Friday, March 27, 2015

Pharmacists provide care with pharmacist-provided care

Lately I've seen the following header on emails that I have received from the APhA regarding the push for provider status. Maybe you have seen it as well. 






Maybe you've thought to yourself, "I think I've seen that phrase before...Pharmacists Provide Care." 


That's because you saw it here first...two years ago.




I'm kicking myself in the rear end for not trademarking or copyrighting the phrase.

I feel a little bit hurt that the APhA has stolen taken my phrase.  




Maybe they will want to make amends by floating a free multi-year membership or a free trip to the annual convention my way.



Monday, August 25, 2014

Any PPC/MTM success stories our there?

About a year-and-a-half ago I put up a post on providing pharmacist provided care (PPC) as opposed to medication therapy management (MTM).  Since that time I've had dozens of pharmacists contact me with their thoughts and plans for attempting to start a successful PPC/MTM business.

If you've contacted me and had success, please shoot me an email to let me know how things are going.  Let me know what has worked and what hasn't so I can share that information for others.  One of the problems that I see is that many of us are attempting to reinvent the same failed wheel. 

For me personally, I have been able to open an outpatient anticoagulation clinic at my hospital.  We recently celebrated our first year anniversary.  I'll share on that sometime in the (hopefully) near future.

Until then, it's off to one of the kids' soccer/cross country/swim events and/or practices.

Monday, August 12, 2013

Flash follow-up



In my last post, I suggested that patients carry a flash drive that contains their health information.  This drive would contain all medical information, including all labs/procedures/prescriptions that were ordered.  Upon admission to the hospital (or visit to the physician) the staff could review this information and be able to see if the patient had been compliant with the prescribed treatment plan.

I realize that asking the typical patient to keep track of a flash drive is an impossibility.  But with the way technology is evolving it wouldn’t surprise me to see data like this being able to be stored on a chip that is embedded in the patient’s insurance card.

It would be easier to just design a system where all of this data feeds into a central database, but I can’t see how such a system could be secured.  When our government can’t keep national security documents safe I really can’t trust that the medical records of millions of people would be able to be secured.

A few days ago I was talking with an acquaintance who works with health insurance.  We discussed compliance, wellness plans, cost of healthcare.  Pretty much everything that has come up over the past ten years in the world of health care costs.  We came to the same conclusion after our discussion.

People are going to do what they want.  You can only incentivize so much, and some people won’t go for the incentives no matter what. 

With the way the system is currently operating, we are enabling the patients to be non-compliant.  If the patient doesn’t follow the treatment plan that has been developed by their physician/health care facility, it’s the physician/facility that is going to get dinged by not getting reimbursed.  The patient has no skin in the game.

By capturing all of the ordered procedures/tests/medications on a device that the patients must carry with them, compliance with therapy can quickly be determined.  If the patient is not compliant with therapy, the financial responsibility would get shifted from the provider to the patient.  Patients who are chronically non-compliant would, as mean as it sounds, receive a lesser standard of care as providers will be able to see that the patient is not compliant and adjust the treatment to a level with which the patient would be able to comply.

Before jumping down my throat about not giving the best care to all patients, remember that the patients who this would apply to are the patients who have already been given the best care.  They have chosen not to continue with the care plan that has been determined.  The cost for the additional health care expense should not be passed on to the other members of the health care plan or to the taxpayers if the patient is on government-funded insurance.

A provider/facility can only order so many tests, arrange so much home health care, and provide so much medication to a patient.  But when the patient doesn’t have the tests run, cancels the home health care, and doesn’t get their prescriptions filled, is it really the provider/facility’s fault that the patient is readmitted to the hospital twelve days after discharge for the exact same diagnosis?

Maybe a little de-incentivizing is what is needed.  When the patient realizes that they are going to bear a greater portion of their health care expense if they are non-compliant, perhaps they will follow the treatment plan.  For people who want to be compliant, but financial situations prevent them from doing so completely, services such as pharmacist-provided care could help them find alternatives to therapy that help achieve the therapy goals (at a lesser expense).  These services would be reimbursable to the providers, and would be recorded on the device that the patient carries with them as proof that they are attempting to comply with the treatment plan.