed to help students enrolled in the Entrepreneurial Pharmacy Practice Program gain valuable information about the actual working environment of a pharmacy. Criteria and characteristics of a great ementor:

• Ability to listen actively • Ability to ask probing questions to stimulate deeper discussion • Willingness to share personal learning experiences • Ability to co-create development goals and action learning activities • Willingness to engage in the development of the mentee • Have personal and professional influence and connections • Provide the mentee with a sense of feeling focused upon and valued • Maintain the focus of the mentee

Ementors have the following responsibilities:

• Communicating effectively with the mentees by conducting monthly virtual meetings and discussing provided standardized evaluation questions

• Providing guidance based on prior experiences, sharing successes and failures • Creating a positive mentoring relationship and a climate of open communication • Offering constructive criticism in a supportive way • Being honest about business associations and associates • Being prepared to discuss career-related issues • Soliciting feedback from the mentee

Acting as a role model, confidant, and coach • Maintaining mentor – mentee confidentiality • Leading by example • Participating in mentor training supported by the Thomas J. Long School of Pharmacy and Health Sciences • Working with the Faculty Chair to organize the ementor/mentee experience

Near the end of the assigned time for the ementor/mentee pairing, the ementor should make the mentee aware that their mentoring relationship will be coming to an end and provide the mentee the opportunity to say goodbye.

Criteria and Responsibilities of Preceptors

Preceptors should, in general, fulfill these criteria and responsibilities:

• Possess current pharmacist license in good standing or other acceptable credential related to their practice

• Possess professional competency, high standards of ethics, excellent character, and an attitude appropriate for the presence of student

• Have practiced in their specific area for a minimum of one year • Be respected by peers and provide a high quality pharmacy practice that is well received by

healthcare professionals and patients • Have a professional history of innovative practice and entrepreneurship • Use clinical and other appropriate literature to provide an evidence-based practice. Keep

abreast of and be attuned to trends in pharmacy practice and health care. • Be receptive to new roles of pharmacy practice and the provision of patient-centered care in

their practice setting • Interact with other healthcare professionals • Be committed to the profession through membership in professional organizations • Contribute to the mission of the Good Neighbor Pharmacy Entrepreneurial Pharmacy

Practice Program at the Thomas J. Long School of Pharmacy and Health Sciences • Complete the appropriate preceptor training modules located in The Preceptor Home of The

Pharmacist’s Letter

Criteria and Responsibilities of Practice Sites

Practice sites, in general, should fulfill these criteria and responsibilities:

• Meet all state and federal laws related to the practice of pharmacy • Provide a site equipped with the technology needed to reflect contemporary practice and to support

student training • Be clean, organized, and well managed • Conduct patient care and business in an ethical manner • Provide an adequate patient population based on the learning objectives for the rotation • Have sufficient work volume and working space to facilitate learning • Ensure that the student has daily contact with the preceptor or a qualified designee to receive feedback

and have opportunities to ask questions. • Provide access to onsite and online learning resources • Have a commitment to the education of pharmacy students • Enable student activities and experiences that meet the learning objectives of the entrepreneurial focus. • Have management that is supportive of professional staff involvement in the education of pharmacy

students • Provide space for the student’s personal belongings • Provide time for the student’s breaks/meals • Provide parking access • Execute a written affiliation agreement with the Thomas J. Long School of Pharmacy and Health Sciences

Affiliation Agreement between Pharmacy and Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific 1 of 4

AFFILIATION AGREEMENT This AGREEMENT made and entered into [date], by and between [legal name of pharmacy], hereinafter designated as “Pharmacy” and the University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences, 3601 Pacific Avenue, Stockton, California 95211, hereinafter designated as “the University”: WITNESSETH:

WHEREAS, it is the purpose of this Agreement to establish an Affiliation between the University and Pharmacy to provide, mutually, educational experiences and programs for students duly enrolled at the University of the Pacific School of Pharmacy and Graduate School and the professional staff of said Pharmacy; and,

WHEREAS, the Board of Regents of the University of the Pacific has established an approved professional program of training in community pharmacy which program requires facilities wherein students enrolled in the respective programs can obtain training in the field of community pharmacy; and,

WHEREAS, Pharmacy, has defined education and training in the care professions as objectives; and,

WHEREAS, the facilities and professional staff of the two institutions, through their mutual contributions within the context of the Agreement, are committed to the continuous improvement of health care delivery by providing expanded educational and training programs in community pharmacy; and,

WHEREAS, facilities of Pharmacy furnish a resource essential to the implementation of those commitments.

NOW, THEREFORE, it is mutually covenanted and agreed by and between Pharmacy and the University as follows: 1. Pharmacy will:

A. Make available its facilities for the students enrolled in the basic professional pharmacy program at the University and who are designated by the University for such learning experience.

