Empowering Pharmacists to Use Their Training Can Help Patients, Expert Says

In an interview with Pharmacy Times^®, Madeline Camejo, MS, PharmD, vice president and chief pharmacy officer at Baptist Health South Florida, emphasizes the strategic vision for pharmacy services, focusing on pharmacist integration, operational efficiencies, compliance, innovation, and clinical program development. She advocates for pharmacists to lead in nontraditional roles, leveraging artificial intelligence (AI) to enhance their roles rather than replace them. Additionally, Camejo highlights the need for unified advocacy and clear business plans linked to Centers for Medicare & Medicaid Services (CMS) to recognize pharmacists' contributions while calling for reimbursement for preventative services, aligning payments with outcomes, and empowering pharmacists to optimize therapeutic interventions and improve patient access.

Pharmacy Times: Can you introduce yourself and describe your role as a chief pharmacy officer?

Madeline Camejo, MS, PharmD: My name is Madeline Camejo, I'm the chief pharmacy officer at Baptist Health South Florida, and my role really is to set the strategic vision for pharmacy services and prioritize pharmacist integration. Operational efficiencies are really important, compliance and, most importantly, innovation. I think my responsibility also includes developing clinical programs, leveraging technology, mentoring staff. I think aligning pharmacy goals with the broader health care system goals to improve patient access, safety, and outcomes. I think those are really important, but I really consider [the] most important part of my job is to develop pharmacists into strong leaders, encourage creativity, and really help them advance the field of pharmacy.

Pharmacy Times: As chief pharmacy officer, how might you help shape pharmacists into leadership positions?

Camejo: For me, leadership is really about enabling pharmacists to lead, creating opportunities in kind of nontraditional pharmacist roles, like business analytics, informatics, population health, and even in preventative care. I think to prepare for tomorrow's challenges, both mentorship and executive inclusion, are really essential. Nationally we need to influence—what I believe we need to influence—by starting to foster local leadership skills throughout all our pharmacy sectors.

Pharmacy Times: Technology is continuing to advance, with AI becoming a prominent aspect of new developments. How might pharmacists use AI and machine learning as a tool within practice? Do you foresee any drawbacks?

Camejo: Well, I believe AI isn't meant to replace pharmacists but to enhance their roles. Imagine AI capturing the thousands of patient questions pharmacists answer daily that go today, currently undocumented. But even streamlining prior authorizations, flagging drug interactions, or preventing dosing errors in real time. I know some of that is done with the [electronic health records] today, but if you can capture ahead of time before pharmacists meet with patients and really streamline that workflow, I think it would be amazing. And I think this will allow pharmacists to focus more on patient care, and AI effectiveness will really rely on ethical training and smooth integration into clinical workflows. I think tech companies should be more transparent and help support the pharmacist–patient relationship during implementation and not weaken it or sell it as a replacement.

Pharmacy Times: Previously, you have been vocal about provider status. For what reasons do you think it has yet to move forward internationally?

Camejo: I think the problem is that provider status has stalled due to the fragmented advocacy in our space and the limited recognition of pharmacists' impact. I think physician groups worry about scope creep, while payers and policy makers really lack the complete economic view, and I think evidence like The Asheville Project, which showed managed care saves about $4 for every $1 spent on pharmacist-managed care services, yet our current attribution models credit the physicians for those services and not the pharmacists. We need a unified advocacy, and a clear business plan linked back to CKS Star Ratings, and reimbursement for preventative services [is] going to be needed to make that progress.

Pharmacy Times: Can you describe any necessary innovations, initiatives, or proposals that, if implemented, could influence pharmacists in all settings?

Camejo: The problem is the proposals need to focus on ensuring recognition actually reflects the actual practice. Pharmacists provide services today, including blood pressure management, diabetes, A1c monitoring, smoking cessation, weight management, and even vaccinations at point of care. Many of the retail pharmacies do that today; however, these services are not consistently reimbursed at the provider level because those contributions are invisible to CMS, and they are credited under a physician's NPI in many of our clinical services. I think nearly 90% of chronic disease is preventable, but with patients averaging 20 minutes in a primary care visit, I don't think prevention is really happening at that scale, and I think pharmacists, who are accessible to 90% of Americans within a 5-mile radius, are the logical extension of preventative care workforce.

So, let's give patients faster access to prevention services and align payments with the outcomes pharmacists already can deliver. I mean, we've seen the impact when pharmacists are empowered; why not create a national payment model by directly reimbursing pharmacists for that preventative care services for all health care systems? It will mean lowering the readmission rate, improving star ratings, reducing total cost of care, and then having a more sustainable workforce. And for physician practices, what it will do—I think—it will reduce physician burnout and create more access for new patients that today wait months to see a primary care doctor.

Pharmacy Times: Some health care groups say pharmacists should not be interpreting labs or being paid for preventative services as part of chronic care management because those are roles reserved for other health care professionals. What is your response?

Camejo: I think the concern often raised is that pharmacists would be stepping into roles meant only for physicians. The reality is different. I think pharmacists are not asking to diagnose; rather, their aim is to optimize therapeutic interventions and improve access to care. Today, if you look at hospital settings, pharmacists routinely titrate medications all day long. They manage anticoagulant therapies, and they formulate parental nutrition based all on laboratory data, so that demonstrates sound clinical judgment, even within established guidelines. In the community setting, these skills translate into conducting blood pressure assessments, performing point-of-care treatment, testings, adjusting medications under collaborative practice agreements, or even providing lifestyle counseling, like how to eat better, how to do things, or even if you want to take certain vitamins to improve your health.

I think these activities serve more as extensions of health care services rather than a replacement for physician-led care.

Pharmacy Times: Incident-to billing has been promoted as a way to reimburse pharmacists for their services. What is your perspective on this?

Camejo: Incident-to billing enables pharmacists to interact directly with patients and supports reimbursement for clinical care services. It's a start, but I don't think it's the end to this. I think currently, payments are approximately around $23 for 30 to 60 minutes of an encounter, and that billing again, occurs under the physician. But most patient interactions really take place in the community setting, rather than the hospital, and I think standardizing the way we practice, whether it's collaborative practice agreements or training or payment models that actually acknowledge pharmacist roles as physician extenders, along with appropriate feedback mechanisms back to the physician and payers about the patient's care, is what I consider the approach to increase access and help improve patient outcomes, whether the pharmacist is in a clinic or in a retail setting.

Pharmacy Times: Any final or concluding thoughts?

Camejo: For me, I just think at the end of the day, pharmacy needs recognition for its existing contributions, not more permissions. When pharmacists are integrated into care teams and patient access improves, physicians benefit from the collaboration, and so do health care systems thrive. I think this is not about competing with a physician. It's about alignment within pharmacy, coordinating training technology, [and] even payment systems will enable the community and health system pharmacies to advance prevention and safety in Americans' health care today. Pharmacists are really among the most successful health care providers, so [we should] empower them to use their training can help reduce costs and prevent hospital and emergency room department admissions.