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Key steps for becoming an ‘outcomes powerhouse’
Health Systems Prove Value in Specialty Care
C
ompared with other types of specialty pharmacies, those based in health systems have superior access to patients and providers, as well as information in medical records, speakers said during a session at the virtual 2021 ASHP Specialty Pharmacy Conference. These factors can be leveraged to demonstrate value to various stakeholders.
“Metrics commonly used to measure specialty pharmacy services today focus mostly on operational requirements,” said Amber Skrtic, PharmD, CSP, AAHIVP, a clinical pharmacist with Trellis Rx at Parkview Health, in Fort Wayne, Ind. “While we perform better on these metrics, they don’t show the full impact of our integrated services. Proving our value
lies in showing how our higher level of integration allows us to provide differentiated services [and improve] clinical and qualitative outcomes.” Determining what metrics to measure is not always straightforward, especially in disease states that don’t have clinical markers, Dr. Skrtic said. She recommended looking to clinical trials,
Free CME now available! 1.0 AMA PRA Category 1 Credit™
New Horizons in Migraine Management RELEASE DATE: NOVEMBER 1, 2021 EXPIRATION DATE: DECEMBER 31, 2022
This activity is jointly provided by Global Education Group and Applied Clinical Education.
Faculty Jessica Kiarashi, MD This activity is supported by an educational grant from AbbVie. Distributed by CMEZone.com
Assistant Professor Department of Neurology University of Texas Southwestern Medical Center Dallas, Texas
evidence-based guidelines, peer organizations and stakeholder colleagues for guidance. One metric all stakeholders agree on is better outcomes, she noted. Once you determine outcomes to measure, then decide what activities are needed to achieve them. A health-system specialty pharmacy should consider three critical strategies to become an “outcomes powerhouse,” Dr. Skrtic said: 1. Develop disease-specific protocols. These should account for the full patient journey, she emphasized. It’s also important to consider patient onboarding to ensure they can afford therapy and start in a timely manner, how to proactively manage refills, and how to determine what clinical activity is needed to ensure therapy is appropriate and patients receive support to remain adherent. 2. Leverage electronic health records (EHRs). EHRs can be a critical technology for deploying these protocols and workflows, Dr. Skrtic said. Ideally, the programming/protocol should trigger interventions automatically based on data captured by the EHR or the specialty pharmacy team. The programming/protocol also should collect data in a consistent, reportable fashion. 3. Embed pharmacists and liaisons on-site. The pharmacists should work closely with providers to see patients in person whenever possible, Dr. Skrtic said. The pharmacists also need access to the EHR to see pertinent information and document updates. In one project, Dr. Skrtic and her colleagues at Parkview Health—a 10-hospital health system in Indiana and Ohio that launched integrated specialty pharmacy services in 2019 with Trellis Rx—evaluated their impact on lost work productivity among patients experiencing migraines. These patients were covered under Parkview’s employee health plan and prescribed calcitonin gene–related peptide specialty medications for migraine. Pharmacists routinely conducted patient-reported outcome measure assessments and performed interventions, if necessary, based on the results. Over an eight-month period, pharmacists performed 29 interventions, such as dose or therapy changes, adherence counseling and adverse event management for 38 patients. The number of migraine days per month decreased by 55%, and lost productivity per month, including workdays missed and productivity lost during migraine attacks, decreased by 60%.
4 Steps to Demonstrating Value When using metrics and measures to demonstrate value, consider four points, said Ann McNamara, PharmD, the director of clinical development at Fairview
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