Improvement and Team Members Improvement: Increased utilization of
generic medications through therapeutic substitution. Department of Family Medicine, Ohio State University Wexner Medical
Center.
Emily Vrontos, PharmD, CDE Bella Mehta, Pharm.D. Director, Clinical Partners Program Randy Wexler MD MPH FAAFP. Clinical Vice Chair
The Ohio State University Health Plan
Bruce Wall MD, Medical Director of The Ohio State University Health Plan
Plan Co-creation between a health plan and
providers of a clinical program that adds value to the member/patients it serves (value defined as the quality of care divided by the overall cost of care). Identify and maximize the respective strengths among both organizations to realize maximum efficiency and effectiveness.
Plan-actionable data/Providers-relationship with patient
Do Pharmacist reviewed therapeutic cost savings opportunities
Recommended to prescriber if appropriate
PCN data:
46% of claims recommended to physician, 61% accepted, 45% documented change
Clinical Partners data:
Gahanna: 63% of claims recommended to physician, 91% accepted by physician, 41% accepted by patients Lewis Center: 44% of claims recommended to physician, 29% accepted by physician, 0% accepted by patients
Study Lessons learned
Prepare providers ahead of time. Provide the names of those who will be contacting providers Inform staff as well as physicians
Ensure complete documentation present in patient
chart Reduces unnecessary time that can be dedicated to other pursuits – Include intolerances/adverse effects in allergies or specialty comments
Act Understand variance of uptake by site Expand process to multiple payers Enhance evaluation and management of high
risk patients Improve medication regimen concordance
following hospital and ED discharge