B. Maintain the facilities at Pharmacy according to California State laws and the applicable

standards mandated by the California State Board of Pharmacy, to ensure that the facility conforms to said laws and standards.

C. Establish with the Director of Pharmacy, in collaboration with the Director of Clinical

Experience Programs at the University, the program and specific areas to be included in that learning experience.

D. Maintain pharmacy services without reliance on assigned students.

Affiliation Agreement between Pharmacy and Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific 2 of 4

E. Appropriate space for safeguarding of personal belongings, such as clothing, purses, and textbooks.

F. Permit, on reasonable request, the inspection of facilities by agencies charged with the

responsibility for accreditation of the University of the Pacific School of Pharmacy and Graduate School.

2. The University will:

A. Contact the Director of Pharmacy prior to the start of clinical rotations to gain agreement on the number of students to be assigned at one time to Pharmacy for training.

B. Supervise, in liaison with the Pharmacy Director and Division of Education, all

instruction and learning experiences given at Pharmacy.

C. Provide and be responsible for the care and control of educational supplies and educational equipment necessary for instruction, including audiovisual equipment and supplies which are not customarily available at Pharmacy.

D. Provide access to laboratory facilities of the School of Pharmacy as required in the joint

cooperation of the two institutions in accomplishing the goals set forth in the Agreement.

E. Be responsible for keeping all attendance and academic record of the students.

F. Be responsible for physical examination, tuberculin testing, professional liability

insurance, and such other protective measures as Pharmacy and University mutually agree to be necessary.

G. Maintain and provide upon request documentation that all students assigned to

Pharmacy have adequate personal medical insurance to provide for their treatment in the event of illness or injury while on the premises of Pharmacy or while participating in a clinical experience under this Agreement.

H. Require every student to conform to all applicable Pharmacy policies, procedures, and

regulations, and all requirements and restrictions specified jointly representatives of the University and Pharmacy.

I. In cooperation with Dr. Allen Shek, director of Advanced Pharmacy Practice

Experience, arrange for periodic conferences between representatives of the University and the Pharmacy to evaluate the community pharmacy practice program under this Agreement.

3. Pharmacy and the University shall:

A. Be subject to the requirements and restrictions specified jointly by representatives of Pharmacy and the University, with respect to the rules and regulations of the respective

Affiliation Agreement between Pharmacy and Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific 3 of 4

institutions governing conduct. B. Be provided with the number of participants to be assigned, the dates and hours they

will be assigned, and the areas to which they will be assigned, by the beginning of each training period.

C. Pharmacy shall provide a Pharmacy Preceptor with responsibility for organizing,

supervising, and monitoring educational programs in community pharmacy within Pharmacy.

D. Retain the right individually to approve before release any publication by students and

faculty or staff members of any material relative to projects undertaken under the terms of this Agreement.

E. Follow appropriate procedures to ensure that privileged institution information and

patient confidentiality are not compromised, in accordance with applicable confidentiality laws and institutional policies. Reference Exhibit A, Business Associate Obligations, with respect to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).

4. The University will hold Pharmacy harmless for any and all claims and causes of actions which

students or instructors of the University may have or assert against Pharmacy on account of illness, injury to their persons, or damage to their property while on the premises of Pharmacy or while participating in the program described by this Agreement, which may result in Workman's Compensation, malpractice, or other claims and actions, except those caused by the wrongful or negligent acts or omissions of Pharmacy and its officers, employees, or agents.

5. Pharmacy will hold the University harmless from any and all claims and causes of actions which

employees of Pharmacy may have or assert against the University on account of illness, injury to their persons, or damage to their property while on the premises of Pharmacy or while participating in a community pharmacy experience under this Agreement, except those caused by the wrongful or negligent acts or omissions of the University and its officers, employees, students or agents.

6. Each party shall extend its usual worker's compensation insurance to cover all employees who

are participating in the Programs at Pharmacy. The parties hereto agree that University's students are fulfilling specific requirements for pharmacy practice experiences as part of a degree requirement. Therefore, University's students are not to be considered employees of the University or Pharmacy for purposes of worker's compensation, employee benefit programs or any other purpose.

7. A. The University warrants that it carries policies of insurance placed with reputable insurance

companies licensed to do business in the State of California which insure against the perils of bodily injury, personal injury, malpractice, and property damage, and covers such liabilities as are imposed by law. The University shall continue to maintain such insurance in full force and effect during the term of this agreement and carry a limit of liability of at least one million dollars ($1,000,000) per incident and three million dollars ($3,000,000) aggregate.

Affiliation Agreement between Pharmacy and Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific 4 of 4

B. The Pharmacy warrants that it carries policies of insurance placed with reputable insurance companies licensed to do business in the State of California which insure against the perils of bodily injury, personal injury, malpractice, and property damage, and covers such liabilities as are imposed by law. The Pharmacy shall continue to maintain such insurance in full force and effect during the term of this agreement and carry a limit of liability of at least one million dollars ($1,000,000) per incident and three million dollars ($3,000,000) aggregate.

