San Diego Right Care-GO Leadership Forum on the Prevention of Heart Attacks and Strokes June 4, 2010 Daniel Cusator, MD, MBA Rebecca Cupp, RPh Chief Medical Officer VP of Pharmacy Greater Newport Physicians Ralphs Grocery Company
Jan 17, 2016
San Diego Right Care-GOLeadership Forum on the Prevention of
Heart Attacks and StrokesJune 4, 2010
Daniel Cusator, MD, MBA Rebecca Cupp, RPhChief Medical Officer VP of Pharmacy
Greater Newport Physicians Ralphs Grocery Company
Disruptive Innovation:◦ Unexpected new offering through price or quality
improvement that turns a market on its head.
Benefit of using Appropriate Skill Level
PhysiciansNursesClinical
PharmacistsPhysician
Assistants
Nurse PractitionersMedical AssistantsSocial WorkersTechnicians
Making the case for clinical pharmacists as part of the health care team
Pharmacy profession has been moving from a product- focused to patient-focused practice
The Asheville Project ◦ Recognized as a promising intervention for rapid improvement in C/V Dz
Including pharmacists on the care team can provide better outcomes ◦ Kaiser Permanente (early 1990’s) study: improved survival and
decreased hospitalizations
◦ Planas, 2009-Improving BP Control in DM HTN patients
◦ de Oliveria, 2010- MTM ROI $1.29 per $1.00 MTM Costs
IPA Group In-House Pharmacist
Academic Clinic Pharmacist
Community Pharmacist
Imbedded Clinical Pharmacist
◦Supports Specific Group Practice
◦Continuum of Care for Practice Population
PharmD-MD Collaborative Usual Care
• Internal Medicine Group – UCSD • HTN patients• Collaborative Practice Protocol• MTMS activities• Clinic visits and follow-up phone calls
RCI Demonstration Project
Medication Therapy Management Services (MTMS)
◦Drug therapy initiation and monitoring◦Medication dosage adjustments◦Physical assessment◦Laboratory test review/order◦Patient Education
Measurable Outcomes
Standardized Pharmacist Coaching Program
◦Initial Visit
◦Follow Up Visits
◦Documentation
Patient Care Services
◦Medication Therapy Management
◦Point-of-Care Testing
◦Patient Education
Benefits◦Accessibility◦Familiar and comfortable environment
◦Convenience Location Hours
◦Measurable Results Improved Scores