Pharmacy Perspectives - Fall 2012 - (Page 16)

F A C u Lt Y Drug expertise at a distance and Pharmaceutical Sciences and clinical pharmacist at the University of Colorado Seniors Clinic, took on the challenge of doing the remote consults. The idea was to leverage the Epic electronic health record to enable clear communications with physicians at University Family Medicine-Park Meadows in Lone Tree. It’s a small practice, with medical director Debra Bislip, MD, two part-time physicians and a part-time nurse practitioner. Vande Griend recognized immediately that Epic’s technology alone would not suffice. He saw that he needed to build relationships with Park Meadows’ providers before they would let him peruse patient medical records – much less follow Vande Griend’s recommendations as to improving care. “You can do a lot remotely via Epic,” Vande Griend said. “The big piece was they needed to trust me.” That insight proved to be decisive, differentiating the grant program from the third-party pharmaceutical recommendations often faxed or emailed in via insurance providers. Such information has little currency among many physicians, Vande Griend says, because it often lacks context about the subtleties of a particular patient’s status. By Todd Neff Joe Vande Griend, PharmD, aims to bring pharmacist consults to remote practices Got Your Back Bislip, who is also the lead physician in developing the Park Meadows Clinic’s Patient-Centered Medical Home program, is a fan. “I see it as a very good tool as far as enhancing the team approach, so that everybody is involved in patient care,” Bislip said. “And patients like it, too.” Among other positives, she said, is that Vande Griend’s availability motivates physicians to review – and often change up – the prescriptions of patients who have been on the same medications for years. In addition, Bislip says, she finds herself sending Vande Griend questions – and even forwarding those patients send through Epic’s MyHealthConnection – about medications. She’ll send responses back to patients, she says, in which she says, “It’s not just my opinion. I ran this by the clinical pharmacist and this is our opinion.” But not all patients are receptive, Bislip said. Some view the medication review as an excuse to lower health-care costs at their expense. Also, some physicians are more receptive to team-based care approach than others, she said. Still, the experiment appears to have been a success, and Family Medicine aims to roll it out to its Boulder and Westminster clinics. Vande Griend’s chief interest now, he says, is to establish how many patients and practices a remote pharmacist might realistically handle. The model could extend well past University of Colorado Health, he says. Vande Griend’s work with Park Meadows continues, now paid for by the Department of Family Medicine. He’s planning on publishing on the results of the grant, which expired in July. He’s hopeful that insurers will recognize the value of the remote pharmacist and reimburse for such services. It certainly fits into the concept of the patientcentered medical home, he says. “Clinics will ultimately receive incentives for providing better care, and I can help providers with the medication management piece of that,” Vande Griend said. Forget that stereotype of the pharmacist behind a counter, filling bottles with pills. For years now, pharmacists have been core members of UCH patient-care teams, rounding with physicians in the Anschutz Inpatient Pavilion and also serving patients at clinics such as the AF Williams Family Medicine Center at Stapleton and the Seniors Clinic. Their knowledge of the nuances of the growing roster of drugs – what’s passé and what’s emergent, what interacts with what, what can be substituted for what – takes pressure off busy doctors, enhances patient safety, and improves the quality of care. But pharmacists are in short supply, and only hospitals and the largest clinics – AF Williams has 10 faculty and 20 residents – can afford them. That may be about to change, thanks to a pioneering effort led by Joe Vande Griend, PharmD, and Colleen Conry, MD. “Working with pharmacists at AF Williams for more than 10 years, they’ve become integral members of the care team, and I can’t imagine not having a pharmacist around to ask questions of,” said Conry, vice chair of the University of Colorado School of Medicine’s Department of Family Medicine. To Lone Tree Once a week or so, Vande Griend headed to Park Meadows to meet with physicians and patients. As time passed and those relationships solidified, the visits became less frequent – now he’s in Lone Tree perhaps once a month – at least physically. Via Epic, Vande Griend spends hours each week in the Park Meadows practice. On Thursdays and Fridays, he reviews the records of the 80 or 90 patients scheduled to visit the following week, with an eye out for those with chronic conditions and multiple medications. He’ll drop a note via Epic with his thoughts on certain ones. He might zip through a dozen cases in a few minutes, then dwell on one for 45 minutes, he said. “But if my recommendation results in one medication they don’t need being stopped, we could be talking savings of $200 or $300 a month,” not to mention sparing the patient the unneeded chemistry, he said. The grant They wrote a grant proposal, the idea being to try and replicate what onsite pharmacists do, but remotely. Officials at the University Physicians, Inc.School of Medicine Primary Care Strategic Initiative program liked what they saw, and in July 2011, they funded the program with a one-year, $25,000 grant. Vande Griend, who is an assistant professor at the University of Colorado Skaggs School of Pharmacy 16 CU Ska g g s School of Phar m acy and Phar m ace ut i cal S c i e n c e s

Table of Contents for the Digital Edition of Pharmacy Perspectives - Fall 2012

Pharmacy Perspectives - Fall 2012
Contents
Dean’s Message
Centennial Scholars
Commencement
Faculty
Tributes

Pharmacy Perspectives - Fall 2012