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care delivery team consultation

Practice & Care Delivery Transformation Workgroup

The overarching purpose of this workgroup is to explore strategies to accelerate delivery reform at the point of care which enable medication optimization. For the Practice & Care Delivery Transformation Workgroup, the guiding principle will be focused on engaging physicians, clinical pharmacists and other team members who share a complete commitment to medication optimization by providing tools, data, practice standards and implementation resources to advance their ability to optimize medication use in their own settings. Capitalizing on all aspects of advances in practice redesign that recognize and demonstrate medication optimization both in the U.S. private and public sectors, and informed by international best practices, this workgroup will give a clear picture and roadmap of the changes necessary (barriers and enablers) to optimize medication therapy. It will also prepare for the transition from population-based clinical guidelines to personalized/precision medication selection and use. In addition, they will work closely with the other workgroups to ensure advances in diagnostics, IT and analytics, and policy and reimbursement align with their delivery/practice changes. To truly optimize care, a systematic approach to medication use must be present. Enabling these changes requires payment, practice and policy models that leverage diagnostics and recognize the important role of team-based medication experts to provide a more personalized and targeted approach to medication use throughout the continuum of care.

Workgroup Executive Leadership

Anthony MorrealeExecutive Lead: Anthony P. Morreale, Pharm.D., MBA, BCPS, FASHP, Associate Chief Consultant for Clinical Pharmacy and Policy, Department of Veterans Affairs Pharmacy Benefits Management

Executive Lead: Kasey K. Thompson, Pharm.D., MS, MBA, ASHP designee, Chief Operating Officer and Senior Vice President, ASHP

Marcia Buck headshotExecutive Lead: Marcia Buck, Pharm.D., FCCP, FPPAG, Director, Clinical Practice Advancement, American College of Clinical Pharmacy

Subgroup 1: Care Delivery

  • Identify outcomes attributable to clinical pharmacists’ involvement in team-based care that supports CMM expansion and identifies barriers and enablers
  • Examine key elements and strong practices around collaborative practice agreements that might serve as models to strive for uniformity

Julie Groppi HeadshotLead: Julie Groppi, Pharm.D., FASHP, National Program Manager, Clinical Pharmacy Practice, Policy and Standards, Clinical Pharmacy Practice Office (CPPO), Pharmacy Benefits Management (PBM) Service (10P4P), VA Central Office

Rita Shane headshotCo-Lead: Rita Shane, Pharm.D., FASHP, FCSHP, ASHP designee, Chief Pharmacy Officer and Professor, Department of Medicine, Cedars-Sinai Medical Center, Assistant Dean, Clinical Pharmacy, UCSF School of Pharmacy

Amie Brooks headshotCo-Lead: Amie Brooks, Pharm.D., FCCP, BCACP, Director of Strategic Initiatives, American College of Clinical Pharmacy (ACCP)

Co-Lead: Keri Hager, Pharm.D., BCACP, AACP designee, Associate Professor, University of Minnesota College of Pharmacy, Clinical Pharmacist Faculty, Center for Alcohol and Drug Treatment

Additional Participants

  • Leeann K. Webster, RPhCDE, Geisinger
  • Ellina Seckel, PharmD, BCACPDPLA, VA
  • Mary Ann Kliethermes, BS, PharmD, Chicago College of Pharmacy, Midwestern University
  • Lori Armistead, MA, PharmD, Center for Medication Optimization, UNC School of Pharmacy
  • Allyson Schlichte, PharmD, MBA, BCACP, Fairview Health Services
  • Melanie A. Dodd, Pharm.D., Ph.C., BCPSFASHP, College of Pharmacy, University of New Mexico
  • Jaclyn Boyle, PharmD, MS, MBA, BCACPBCPS
  • Nirav R. Shah, MD, MPH, Stanford University Research Center
  • Sonja Rosen, MD, Cedars-Sinai Medical Care Foundation
  • Steven Chen, PharmD, FASHPFCSHP, FNAP, USC School of Pharmacy

Subgroup 2: System Transformation

  • Collect and review existing value-based business agreements with the intent of spreading profitable and sustainable practices to support CMM expansion
  • Define key barriers and strategies to improving access to health IT solutions that liberate clinical data and allow for efficient CMM practice delivery

Heather Ourth headshotLead: Heather Ourth, Pharm.D., BCPS, BCGP, National Program Manager: Clinical Pharmacy Practice Program and Outcomes Assessment, Pharmacy Benefits Management Services 10P4P, Department of Veterans Affairs

John Armistead headshotCo-Lead: John Armitstead, MS, RPh, FASHP, ASHP designee, System Director of Pharmacy Services, Lee Health

Co-Lead: Curtis Haas, Pharm.D., FCCP, ACCP designee, Director of Pharmacy, University of Rochester Medical Center

Ron Jordan headshot Co-Lead: Ron Jordan, RPh, FAPhA, AACP designee, Dean, Chapman University School of Pharmacy

Additional Participants:

  • Randy McDonough, BS, PharmD, MS, CGPBCPSFAPhATowncrest Pharmacy
  • Meghan Swarthout, PharmD, MBA, BCPS, Johns Hopkins Home Care Group Pharmacy Services 
  • Kelly Epplen, PharmD, BCACPFASHP, James L. Winkle College of Pharmacy, University of Cincinnati
  • Kevin Marvin, RPh, MS, FASHP, Kevin Marvin Consulting LLC
  • Darren Triller, PharmD, WellScriptED Consulting, LLC
  • Enrique Seoane-Vasquez, Professor, School of Pharmacy, Economic Science Institute, Chapman University 
  • Robert Alesiani, PharmD, BCGP, Care Kinesis

Subgroup 3: Practice Integration

  • Identify strong CMM practices and explore methods proven to enhance physician leadership, engagement and support
  • Develop the business case to demonstrate the value of clinical pharmacy services targeted to patients, providers and healthcare leadership in order improve demand and engagement

Shawn McFarland headshotLead: M. Shawn McFarland, Pharm.D., FCCP, BCACP, National Clinical Pharmacy Practice Program Manager, Clinical Practice Integration and Model Advancement, Clinical Pharmacy Practice Office, Pharmacy Benefits Management Services, Veterans Health Administration

Marcia Buck headshotCo-Lead: Marcia Buck, Pharm.D., FCCP, FPPAG, Director, Clinical Practice Advancement, American College of Clinical Pharmacy

Mary McClurg headshot Co-Lead: Mary McClurg, Pharm.D., MHS, AACP designee, Professor, Executive Vice Dean-Chief Academic Officer, UNC Eshelman School of Pharmacy

Additional Participants:

  • Amanda Brummel, PharmD, BCACP, Fairview Pharmacy Services
  • Kyleigh Gould, PharmD, BCACP,  Kansas City VA Medical Center
  • Daniel Rehrauer, PharmD, Medication Therapy Management Program and Community Pharmacy Partnerships
  • Toby Trujillo, PharmD, FCCPFAHABCPS-AQ Cardiology, University of Colorado
  • Bruce Sherman, MD, FCCPFACOEM, National Alliance of Healthcare Purchaser Coalitions

Areas of Further Work

Subgroup 1: Care Delivery

  1. Identify evidence and develop use cases to promote the value of optimized medication use to payors, consumers and providers
  2. Clearly identify and offer guidance on the care team, their roles, responsibilities and accountabilities in the provision of a systematic approach identifying CMM as a process (e.g. focus first on high risk patient populations)
  3. Develop guidance tools for consumers, payors and providers so they understand the role of an appropriately skilled pharmacist as medication expert
  4. Develop tools to engage patient advocacy and professional groups to move them to a full understanding of the economic and human toll resulting from non-optimized medication use
  5. Create guidance, definitions and tools for physicians and other professional organizations, consumer and employers to educate and gain support for CMM
  6. Further develop and disseminate an evidence-based resource tool to be used by the care team that is web-based, interactive and allows team members to build successful collaborative practice

Subgroup 2: System Transformation

  1. Develop resources to adequately communicate the extent and underlying causes of the economic and human toll on non-optimized medication use and evidence that CMM can reverse these trends to promote the value of team-based CMM services to employers, health plans and PBMs
  2. Further develop and disseminate resource tool(s) outlining the essential structures and language to incorporate CMM services within value-based agreements in response to demand created for expansion of CMM services (e.g. expand the VBP glossary; focus on POV and needs of each stakeholder)
  3. Develop guidance to promote and ensure the efficient flow of all relevant health information to all team members as a point-of-care resource for the effective delivery of CMM services (e.g. promote use of HIT and AI workgroup “maturity matrix”)

Subgroup 3: Practice Integration

  1. Create guidance, use cases, best practices, and resources to support GTMRx efforts to educate and support care teams moving forward to adopt and integrate comprehensive medication management services into practice (engaging patients).
  2. Offer guidance to shape and inform consistent practice integration of CMM level services for physicians to ensure a consistent and standardized approach to practice.
  3. Offer guidance to shape and inform consumers and employers (from their point-of-view) of what to expect from the care team, and the clinical pharmacist as we build demand for a systematic approach to medication use (CMM).
  4. Offer guidance to inform contract standards and common definitions between those who buy care (consumers and employers) and those who contract for care (health plans, consumers, government).
  5. Perform a systematic review of literature around CMM practice integration to identify  impact on cost, quality and provider satisfaction (include examples in public, private and commercial sector) outlining cost savings, impact on patient outcomes and provider satisfaction.  The goal is to assure consistent, effective and sustainable delivery and integration of CMM into practice and to offer payors activities and results to inform contract requirements and network requirements.
  6. Identify partners, develop tools, guidance and a dissemination plan (practice leaders, physicians/their agents, consultants, care teams and payors) to increase awareness, build demand for, and ensure adoption and use of a successful strategies and standardized implementation processes for CMM integration.
  7. Work with professional organizations to ensure more rapid practice transformation nationwide.
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