8 hours ago Abstract. This paper describes a proactive, patient-centered, interprofessional approach to medication review in a long-term care facility. Clinical pharmacy services were provided to residents in multiple high-risk areas including transition of care; medication reconciliation; monitoring of infectious disease, pain, anticoagulation, psychotropic drugs, and falls; and … >> Go To The Portal
Patient-Centered Pharmacy Services: A Descriptive Report Abstract This paper describes a proactive, patient-centered, interprofessional approach to medication review in a long-term care facility.
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The NHS needs to develop new models of care for people with long-term conditions that put individuals at the centre of their own care, supporting them to manage their conditions. Pharmacists can help support a shift toward person-centred care but they and the NHS need to think and work in new ways.
Many people are not aware of what services and support can already be accessed in community pharmacies – the setting where most people encounter pharmacists. They associate pharmacy with convenience and speed but see it as offering limited personal care.
Patient centrism is not a promotional activity. It also cannot be viewed through a solely financial lens. It requires a transformation of the frame of reference through which a company operates.
Involvement: The first step to becoming patient-centric is creating mechanisms to capture real patient and caregiver experiences. This is more than just market insights or traditional patient research – truly considering what the patient encounters.
This paper describes a proactive, patient-centered, interprofessional approach to medication review in a long-term care facility.
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The first step to becoming patient-centric is creating mechanisms to capture real patient and caregiver experiences. This is more than just market insights or traditional patient research – truly considering what the patient encounters.
Partner types include pharmacy networks, HCP networks, advisory boards, digital health, and government.
The second step is to translate the patient and caregiver experiences into internal initiatives, programs, and learnings that will improve offerings and drive better outcomes. The key is to focus on solving the problems your patient has, and making this your primary focus. Use your treatment, mixed with innovations beyond the pill to accomplish this.
Disseminate, communicate, and integrate: Data can only be used to drive improved outcomes if it is appropriately spread throughout an organization . Manufacturers must create structures to disseminate information and integrate patient-centrism as a role requirement for every level in the company.
The C-suite of a successful company must be patient-obsessed regardless of their functional role. This not only communicates the desired behavior to the organization but also helps to ensure that top leaders do not make business decisions that run counter to your commitment to the patient (ruining trust).
Patient centrism is not a promotional activity. It also cannot be viewed through a solely financial lens. It requires a transformation of the frame of reference through which a company operates. Other companies in the healthcare spectrum are also striving to transform themselves.
According to the National Academy of Medicine, health care should be patient-centered, which means “providing care that is respectful of and responsive to individual patient preferences, needs and values and ensuring that patient values guide all clinical decisions ” ( Institute of Medicine, 2001 ).
A patient-centered health information technology system gives patients the ability to communicate effectively and immediately with their providers, provides access to information that is personally important and useful when it is needed, and allows providers to look holistically at an individual and treat them through the coordina tion of other providers ( Dimick, 2011 ). Despite this vision and continuous national support, there is either a lack of or underdeveloped EHR systems and HIE platforms in all professionals’ settings ( Daniel et al., 2014 ).
The profession of pharmacy formed the Pharmacy Health Information Technology Collaborative in 2010. Three HIT roadmaps have been developed through the collaborative with a primary focus to both assure effective medication use through providing access to the patient-care services of pharmacists with other members of the interdisciplinary health care team and to assure that the pharmacists’ role is integrated into the National HIT interoperable framework. The most recent roadmap is accessible as a pdf document reflecting the time period of 2017 through 2021 ( Pharmacy Health Information Technology Collaborative, 2019 ).
Payers expectations are becoming positive toward supporting pharmacists’ patient-centered services and there is an increased willingness to pay. They are rethinking and have shifted reimbursement models in the last 5 years from a fee for service approach to a fee for performance, or value-based approach. At the time of this writing, fee for service continues to dominate. But this is changing rapidly through creative and proactive pharmacists working within the profession as a collective to develop and implement payment approaches. In the community practice setting, pharmacists are forming clinically integrated networks in order to establish quality-improvement processes required from payers to compensate pharmacists within the value based model.
Culture is a property of society; there is no such thing as a pure or singular culture. Within a specific ethnic or religious group, there may be variation in educational background, racial characteristics, age, socioeconomic status, disability classification, or gender identity. There is a great deal to learn about the cultural characteristics of the patient’s that pharmacists care for. Patient-centered care requires that pharmacists gain a reasonable understanding of each patient’s culture relevant to how this affects patient’s health beliefs and incorporate this understanding into care recommendations and patient communications ( Sensky, 1996 ).
Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Social, economic, and physical conditions in the various environments and settings patients live in, their social engagements, and sense of security and well-being affect health. Other resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. Understanding the relationship between how patients experience the environment and the impact of this experience on health is important in the patient’s care ( Secretary’s Advisory Committee on Health Promotion and Disease Prevention Objectives for 2020, 2010 ).
Including pharmacists on chronic-care delivery teams improves health outcomes. Studies of pharmacists providing MTM services shows these services can improve outcomes and reduce costs. Pharmacists typically provide those services in interdisciplinary teams through collaborative practice agreements (CPAs). Such agreements with other health care providers allow a licensed provider to refer patients to a pharmacist and delegate the delivery of clinical services under supervision. Several key challenges and barriers, however, prevent the full impact of this approach: restrictive laws and regulations governing CPAs, lack of provider recognition in federal and state law governing compensation of pharmacists who provide direct patient-care services, and limitations on pharmacists’ ability to access health information system. In recent years, we have seen a few state laws improve, an early trend toward what is needed in regulations to align policies with professional scope and expertise.
On the 24 February 2015, The Royal Pharmaceutical Society and National Voices held a joint event attended by members of National Voices to explore the role of pharmacy in delivering person-centred care to people with long-term conditions. This short report contains excerpts from the discussions.
There was excitement about the potential for pharmacists to offer people with long-term conditions more information about their medicines and support to help them manage their conditions, in particular if these could be accessed in a more convenient way.