8. This Agreement shall be effective [date], and shall continue until either the University or

Pharmacy determines that Agreement should be discontinued and gives a 30 day notice of such a determination.

IN WITNESS WHEREOF, we have hereunto subscribed our names effective [date].

[legal name of pharmacy] [mailing address] Contact: By ____________________________________________________

(Print Name & Title) ______________________________________________

By ____________________________________________________

(Print Name & Title) ______________________________________________

Hereinabove referred to as “Pharmacy”

THE UNIVERSITY OF THE PACIFIC Thomas J. Long School of Pharmacy and Health Sciences 3601 Pacific Avenue, Stockton, CA 95211 Contact: Dr. Allen Shek, Vice Chair, Department of Pharmacy Practice, 209-946-2301

By ____________________________________________________

Patrick Cavanaugh, J.D. Vice President for Finance

Hereinabove referred to as “the University”

University of the Pacific Thomas J. Long School of Pharmacy & Health Sciences

1

HOSPITAL AFFILIATION AGREEMENT

This AGREEMENT made and entered into this _____ day of ___________, _____, by and between (HOSPITAL) __________________________________________, hereinafter designated as “the HOSPITAL” and University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences, 3601 Pacific Avenue, Stockton, CA 95211, hereinafter designated as “the UNIVERSITY”: WITNESSETH:

WHEREAS, it is the purpose of this Agreement to establish an Affiliation between the UNIVERSITY and the HOSPITAL to provide, mutually, educational experiences and programs for students duly enrolled at University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences and the professional staff of said HOSPITAL; and,

WHEREAS, the Board of Regents of University of the Pacific has established an approved professional program of training in clinical pharmacy which program requires clinical facilities wherein students enrolled in the respective programs can obtain the clinical learning experience needed in the curricula for those studies; and,

WHEREAS, the HOSPITAL, has defined education in the health care professions as one of its missions; and,

WHEREAS, the facilities and professional staff of the two institutions, through their mutual contributions within the context of the Agreement, are committed to the continuous improvement of health care delivery by providing expanded educational programs and supportive research, and,

WHEREAS, clinical facilities of the HOSPITAL and research facilities of the UNIVERSITY furnish two of the resources essential to the implementation of those commitments.

NOW, THEREFORE, it is mutually covenanted and agreed by and between the HOSPITAL and the UNIVERSITY as follows: 1. The HOSPITAL will:

A. Make available the clinical and related facilities of the HOSPITAL needed for the clinical learning experience in clinical pharmacy for the students enrolled in the basic professional pharmacy program at the UNIVERSITY and who are designated by the UNIVERSITY for such learning experience.

B. Maintain the clinical facilities at the HOSPITAL in conformance with the standards

required by the Joint Commission on Accreditation of Healthcare Organizations, and such other requirements to insure that the facility is an accredited institution.

C. Establish with the Director of Pharmacy, in collaboration with the Director of Clinical Experience Programs at the UNIVERSITY, the program and specific areas to be included in that learning experience.

University of the Pacific Thomas J. Long School of Pharmacy & Health Sciences

2

D. Provide whenever possible in connection with such clinical experience the following accommodation at the HOSPITAL for the teachers and students taking part in the program.

1. Access to library facilities.

2. Class or conference rooms that are determined to be reasonably

necessary.

3. Appropriate space for safeguarding of personal belongings, such as clothing, purses, and textbooks.

4. Access to cafeteria services as normally available to the HOSPITAL

personnel.

E. Provide opportunity for research in medical and pharmaceutical sciences through joint collaboration between the medical staff of the HOSPITAL and the graduate faculty of the School of Pharmacy.

F. Permit, on reasonable request, the inspection of clinical and related facilities by

agencies charged with the responsibility for accreditation of the UNIVERSITY of the Pacific School of Pharmacy and Graduate School.

2. The UNIVERSITY will:

A. Contact the Director of Pharmacy prior to the start of clinical rotations to gain agreement on the number of students to be assigned at one time to the HOSPITAL for training.

B. Supervise, in liaison with the Administration of the HOSPITAL, Director, Division

of Education, and Director of Pharmacy, all instruction and learning experiences and clinical experiences given at the HOSPITAL.

C. Provide and be responsible for the care and control of educational supplies and

educational equipment necessary for instruction, including audiovisual equipment and supplies which are not customarily available at the HOSPITAL.

D. Provide access to laboratory facilities of the School of Pharmacy as required in the

joint cooperation of the two institutions in accomplishing the goals set forth in the Agreement.

