Many hospitals are missing a key opportunity to improve patient outcomes and hospital finances: leveraging pharmacists, says Advisory Board expert Lindsay Conway.
Conway, who oversees research for Advisory Board's Pharmacy Executive Forum, sat down with the Daily Briefing's Aly Seidel to discuss pharmacists' growing role in population health and care management.
Question: Pharmacy has always been a part of the hospital. So why are hospital executives increasingly focused on pharmacists now?
Conway: Hospitals are increasingly held accountable for their quality performance, and pharmacists play an increasingly important role in quality performance. Unfortunately, their contributions to patient care are often overlooked and underleveraged.
For example, many of the measures in CMS' Value-Based Purchasing program have significant pharmacy components. So the quality of a health system's medication management directly influences its revenues. Pharmacists also factor into the HCAHPS survey—which includes several questions asking patients whether they understand how to take their medications—and hospital-acquired infections, which are strongly tied to how well the hospital uses and manages antibiotics.
This isn't new: Pharmacists have always played a large role in improving patient safety and patient outcomes. There are all kinds of great data that show pharmacists can reduce medication errors, reduce readmissions, and provide the support patients need to follow through on their medication regimens.
What is new is the current regulatory environment. In a fee-for-service environment, there's no reimbursement for pharmacists' time. But now, in a population health world, all of these factors have financial value.
Q: So are health systems beginning to better utilize pharmacists?
Conway: Slowly but surely, more hospitals and health systems are leveraging pharmacists for population health wins.
For example, Froedtert Hospital recognized the variety of reasons why patients don't fill their prescriptions post-discharge, including that they don't want to wait in line at a retail pharmacy, they're concerned about drug costs, or they lack transportation.
That's why Froedtert instituted a bedside medication delivery program to ensure patients had their medications upon discharge and to give pharmacists the opportunity to educate patients about their drug regimens.
A pharmacist also follows up with high-risk patients post-discharge to check whether they're having any adverse events and to ensure they are complying with their medication regimens.
The program not only helps more patients follow through on their medication regimens—it also enhances the patient experience and adds additional revenue, as Froedtert fills the medications in their own on-campus retail pharmacies.
Q: What other steps can health systems take to leverage their pharmacists?
Conway: There are a ton of data out there showing that embedding pharmacists as part of the care team improves patient outcomes, particularly when caring for complex or chronic disease patients. Pharmacy has a huge role to play, particularly for medication reconciliation and medication therapy management.
The pharmacist can help with patient consults, asking everything from 'Do you know what medications you're taking and why?' to 'When you go the pharmacy, can you afford to pay for your medications?' Those consultations are vital to providing patients with tools and support to make sure they're able to adhere to a medication regimen, such as by setting up reminders for patients to take their pills every day at the same time.
Pharmacist consultations can also reduce patient confusion about their condition. A patient might not fully understand a drug's side effects and end up utilizing urgent care or emergency services for something that's normal. Talking with a pharmacist about what to expect, what's normal, and what's cause for concern can help patients take more control over their care. In today's health care climate, that's vital.
Learn more: The 5 things CEOs need to know about pharmacy
Join our webconference on Monday, August 22 for a conversation with Rita Shane, Chief Pharmacy Officer at Cedars-Sinai Medical Center and John A. Armitstead, System Director of Pharmacy at Lee Memorial Health System. They'll discuss the top issues pharmacy leaders face, the opportunities and pitfalls in specialty pharmacy, the critical role pharmacy plays in population health—and how executives can better support them.