Transcript CCNC Networks - Indiana Pharmacists

PHARMACeHOME:
Implications for Pharmacy
Practice in Indiana
Michael Melby, MS, FASHP
Jennifer Reiter, PharmD
7/20/2015
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DISCLOSURE STATEMENT
Neither Mr. Melby nor Dr. Reiter have no actual or
potential conflicts of interest to disclose in
relation to this presentation
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PHARMACeHOME
OBJECTIVES FOR PHARMACISTS
• Describe an innovative, collaborative, community based
pharmacy practice model successfully implemented in
Bloomington Indiana secondary to a CMS Innovation
Grant
• Identify the potential of this practice model to positively
influence the strategic direction of pharmacy practice in
Indiana
• Describe the stages in a high level gap analysis to
evaluative what it would take to move the practice model
forward in the State
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OBJECTIVES FOR PHARMACY TECHNICIANS
• Describe an innovative, collaborative, community
based pharmacy practice model successfully
implemented in Bloomington Indiana secondary to
a CMS Innovation Grant
• Identify the potential of this practice model to
positively influence the strategic direction of
pharmacy practice in Indiana
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PHARMACeHOME
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The Obligatory
“Cost of Health Care”
and
“What We Are Going To
Do About It”
Slides
• Done in Triple Time
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PHARMACeHOME
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PHARMACeHOME
2014 Milliman Medical Index, http://www.milliman.com/mmi/
By Christopher S. Girod, Lorraine W. Mayne, Scott A. Weltz, Susan K. Hart | 20 May 2014
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PHARMACeHOME
http://www.rollingalpha.com/2014/03/18/the-economics-of-death/
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PHARMACeHOME
PharmaPoint: The point of complete carewww.pharmapointrx.com
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PHARMACeHOME
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Source: Centers for Disease Control
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PHARMACeHOME
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PHARMACeHOME
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What is This Weirdly
Spelled
PHARMACeHOME
Thing?
• And what could it possibly have to do
with me?
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PHARMACeHOME
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CCNC Networks
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PHARMACeHOME
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PHARMACeHOME
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PHARMACeHOME
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PHARMACeHOME
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PHARMACeHOME
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PHARMACeHOME
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CareTriage
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CareTriage
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Impact
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Impact
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Community Medication
Management (CMM)
Jennifer Reiter
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Which is the most correct
medication list?
A) Medication list gathered when interviewing the
patient
B) List from Primary Care/Specialty Care Office
electronic medical record (EMR)
C) Fill history obtained from patient’s community
pharmacy of record
D) Previous discharge medication list from
hospitalization two weeks ago
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Community Medication Management (CMM)
• Important to remember patients are often
involved in MANY systems of care
• Bloomington belief—
– “There is no such thing as the absolute, correct
medication list or ultimate source of truth”
– It is an ever-changing list that must be complied
from many sources
Current “Actors”
• Emergency Department Pharmacy Technicians
• Inpatient Clinical Pharmacists
• Ambulatory Care Clinical Pharmacists
• Nurse Care Managers
• Home Health Pharmacist
• Home Health Pharmacy Technicians
• Nurse Practitioner Care Manager
• Registered Nurses
• Behavioral Health Pharmacist
Where are my patients?
Sources of Truth?
It’s not (always) about the list…
• Meds supplied in blister pack and patient does
not like packaging
• Patient reports “never want to take this
medication again”
• Reasons for using scheduled medications as
needed
• Patient “has not the slightest clue what he is
taking”
Adherence Check-Up
Future “Actors”
• Home Health Nurses
• Community Pharmacies
• Behavioral Health Nurses/Case Workers
• Physicians/Providers
• Social Workers
• Dieticians/Physical Therapists
• Patients??
Transitional Care/Medication
Management Models
• Walgreens providing refill histories and followup phone call care
• Delivering medications to bedside
• Pharmacist discharge counseling
• Follow-up phone calls and home visits
• Adherence packaging
• Multidisciplinary follow-up visits
Barriers and Future Considerations
• Less engagement from non-pharmacist “actors”
• Work flow for medication reconciliation
undeveloped in some practices
• Increase Pharmacy Technician involvement
• Expand CMM model in non-transition patients
– Use risk assessments to screen patients coming
in for appointments
• Need coordination of regimens with retail/mail
order pharmacies
Questions