Innovator: William Lee, DPh, MPA, FASCP
Position: Pharmacy System Director, Carilion Medical Center
VHIN: Tell us about your work under the Healthcare Innovation Award to train pharmacists in patient education and medication management.
BL: Carilion New River Valley Medical Center was the recipient of a $4.2 million dollar CMS Innovation award to demonstrate how pharmacist can Improve the Health of patients AT Risk in Rural areas (IHARP) The focus of the project was to see how we as pharmacists through our expertise as medication experts can make a difference in the quality and outcome of those high risk patients, specifically patients that were identified as being in those high risk categories: COPD, Asthma, CHF, Hyperlipidemia, Behavioral Health, Hypertension, and Diabetes. The role of the pharmacists in the physician clinic (medical Home) in an ACO model was the focus of the project. We employed pharmacists in the clinics with the specific task of intervening and meeting with the patients in a face-to-face encounter as well as follow-up phone calls of patients upon discharge from the hospital or the emergency room. The intent of the encounters were to document specific interventions by the pharmacist that impacted the outcome of those patients’ adherence to the mediation therapies that were being prescribed and the prevention of potential adverse reactions and unnecessary admissions/re-admissions. These patients were enrolled into the program voluntarily after consulting with the pharmacist and had the option to opt out at any time. We have to date enrolled over 2400 patients and our collaborative agreement with CMS will end officially in June 2015. Our challenge from day one has been to be able to identify how we were going to train our pharmacists for this new pharmacy model in transitional care and to get them properly oriented and trained for the medication management aspects within the clinic environment. The uniqueness of the model is that we found a way to connect with the community pharmacist by allowing them to view the entire hospital medical record of the patient through a link that was created within our EPIC , hospital information system, in a secure read-only mode. The challenge now based upon the success of the program is how we are going to train the rest of the pharmacists throughout the system, and at the same time, re-engineer the pharmacy operations to be able to deploy the pharmacist into the ambulatory care environment. Through the adoption of technology and other software discovered in the process, we’ve been able to also document patient satisfaction and measure the quality of service tied to NCQA standards. For the first time, we in pharmacy can truly measure the quality of service to the patient and the competence of the pharmacist.