provider relations: taking view.pdf · provider relations: taking the next steps in patient care...

Provider Relations: Taking the Next Steps in Patient Care

Erica Mahn, PharmDDirector of Community PharmacyAlps Pharmacy

Disclosure and Conflict of Interest

Erica Mahn has no personal or financial conflicts of interest to disclose.

Pharmacist Objectives

At the conclusion of this program, the pharmacist will be able to:

1. Define the pharmacist's role in the Patient Care Process.

2. Identify providers to focus on for relationship development.

3. Employ strategies discussed to form new provider relationships that focus on the services offered by the pharmacy.

Technician Objectives

At the conclusion of this program, the technician will be able to:

1. Define the technician's role in the Patient Care Process.

2. Identify gaps in care through patient conversations to initiate new provider relationships.

3. Examine opportunities and assist the pharmacist in creating an effective workflow for provider outreach.

Background• UMKC School of Pharmacy-Class of 2012

• Have worked for Alps Pharmacies in Springfield, Missouri for 6 years

• 2 Patient-Centered Pharmacy Home accredited community pharmacies, URAC-accredited specialty pharmacy, AADE accredited DSME program, long term care pharmacy

• Community Pharmacy Residency Program

• Precept UMKC School of Pharmacy students

Resources: https://jcpp.net/patient-care-process/

Pharmacist’s Patient Care

Process


Promote consistency across the profession.

Pharmacist’s Patient Care Process was created to:


Provide a framework for delivering patient care in

any practice setting.



Be a contemporary and comprehensive approach to patient-centered care delivered in collaboration

with other members of the health care team.



Be applicable to a variety of patient care services

delivered by pharmacists, including medication

management.


What is the role of the pharmacist?


What is the role of the technician?

• Identify• Create• Implement


What is the role of the pharmacy team?


• Identify• Notify• Follow-up



• Interns• Cashiers• Delivery Drivers• Students







How does this apply to your pharmacy?

How does this apply to your pharmacy?







• Embrace new opportunities

• Develop Relationships

Assessment1. What is the pharmacist’s role in the patient

care process?

Answer: Identify, Create, Implement

Assessment

2. What is the technician’s role in the patient care process?

Answer: Identify, Notify, Follow-up

Assessment3. When a new opportunity is identified through

patient conversations, where could that information be stored?

Answer: Pharmacy computer system, spreadsheets, project management applications

Assessment4. Who should be in charge of guiding new

relationships?

Answer: Everyone! The team has to work together to make a change.

Application• Once you feel confident with the process within

your pharmacy, what are you going to do with it?

• Most providers do not know about the Pharmacists’ Patient Care Process.

• An interprofessional health care team makes sense, we are working towards the same goals and can help to support each other.

www.nationalahec.org/pdfs/VSRT-Team-Based-Care-Principles-Values.pdf


• Team-based care does not need to be restricted to hospitals or doctor’s offices. Outpatient clinical data can play a large role in patient outcomes.

• Use your outpatient data to become member of the provider’s team.

• Reimbursement models are shifting from a volume-based, fee-for-service system to a value-based payment system.

• Value-based payment models present a great opportunity for pharmacists because providers need additional resources.

https://www.pharmacist.com/article/apha2018-journey-toward-value-based-payment-modelswww.nationalahec.org/pdfs/VSRT-Team-Based-Care-Principles-Values.pdf

Community pharmacies can help to identify:• Adherence issues• Medication misuse concerns• Changes in emotional status• Changes in insurance coverage• Acute disease-state status changes

• Each of these issues can affect pharmacy quality measures, as well as physician quality measures.

• By communicating back to the provider, you are able to build a relationship and provide better

overall patient care.

AssessmentWhat type of reimbursement model presents the most opportunity currently for pharmacists?

a. Volume-Based Modelsb. Fee-for-Service Modelsc. Value-Based Models

Answer: Value-Based Models

1. Identify providers you can do more for.

• Who do you fill the most prescriptions for?

• What disease state do you see most?

• What geographical area do you service most?

Where should you start?

2. Talk to your providers about their biggest concerns.

• Do they need help with diabetic patients? Hypertension? Smoking cessation?

• Prior authorization overload?

• Reaching vaccination goals?


3. Tell providers and the community what you are doing!

• Vaccinations• Medication

Administration• Synchronization

• Diabetes Education• Durable Medical

Equipment• Pharmacogenomics


Innovation PlanAsking Questions and Defining Problems

I feel good about…(something I’m doing)

I want to learn more about...

What can I do Monday to help me get there?

Mentor/Colleague to assist

Date Contacted

Case StudyA provider in a nearby pain clinic has reached out to your pharmacy staff regarding the dispensing of Narcan and naloxone injections to increase patient safety. They are wanting to provide all of their patients with prescriptions for the products, but don’t know where to start. What next steps can you take to ensure that they see your pharmacy as a resource through this process?

Case Study• Perform benefits investigation to let the office staff

know which products are covered for which plans• Investigate copay assistance programs to use for

patients• Offer staff counseling provided by your pharmacy

team• Set order points on the products to ensure that

they will always be available, and let the doctor staff know that they can rely on you

• Colleagues• Schools of Pharmacy• Competition• Email Updates• Magazines

Use your resources

• Community Pharmacy Enhanced Services Network• Missouri Pharmacy Association• Ozarks Area Pharmacy Association• National Organizations

Stay Involved

✓ Patient-centered care creates better relationships with your patients and their providers.

✓ Tell your providers about what you are doing.

✓ Work within your pharmacy to identify your next steps for change.

Takeaways

ResourcesPharmacy Today, A Whirlwind Tour of Value-Based Payment Models-with Pharmacists as Your Guide, June 2018

https://www.pharmacist.com/article/apha2018-journey-toward-value-based-payment-models

Interprofessional team-based primary care for chronically ill adults: State of the science. Unpublished white paper presented at the ABIM Foundation meeting to Advance Team-Based Care for the Chronically Ill in Ambulatory Settings. March 24–25, 2010; Philadelphia


www.accp.com/docs/positions/misc/PatientsForgingEffectivePartnerships%20-%20IOM%20discussion%20paper%202014.pdf

https://pcmh.ahrq.gov/page/creating-patient-centered-team-based-primary-care#ref1

https://jcpp.net/patient-care-process/

Speaker Contact Information

Alps Pharmacy2650 W. Kearney St.Springfield, MO 65803417-865-1547

Alps Pharmacy2828 N. National Ave.Springfield, MO 65803417-893-3900

Cell: 417-773-1796Email: [email protected]

Erica Mahn

provider relations: taking view.pdf · provider relations: taking the next steps in patient care...

Documents