E. Be responsible for keeping all attendance and academic record of the students.

F. Be responsible for physical examination, tuberculin testing, professional liability

insurance, and such other protective measures as the HOSPITAL and UNIVERSITY mutually agree to be necessary.

University of the Pacific Thomas J. Long School of Pharmacy & Health Sciences

3

G. Maintain and provide upon request documentation that all students assigned to the HOSPITAL have adequate personal medical insurance to provide for their treatment in the event of illness or injury while on the premises of the HOSPITAL or while participating in a clinical experience under this Agreement.

3. The HOSPITAL and the UNIVERSITY shall:

A. Be subject to the requirements and restrictions specified jointly by representatives of the HOSPITAL and the UNIVERSITY, with respect to the rules and regulations of the respective institutions governing conduct.

B. Be provided with the number of participants to be assigned, the dates and hours they

will be assigned, and the areas to which they will be assigned, by the beginning of each training period.

C. the HOSPITAL shall provide a Clinical Pharmacy Preceptor with responsibility for

organizing, supervising, and monitoring educational programs in clinical pharmacy within the HOSPITAL.

D. Retain the right individually to approve before release any publication by students

and faculty or staff members of any material relative to projects undertaken under the terms of this Agreement.

E. Follow appropriate procedures to ensure that privileged institution information and

patient confidentiality are not compromised, in accordance with applicable confidentiality laws and institutional policies. Refer to Exhibit A, Business Associate Obligations.

4. The UNIVERSITY will hold the HOSPITAL harmless for any and all claims and causes of

actions which students or instructors of the UNIVERSITY may have or assert against the HOSPITAL on account of illness, injury to their persons, or damage to their property while on the premises of the HOSPITAL or while participating in a clinical experience under this Agreement, which may result in Workman's Compensation, malpractice, or other claims and actions, except those caused by the wrongful or negligent acts or omissions of the HOSPITAL and its officers, employees, or agents.

5. The HOSPITAL will hold the UNIVERSITY harmless from any and all claims and causes of

actions which employees of the HOSPITAL may have or assert against the UNIVERSITY on account of illness, injury to their persons, or damage to their property while on the premises of the HOSPITAL or while participating in a clinical experience under this Agreement, except those caused by the wrongful or negligent acts or omissions of the UNIVERSITY and its officers, employees, students or agents.

6. Each party shall extend its usual worker's compensation insurance to cover all employees

University of the Pacific Thomas J. Long School of Pharmacy & Health Sciences

4

who are participating in the Programs at the Clinical Facilities. The parties hereto agree that the UNIVERSITY's students are fulfilling specific requirements for clinical experiences as part of a degree requirement. Therefore, the UNIVERSITY's students are not to be considered employees of the UNIVERSITY or the HOSPITAL for purposes of worker's compensation, employee benefit programs or any other purpose.

7. A. The UNIVERSITY warrants that it carries policies of insurance placed with reputable

insurance companies licensed to do business in the State of California which insure against the perils of bodily injury, personal injury, malpractice, and property damage, and covers such liabilities as are imposed by law. The UNIVERSITY shall continue to maintain such insurance in full force and effect during the term of this agreement and carry a limit of liability of at least one million dollars ($1,000,000) per incident and three million dollars ($3,000,000) aggregate.

B. The Hospital warrants that it carries policies of insurance placed with reputable insurance

companies licensed to do business in the State of California which insure against the perils of bodily injury, personal injury, malpractice, and property damage, and covers such liabilities as are imposed by law. The Hospital shall continue to maintain such insurance in full force and effect during the term of this agreement and carry a limit of liability of at least one million dollars ($1,000,000) per incident and three million dollars ($3,000,000) aggregate.

8. This Agreement shall be effective (date)___________ and shall continue until either the

UNIVERSITY or the HOSPITAL determines that Agreement should be discontinued and gives a 30 day notice of such a determination. Notices shall be sent to:

Facility ___________________________ Name_____________________________ Title _____________________________ Date _______________________________

UNIVERSITY of the Pacific THOMAS J. LONG SCHOOL OF PHARMACY & HEALTH SCIENCES

Pharmacy Practice Experience 3601 Pacific Avenue Stockton, CA 95211 T 209-946-7754, F 209-946-2868

University of the Pacific Thomas J. Long School of Pharmacy & Health Sciences

5

IN WITNESS WHEREOF, we have hereunto subscribed our names effective ____________. By ____________________________________________________

(Print Name & Title) ______________________________________________

By ____________________________________________________

(Print Name & Title) ______________________________________________

Hereinabove referred to as "the HOSPITAL"

THE UNIVERSITY OF THE PACIFIC Thomas J. Long School of Pharmacy and Health Sciences 3601 Pacific Avenue, Stockton, CA 95211

By ____________________________________________________

Patrick Cavanaugh, J.D. Vice President for Finance

Hereinabove referred to as "the UNIVERSITY"