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Bringing Patient-Centered Health Care to the Patient by Integrating Retail Pharmacy Wayne Pan, MD, MBA, Chief Medical Officer The Individual Practice Association Medical Group of Santa Clara County Inc. (SCCIPA) The National Medical Home Summit West • September 20-22, 2011 • San Francisco

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Page 1: Bringing patient centered health care to the patient by integrating retail pharmacy v2

Bringing Patient-Centered Health Care to the Patient by Integrating Retail PharmacyWayne Pan, MD, MBA, Chief Medical OfficerThe Individual Practice Association Medical Group of Santa Clara County Inc. (SCCIPA)

The National Medical Home Summit West • September 20-22, 2011 • San Francisco

Page 2: Bringing patient centered health care to the patient by integrating retail pharmacy v2

ourjourney

Page 3: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 4: Bringing patient centered health care to the patient by integrating retail pharmacy v2

MIND THE GAP

Page 5: Bringing patient centered health care to the patient by integrating retail pharmacy v2

because of these

Page 6: Bringing patient centered health care to the patient by integrating retail pharmacy v2

too many of these

Page 7: Bringing patient centered health care to the patient by integrating retail pharmacy v2

carecoordinationandtransitions

Page 8: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 9: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 10: Bringing patient centered health care to the patient by integrating retail pharmacy v2

direction• focus on the patient• fix processes first• empower providers and

the care team• clinical must lead

technology initiatives• focus on the patient

Page 11: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 12: Bringing patient centered health care to the patient by integrating retail pharmacy v2

source: SF Jencks et al., Rehospitalizations among Patients in the Medicare Fee-for-Service Program, New England Journal of Medicine, 2009;360:1418-28.

Page 13: Bringing patient centered health care to the patient by integrating retail pharmacy v2

$17Bsource: SF Jencks et al., Rehospitalizations among Patients in the Medicare Fee-for-Service Program, New England Journal of Medicine, 2009;360:1418-28.

Page 14: Bringing patient centered health care to the patient by integrating retail pharmacy v2

from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)

Page 15: Bringing patient centered health care to the patient by integrating retail pharmacy v2

from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)

Page 16: Bringing patient centered health care to the patient by integrating retail pharmacy v2

?from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)

Page 17: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 18: Bringing patient centered health care to the patient by integrating retail pharmacy v2

peopleprocessesplatform

Page 19: Bringing patient centered health care to the patient by integrating retail pharmacy v2

peopleprocessesplatform3P’s

Page 20: Bringing patient centered health care to the patient by integrating retail pharmacy v2

peopleprocessesplatformCbig

Page 21: Bringing patient centered health care to the patient by integrating retail pharmacy v2

culturepeopleprocessesplatform

Page 22: Bringing patient centered health care to the patient by integrating retail pharmacy v2

changingthewaywedothings

Page 23: Bringing patient centered health care to the patient by integrating retail pharmacy v2

a waywedothingsVnew

Page 24: Bringing patient centered health care to the patient by integrating retail pharmacy v2

why?

Page 25: Bringing patient centered health care to the patient by integrating retail pharmacy v2

what got you here

marshall goldsmith

Page 26: Bringing patient centered health care to the patient by integrating retail pharmacy v2

won't get you there

marshall goldsmith

Page 27: Bringing patient centered health care to the patient by integrating retail pharmacy v2

how?

Page 28: Bringing patient centered health care to the patient by integrating retail pharmacy v2

insanity: doing the

same thing over and over

and expecting

different results

Page 29: Bringing patient centered health care to the patient by integrating retail pharmacy v2

get out of the rut?

Page 30: Bringing patient centered health care to the patient by integrating retail pharmacy v2

patientcentereddesign

Page 31: Bringing patient centered health care to the patient by integrating retail pharmacy v2

from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)

Page 32: Bringing patient centered health care to the patient by integrating retail pharmacy v2

behaviordesign

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put hot triggers in the path of

motivated peopleBJ Fogg, PhD

Director, Persuasive Technology LabStanford University

Page 34: Bringing patient centered health care to the patient by integrating retail pharmacy v2

work with humannature

BJ Fogg, PhDDirector, Persuasive Technology Lab

Stanford University

Page 35: Bringing patient centered health care to the patient by integrating retail pharmacy v2

lazysocialhabitsBJ Fogg, PhD

Director, Persuasive Technology LabStanford University

Page 36: Bringing patient centered health care to the patient by integrating retail pharmacy v2

readmissionstheproblem:

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physicianfollow-up

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medicationreconciliation

Page 39: Bringing patient centered health care to the patient by integrating retail pharmacy v2

Santa Clara County1,304.01 sq. miles

1,781,642 (2010)$74,335

Page 40: Bringing patient centered health care to the patient by integrating retail pharmacy v2

5 PCP80 Specialists

57 PCP104 Specialists

173 PCP343 Specialists

11 PCP30 Specialists

SCCIPAfounded in 1986physician-owned, physician-governed800+ physicians - 240+ PCPs, 550+ specialistsall 9 hospitals - including a tertiary care center9 health plans (Commercial and Medicare Advantage)

Page 41: Bringing patient centered health care to the patient by integrating retail pharmacy v2

from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)

Page 42: Bringing patient centered health care to the patient by integrating retail pharmacy v2

thepatientjourney

dischargeplanning

hosspitaldischargeplanner

IPA onsitecase

manager

hospitalist

patient

dischargeinstructionsRx

medicationreconciliation

outpatientphysicianfollow-up

discharge

patient patient patient

hospitalist hospitalist

family

dischargeinstructionsRx

Page 43: Bringing patient centered health care to the patient by integrating retail pharmacy v2

thepatientjourney

dischargeplanning

hosspitaldischargeplanner

IPA onsitecase

manager

hospitalist

patient

dischargeinstructionsRx

medicationreconciliation

outpatientphysicianfollow-up

discharge

patient patient patient

hospitalist hospitalist

family

dischargeinstructionsRx

Page 44: Bringing patient centered health care to the patient by integrating retail pharmacy v2

thepatientjourney

dischargeplanning

hosspitaldischargeplanner

IPA onsitecase

manager

hospitalist

patient

dischargeinstructionsRx

medicationreconciliation

outpatientphysicianfollow-up

discharge

patient patient patient

hospitalist hospitalist

family

dischargeinstructionsRx

Page 45: Bringing patient centered health care to the patient by integrating retail pharmacy v2

from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)

Page 46: Bringing patient centered health care to the patient by integrating retail pharmacy v2

brainstorm

Page 47: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 48: Bringing patient centered health care to the patient by integrating retail pharmacy v2

thepatientjourney

dischargeplanning

hosspitaldischargeplanner

IPA onsitecase

manager

hospitalist

patient

dischargeinstructionsRx

medicationreconciliation

outpatientphysicianfollow-up

discharge

patient patient patient

hospitalist hospitalist

family

dischargeinstructionsRx

Page 49: Bringing patient centered health care to the patient by integrating retail pharmacy v2

thepatientjourney

dischargeplanning

hosspitaldischargeplanner

IPA onsitecase

manager

hospitalist

patient

dischargeinstructionsRx

medicationreconciliation

outpatientphysicianfollow-up

discharge

patient patient patient

pharmacist hospitalist

family

dischargeinstructionsRx

Page 50: Bringing patient centered health care to the patient by integrating retail pharmacy v2

put hot triggers in the path of

motivated peopleBJ Fogg, PhD

Director, Persuasive Technology LabStanford University

Page 51: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 52: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 53: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 54: Bringing patient centered health care to the patient by integrating retail pharmacy v2

Santa Clara County IPA (SCCIPA)Medication Reconciliation Pilot Project

How to find the medication list for patients using AccessExpress

1. Go to the PPMSI AccessExpress provider portal (http://ppmsi.com/accessexpress.html):

2. Select Santa Clara County IPA:

3. Enter USER NAME and PASSWORD, click on “SUBMIT”:

Page 55: Bringing patient centered health care to the patient by integrating retail pharmacy v2
Page 56: Bringing patient centered health care to the patient by integrating retail pharmacy v2

Your SCCIPA doctor wants to help you with your medications, after you leave the hospital.

Please visit the Samaritan Medical Center Pharmacy to pick up your new prescriptions and have a pharmacist review your medications with you.

Michael Lam, RPhpharmacist

Samaritan Medical Center Pharmacy2505 Samaritan DriveSan Jose, CA(408) 356-7111

SCCIPAA Pacific Partners Medical Group

Page 57: Bringing patient centered health care to the patient by integrating retail pharmacy v2

from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)

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it’saboutthepatient

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[email protected]

Page 60: Bringing patient centered health care to the patient by integrating retail pharmacy v2

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