By John Vinson, PharmD, Vice President of Practice Innovation, Arkansas Pharmacists Association
Megan Smith, PharmD, Assistant Professor, University of Arkansas for Medical Sciences
Jordan Foster, Director of Communications, Arkansas Pharmacists Association
In 2014, guided by the Triple Aim to improve the patient’s experience of care, improve population health and reduce health care costs, Community Care of North Carolina (CCNC) created the Community Pharmacy Enhanced Services Network (CPESN), an open network of North Carolina pharmacies dedicated to expanding pharmacists’ services available to patients. The network was designed to benefit the patient, the payer and the pharmacist.
This model demonstrated that bringing pharmacists into the care team elevates the level of care that patients receive, especially when addressing social determinants of health care for highly complex patient populations. The success of the program led to the creation of CPESN-USA, a partnership between CCNC and the National Community Pharmacists Association that helps states create their own CPESN programs.
Now, community pharmacists in Arkansas, with their partners at the Arkansas Pharmacists Association, UAMS College of Pharmacy, Harding College of Pharmacy and CPESN-USA, have brought the same type of enhanced network to the Natural State. And pharmacists across the state have embraced the initiative.
The Arkansas Community Pharmacy Enhanced Services Network (Arkansas CPESN) unites cooperating pharmacies into an engaged network capable of providing services above and beyond what people normally think of as a pharmacy’s services – prescription dispensing and basic patient education.
Working collaboratively with other health care providers, health systems, health insurance companies and additional stakeholders, the Arkansas CPESN seeks to optimize medication therapy to ensure patients are achieving positive therapeutic outcomes and reduce overall health care costs.
Key to the Arkansas CPESN approach is the active integration of community pharmacists with the larger care team, including primary care physicians, specialty providers such as behavioral health professionals and the extended care teams in Patient Centered Medical Homes.
Medication optimization, including medication therapy management, is one service network pharmacists provide that particularly helps improve patient health outcomes. Through medication therapy management, Arkansas CPESN pharmacists work closely with patients, patient representatives and other health care providers to collect pertinent patient clinical information. They identify actual or potential drug therapy problems, provide patient care plans with recommendations to resolve these problems, and provide ongoing follow-up and monitoring services.
Why do this? Arkansas CPESN pharmacists want to ensure that patients are getting the best possible outcomes through safe and effective drug therapy.
These enhanced services have been shown to improve patient health, increase patient accountability and responsibility for their own well-being, and decrease overall costs compared to patients who are non-adherent to their therapy plans.
Pharmacies across the Natural State have joined the Arkansas CPESN, and the network continues to grow. Enlarge• Medication Synchronization with Personal Medication Record: Not to be confused with automatic refills, medication synchronization is a step-by-step process that helps ensure patients have available – and are taking – their medications as prescribed. First, each patient in the program receives a comprehensive medication assessment; then, refills of their regular medications are aligned to be dispensed on the same day.
With each fill, the pharmacist has a discussion with the patient to verify any medication changes and to assess the patient’s progress toward his or her desired health goals. This allows the pharmacist to monitor medication adherence and address any problems with non-adherence.
As part of this service, the patient also receives a personal medication record, which is a comprehensive record of the patient’s active medications (including prescription and over-the-counter medications, vitamin or herbal supplements and medications taken only as needed).
• Adherence Assistance: Network pharmacists also help patients develop a system to organize medications and take them appropriately at the correct time of day. This makes it easier for patients to adhere to their prescribed treatment. The adherence assistance services may include working with the patient or caregiver to determine an appropriate packaging system, such as bubble packaging, medication strips, med planners or the use of an automated medication dispenser.
• Comprehensive Medication Review with Follow-up: Each of the patient’s medications – prescription and non-prescription – is individually assessed to determine appropriateness for the patient, effectiveness for the medical condition and safety. Any concerns or issues then can be resolved by the care team to assure that the patients’ medications are helping to achieve their overall health goals. Pharmacists then provide any appropriate patient-specific follow-up monitoring, such as collecting vitals and other objective measures (blood pressure, blood glucose, weight, etc.).
• Transition of Care: An essential component of the enhanced services network is the coordination and continuity of health care as patients transfer between different settings. Medication reconciliation, medication therapy management and patient education form the core activities of the network pharmacist. These are services designed to improve patient care provided during critical transition periods.
This type of service is provided on referral and is targeted toward patient populations at increased risk for readmission. These patients may include those with heart failure, chronic obstructive pulmonary disease, asthma, advanced age, low health literacy, or those who experience frequent hospitalizations.
Pharmacies will also offer a non-dispensing, 24-hour on-call service to assist in care transitions and may provide home delivery, as needed.
• Immunizations: Network pharmacists also actively screen patients for recommended immunizations, educate patients about needed immunizations and provide various immunizations for their patients, including flu, pneumococcal and shingles vaccines.
With additional pharmacies joining the network each day, Arkansas CPESN is actively looking for partnerships with health systems, other providers and payers to create innovative health solutions.
These additional pharmacy services will benefit the payer’s bottom line, the pharmacist’s ability to thrive in a shifting health care environment, and most importantly, patients’ health.
For additional information about the Community Pharmacy Enhanced Services Network, visit www.cpesn.com or email Max Caldwell at AR@cpesn.com.
The above article is from AHA, a custom publication of Vowell, Inc., which also produces Arkansas Money & Politics.
