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The Truven Health Blog


The latest healthcare topics from a trusted, proven, and unbiased source.


The Expanding Role of Pharmacists: Out of the Basement and Into the Spotlight


By Tina Moen/Wednesday, June 18, 2014
Tina Moen imageWhat does it mean to be a pharmacist in 2014? I recently presented at the Health Connect Partners Spring Pharmacy Conference to a room full of pharmacy leaders from across the country. We discussed the evolution of the practice of pharmacy, the things we have seen change over the years, and the opportunities (and challenges) we see on the horizon. Throughout the conference, many attendees shared stories of how their responsibilities as a pharmacist have evolved throughout their careers. Our conclusion is that now – more than ever – there are visible, meaningful changes to our role as it relates to patient care, collaboration with our peers, and in leadership participation in the healthcare community.

Clinical pharmacy services, as we know it, are a result of continuous evolution of the historical pharmacy role – namely dispensing medications from behind the counter or in the basement. This evolution has taken many years. Pharmacists now deliver enhanced value to their organizations and their patients with a focus on quality, safety, and efficacy of medication therapies. Programs such as enhanced Medication Therapy Management continue to highlight the impact pharmacists can make on reducing adverse effects and improving efficacy of a patient’s medication regimen. Additionally, pharmacists contributing to Medication Reconciliation and specialty services, like Anticoagulation or Diabetes Clinics, continue to demonstrate that rounding out the care team to include a medication specialist improves patient outcomes and enhances the practice and performance of clinical peers. And recently, I have seen emerging cross-functional leadership teams working toward goals such as the IHI “Triple AIM,” begin to include Pharmacy; tying personal goals and incentives for DOPs to these efficiency and quality objectives.

Clearly, great progress has been made in the practice of pharmacy, and I for one am proud of the role pharmacists play in enhancing the patient experience and outcomes. So, what's next? Here are the things that come to mind when I ask myself this question.

Healthcare IT
A recent article in Healthcare IT News advocated for pharmacists playing a larger role in EHR strategy. As a pharmacist who works within the healthcare IT industry, I couldn’t agree more. What percentage of patients in a hospital has at least ONE medication order? I would venture to say “most.” It’s an obvious conclusion that the profession charged with the safe and effective use of medications should have a significant role in the development, selection, and implementation of tools used to properly care for those patients. And then there is Meaningful Use. How many of the Meaningful Use Objectives are related to medications and the services in which pharmacists participate? Who better then to take the lead in organizational efforts for Stage II attestation and Stage III planning?

Care Collaboration
Cross-departmental coordination for initiatives that span hospital leadership continues to grow in scope and importance. Benefits of pharmacists as integral members of rounding teams within the inpatient setting are well-documented. With organizations designing and implementing Population Health and ACO strategies, pharmacy leaders can capitalize on the combination of data analytics and clinical insight that are the hallmarks of pharmacy practice. As Population Health initiatives evolve – who better than a pharmacist to guide trends in medication recommendations in treating high-risk conditions and ensuring safe, cost-conscious practice remains top of mind?

Quality Patient Care
Providing quality patient care has always been a focus of healthcare providers. Today’s environment adds a variety of incentives and penalties to drive quality. How are pharmacists contributing? In many ways! Pharmacists are well-suited to lead the charge on initiatives like Antimicrobial Stewardship, a quality and a cost management initiative. The importance of medication education and adherence in the improvement of HCAHPS scores and the reduction of readmissions are additional examples how pharmacists can and should use their skills as medication specialists to drive improved patient care. Because results summaries from nation-wide HCAHPS surveys indicate that Medication Safety and Pain Management questions are still amongst the lowest performing areas – shouldn’t pharmacists’ input at the patient care level be paramount?

As I said during my visit to Health Connect Partners, it’s good to look back occasionally to see the progress that has been made and to help motivate us for the challenges and opportunities ahead of us. What is next? What have I missed? I would love to hear from my fellow pharmacists on where the practice of pharmacy will be in the next 10 years. What are you doing today to move the needle in the evolution of pharmacy?

Tina Moen, PharmD
Chief Clinical Officer

Enhancing Analytical Capability


By Robert Sutter/Tuesday, June 25, 2013
Robert Sutter imageWith the advent of electronic health records healthcare providers are in the midst of an unprecedented digital revolution - They are becoming awash with data. The question they face is: How to harness all of this data in a manner that facilitates enhancing organizational performance?

The first step to answering this question is to perform an organizational assessment to understand the current state of the organization's analytical capabilities relative to the five stages depicted in Table 1. With that accomplished, the organization can plot a course to advance to the successively higher stages of analytical competency - which will facilitate achieving higher levels of organizational performance.

Table 1


Stage
Analytical Objective
Analytical Process
Skills
Sponsorship
Culture
1:Analytically Impaired
None established
Non-existent
Absent
Absent
Adverse to fact based decision making
2: Localized Analytics
Sparse, not integrated or aligned
Narrow focus, fragmented
Isolated, minimal
Isolated, not uniform
Craves for more and better data
3. Analytical Aspirations
Organizational performance metrics established
Fragmented, not aligned
Analysts to produce dashboards
Early stage of awareness of the advantages of analytics
Senior management support for fact-based decision making
4: Analytical Company
Develop an integrated analytics program
Some integrated, aligned analytics
Analysts with moderate skills but not aligned
Generalized senior management support
Change management underway to transform into fact-based culture
5. Analytical Competitor
Well developed and focused
Fully integrated, aligned analytics
Advanced: predictive modeling, data mining
Genuinely committed
Fact-based decision making is the way business is conducted


In order to be successful at becoming an analytical competitor an organization must have a senior management team that is genuinely committed to fact-based decision making. In addition, a well defined strategy is required to provide direction on the goals to be accomplished, the analytic questions to be answered and how to allocate analytical resources.

Robert Sutter, RN MBA MHA
Consultant


It’s Time to Transform Healthcare – and We in the Industry Know How To Do It


By Michael L. Taylor/Tuesday, February 26, 2013
Mike Taylor imageIn his February 23, 2013 article in the New York Times, Richard Thaler, noted professor of Economics at the Booth School of Business at the University of Chicago, makes several suggestions on how to improve US health care.

Among them are:
  • Paying doctors and hospitals for health, not illness treatment
  • Using evidence-based medicine approaches
  • Making more efficient use of nurse practitioners, pharmacists, physician assistants and other medical professionals
  • Opening opportunities for all patients to have end of life discussions
  • Implementing safe harbor from medical liability under certain situations
  • Incremental changes and experiments with innovation to improve the US health care approach

These are all good ideas that have been under discussion, some for many years. I agree with the ideas, but I would argue in favor of reaching further, reaching for transformational changes. To amplify this thought:
  • The Affordable Care Act opens the door for Accountable Care Organizations (ACOs).  Well designed ACOs have the potential to transform US healthcare in many ways:

  • End of Life discussions and planning are not “death panels,” and we cannot, and must not, get tangled up in arguments based on inaccurate assumptions as a way to avoid these needed discussions.

  • Medical liability reform
A healthcare system implies a uniform, defined approach to problem—something the US does not have. We have a fragmented, expensive sector not designed with the goal of improved health, but organized around principles where the main benefactor is the entire healthcare industry, not the patient. I don’t think we need more experiments; we need transformational change with the goal of achieving the Triple Aim of improving healthcare quality and satisfaction, improving population health, and reducing the cost of healthcare.

Dr Michael L Taylor
Chief Medical Officer

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