Managed Care - November 2008 - (Page 14)

MEDICATION MANAGEMENT Pharmacists Can Be Crucial To Medical Home The increasing use of electronic records may lead the way toward access to diagnostic rationales and long-range patient treatment histories By Martin Sipkoff recent report by Deloitte Consulting promotes the idea of health plans paying retail pharmacists to serve at the core of disease management programs. The idea is to enhance the role of the pharmacist within an integrated system of care delivery, using pharmacists’ databases to improve compliance, diagnostic accuracy, and prescription appropriateness. This approach, Deloitte researchers say, can save money for plans by improving quality — getting the right drug to the right patient at the right time. Medicare, some health plans, and drug store chains are looking at the idea, basically as an expansion of medication therapy management services “The use of pharmacists in this way certainly could be a substantial advantage, especially within the medical home concept,” says Paul Keckley, PhD, director of the Deloitte Center for Health Solutions, who wrote the report, Disease Management and Retail Pharmacies: A Convergence Opportunity. “They could have a role as care coordinators, with associated potential savings for health plans.” macy. “An inherent shortcoming to this idea, however, is lack of pharmacist access to patients’ medical records. For them to play a pivotal part in care management, the medical record is essential.” Keckley agrees. Lack of pharmacist access to patient medical records currently limits the role of the pharmacist to medication management, rather than offering an opportunity to manage care between patients and providers, such as nutritionists and physical therapists, he says. Two promising cultural developments, however, have the potential to change that: the increasing use of electronic medical records (EMRs) and the industrywide promotion of electronic prescription transmission. EMRs will allow pharmacists access to diagnostic rationales and long-range patient treatment histories. For example, an EMR can give pharmacists access to laboratory data. HIPAA privacy concerns may have to be addressed through authorization forms, and state boards of pharmacy may have to re-examine current regulatory practices. But these concerns are already being addressed through medication therapy management (MTM) initiatives across the country — many sponsored by health plans that see a cost advantage in having pharmacists counsel patients. E-prescribing not only gives pharmacists access to insurance information — data that are mostly already available to them through pharmacy benefit management software — but it also enhances communication with physicians. Several emerging e-prescribing models, sponsored by health plans, include e-prescribing as a component of EMRs. “Bring into that the use of clinical management tools, which are the tools that DM comContributing Editor Martin Sipkoff is a long-time health care journalist. A Emerging concept The medical home that Keckley refers to is an emerging concept with considerable support. Essentially, it refers to a health care delivery system in which individuals use primary care practices as the basis for “accessible, continuous, comprehensive and integrated care,” says Keckley. “The goal is to provide patients with both preventive and curative care in a coordinated fashion,” he says.“Pharmacists fit a natural role in that model, in that they are medication management professionals.” “Pharmacists certainly have the skills, training, and knowledge to be prime players in a coordinated approach,” says Judy Cahill, executive director of the Academy of Managed Care Phar- 14 MANAGED CARE / NOVEMBER 2008

Table of Contents Feed for the Digital Edition of Managed Care - November 2008

Managed Care - November 2008 Editor’s Memo Contents News and Commentary Legislation & Regulation Letters Medication Management Compensation Monitor Do It Yourself for Less Biomarkers Promise, but Do They Deliver? Oncologists Complain About Drug Payment Consider Blood Pressure Self-Monitoring Q&A: Keep Industry in the Game Formulary Files Plan Watch Tomorrow’s Medicine Outlook Respiratory Syncytial Virus Managed Care Considerations Contents Continuing Education Objectives RSV Disease in the Pediatric Population In the Trenches RSV Infection in the Adult Population Health Plan Medical Director Health Plan Pharmacy Director RSV Issues and Solutions Assessment/Evaluation/Certificate Request Post-Test

Managed Care - November 2008

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