The Emerging Role of the Pharmacist in the Healthcare Ecosystem

The EMERGING ROLE of the PHARMACIST in the Healthcare Ecosystem Whať's AILING in the TRADITIONAL MODEL? In the long-standing traditional model of healthcare, providers and payers often act in silos, without communicating to the patient or to each other about the patient. $4 Individually prescribed medications may not align with patient's medical care plan. 24 2$ Rx Patient information is fragmented and not shared between providers, pharmacists and insurers, resulting in duplicate processes and care. Payments based on volume, not value or patient outcomes. While healthcare in the U.S. is considered among the highest in Just how. BIG are the GAPS? quality, it is also among the most costly with significant gaps in care. By the RANKING 50% Americans had communication problems with primary care physician 53/100 43% Adults with health issues could rapidly get an appointment when sick! The U.S. scored 53 out of 100 on measures gauging inappropriate, wasteful, or fragmented care, avoidable hospitalization, variation in quality and costs, and use of IT 19% Patients reported undergoing duplicate testing! 50% Patients reported receiving all recommended screening and preventative care !) LAST PLACE Among 16 developed countries, the U.S. ranked last on a measure of mortality that could have been avoided with appropriate medical care U.S. adults went without recommended 37% care, did not see a doctor when sick or failed to fill prescriptions? Such gaps highlight the need for a whole-system approach to care delivery. Our healthcare system already has the resources for high-quality care, but it must be better organized. ?) What 's MISSING? TECHNOLOGY INCENTIVES SHARED RISK Integrate all patient information in a single database where medical records can be accessed quickly by An incentive model for each team player to practice based on improving patient outcomes. A mechanism to share total cost of care risk with other providers and payers. all care team members. The CHANGING MODEL New models of patient care are emerging to address gaps in the system, improve care coordination and more strategically allocate resources. COLLABORATION, 2$ INTEGRATION and IMPROVED OUTCOMES ..... ..... Primary care physician develops a patient's care plan with the patient; is the hub of the medical team and is easily accessible to other players. Coordinated care teams provide efficient, patient-centered care. Provider reimbursement is based on outcomes, not volume of service. %24 %24 New models are emerging in the forms of consolidated and collaborative networks, like ACOS, PCMHs and Medical Neighborhoods. Results? Increased accountability, fewer gaps in care, reduction in patient -...... redundancies and value over volume. ...... 2$ --.. Increasingly, pharmacists are being recognized as critical members of a patient's integrated healthcare team. Pharmacists are well The PHARMACIST'S ROLE equipped to expand their role. 33% American adults take five or more medications 88% Prescriptions filled are for Medicare beneficiares with multiple illnesses? %24 50avg Prescriptions filled each year for Medicare beneficiaries, prescribed from 13 different physicians on %24 TOP 3 For the 11th consecutive year, pharmacists have ranked among the top three most trusted professionals in the U.S., according to a Gallup poll released in December 2013.4 -... .... PHARMACISTS SHIFT ROLES EMERGING OPPORTUNITIES to play a more STRATEGIC ROLE • Follow-up consultation after primary care visits, clinic outpatient visits, hospital discharge • Medication therapy management • Patient education and consultation • Medication reconciliation • Members of chronic disease management teams • Medication care coordinators • Patient engagement • Creating local partnerships for adherence and monitoring programs • Disease management • Patient behavior coaching The MISSING LINK Technology can elevate the pharmacist's role by connecting them to health information exchanges (HIES) for fast, secure communication of vital medical information. PHARMACISTS CONNECT via HIES HIE Pharmacists must own the issue – decide on the roles they want to play, forge relationships with other healthcare entities, market and differentiate their business and understand payers. An important tool to progress in this direction is an informatics infrastructure connecting them to health information exchanges (HIES) and registries. SOURCES: "Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011. The Commonwealth Fund Commission on a High Performance Health System. Accessed at: http://www.commonwealthfund.org/Publications/Fund-Reports/2011/Oct/Why-Not-the-Best-2011.aspx?page=all. New 11-Country Health Care Survey: U.S. Adults Spend Most. The Commonwealth Fund. Nov. 13, 2013. Accessed at: http://www.commonwealthfund.org/News/News-Releases/2013/Nov/New-11-Country-Health-Care-Survey.aspx. The Future of Medicare: Recognizing the Need for Chronic Care Coordination, Serial No. 110-7 (May 9, 2007):19-20. *Pharmacists Receive High Marks for Honesty, Ethics in Gallup Poll. Jan. 13, 2014. Available at: http://www.pharmacytimes.com/publications/issue/2014/January2014/Pharmacists-Receive-High-Marks-for-Honesty-Ethics-in-Gallup-Poll. 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