Collaborative care works well with pharmacist care patient services
Model could be employed by hospitals
The California Chronic Care Coalition brings together a patient community, pharmacy, practitioners, researchers, payers, and pharmaceutical companies with the goal of providing better care through collaboration.
"Our approach is a collaborative that brings value to all the partners," says Eleanor Vogt, PhD, RPh, a clinical professor in the department of clinical pharmacy at the University of California-San Francisco in San Francisco, CA.
The coalition's purpose is to provide a strategy for bringing all of the players together with the overall goal of improving the quality of care and reducing major medical care costs, Vogt says.
"In this regard, patients are receiving quality care and hopefully improving outcomes; the payer is seeing a major shift and reduction in major medical care costs, including inpatient stays and emergency room visits," Vogt explains. "Then the practitioner gets reimbursed for providing quality care, and the pharmaceutical company gets to see their product used appropriately and safely."
Also, researchers benefit from having data to publish about best practices, and clinical pharmacists are able to be integral to providing better quality and safety in care.
"As a side effect, we as pharmacists and practitioners get reimbursed for providing primary care," Vogt says. "It's a win for academia also because we're in the business of teaching."
The intervention works up front through medication monitoring, Vogt says.
"We recommend adjustments in medication and lifestyle and are able to reduce the major medical costs," she adds.
Research has shown that pharmacy counseling in medication management provides a huge return on investment, Vogt says.
Nearly $5 are saved for every dollar invested, she adds.
The first step in medication management is to identify patients. The California coalition focused on community pharmacy employees and members of a local union.
The union was a good fit since their members typically are members for life, and they have an incentive to encourage preventive care and medication management, Vogt notes.
Unfortunately, insurance companies lack that incentive because a person might have one insurer one month and another a different month, she adds.
"There's no business incentive for them, and it's something we're all struggling with," Vogt says.
The model could work for hospitals, and it's been used by health systems, most notably the Mission Health System in Asheville, NC, which developed an innovative program that has been duplicated across the country, Vogt says.
Basically, the intervention involves having community pharmacists counsel patients who have diabetes about managing their disease, Vogt says.
This model could be studied as part of comparative effectiveness research (CER) since it appears to be an ideal model to be evaluated against the traditional way of providing care to populations with chronic diseases, Vogt says.
The staffing resources for providing care exist within the pharmacy profession.
"We're graduating students who have the skills to help patients with lifestyle management," Vogt says. "We have 15 years of research showing how it's clinically effective and cost-effective."
The project, which is about three years old, has shown a positive impact on improving patients' outcomes, but the results have not yet been published, she adds.
"It's really exciting work, and we're hearing from patients some wonderful feedback," Vogt says.
The California Chronic Care Coalition brings together a patient community, pharmacy, practitioners, researchers, payers, and pharmaceutical companies with the goal of providing better care through collaboration.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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