March 15, 2018
Inside: Discover the how-to guide to move your pharmacy from focusing on dispensing prescriptions to implementing a team-based, patient care program.
Does your pharmacy have a set process to provide better patient care?
“As health care starts to evolve, we’re going to have to keep up with it,” said Stefanie Ferreri, Pharm.D., Clinical Professor in the Division of Practice Advancement and Clinical Education at the UNC Eshelman School of Pharmacy. “Community pharmacies need to be creative in keeping their business doors open and looking for ways to have different models of reimbursement and different models for compensation.”
Led by Ferreri, a research team created a comprehensive guide for community pharmacies to develop a patient care management program.
This step-by-step guide explains how to implement process changes and serves as a systematic tool for pharmacies to shift their focus from fee-for-service care to value-based care.
This process moves pharmacies from focusing on dispensing prescriptions to a team-based, patient-centered approach in coordination with other healthcare professionals. “We want community pharmacies to be involved as an essential member of the healthcare team and to work with other healthcare professionals to coordinate care for their patients,” Ferreri said.
The Joint Commission created a common language for the Pharmacist Patient Care Process that could apply to every practice setting, including community pharmacies. But Ferreri said it didn’t go far enough.
“What was not included was how to implement it into different practice settings,” she said. “We have all these great resources in pharmacies. And we develop all these processes and we develop all these guidelines. But what’s always missing is how to implement them.”
The guide lists every step to take to implement the value-based process in a community pharmacy setting. It seeks to help community pharmacies integrate more fully into the healthcare team and to improve patient outcomes.
“If we can develop a process of care where we are demonstrating our worth on that healthcare team, then that will help the pharmacist’s business in the long run,” Ferreri said. “And every single physician will want to collaborate with community pharmacies to improve their patient outcomes.”
Although many community pharmacies already offer patient care management in some form, most pharmacies still have a long way to go. Ferreri and her team studied 273 community pharmacies and interviewed more than 70. What they discovered spurred them to create the guide.
“Community pharmacies were struggling with how to incorporate the patient care process into their practices,” she said. “They know that it’s something they should do. It’s just, ‘How do we put that into our daily process?’”
The guide fills that gap by helping pharmacies evaluate their businesses to find their weaknesses.
And, it provides process changes they can measure and sustain.
The guide includes five components that make up the pharmacist patient care process:
1. Collect information
2. Assess information
3. Develop the care plan
4. Implement the care plan
5.Follow up with the patient
The guide discusses each of the components in detail, explaining what they are and walking pharmacies through process changes in four stages.
And within each of those stages, the guide helps identify:
Ferreri suggests pharmacies tackle the guide one component at a time.
Every pharmacy should start by taking the self-assessment in the guide. The assessment helps the pharmacy team rate the pharmacy on a scale of low, medium, and high for each component of the patient care process.
“I would recommend starting with the lowest-rated one, see how well you do for that one for about three to four months, and then make improvements and go from there,” she said.
During the study, Ferreri found that generally, pharmacies excelled at assessing information and developing a plan but struggled to collect information and follow up with patients.
Pharmacies don’t have much control over data collection, Ferreri said, because they don’t have access to a common electronic health record.
But pharmacies can more easily improve on their follow up. Pharmacists often get task-focused, moving from one job to the next without looking back, she said.
“Follow up is something that we can have a huge impact on in community pharmacies. We have so many touchpoints with our patients that many other healthcare professionals do not. And, I think that was really eye-opening for me. That’s a strength we don’t capitalize on.”
Such drastic process changes won’t happen overnight. “I think it’ll probably take months, if not years, to implement the patient care process within community pharmacies,” Ferreri said.
But now’s the time to start. “It’s something that’s not regularly incorporated into practice because it’s not tied to reimbursement,” Ferreri said. “Hopefully that will change in the future.”
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