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Health Share Pharmacy Workgroup Experience Jim Slater Facilitator.

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Presentation on theme: "Health Share Pharmacy Workgroup Experience Jim Slater Facilitator."— Presentation transcript:

1 Health Share Pharmacy Workgroup Experience Jim Slater Facilitator

2 Workgroup Pharmacist Participants Janice Hogue… Adventist Health Jim Slater, Dean Haxby… CareOregon Sandy Anderson Central City Concern TBD Clackamas County (Mental Health Services) Steve Logan, Nancy Louie Lee… Kaiser Foundation Health Plan of the Northwest Kathy Stoner, Cory Huot… Legacy Health System Carol Richmond, Michele Koder… Multnomah County Yen Pham, Amy Szczukowski… Oregon Health & Science University Priyesh Patel… Steve Stoner… Helen Noonan-Harnsberger/Greg Dietzman… Terri Bianco… Providence Health & Services Hospital Health Plan Medical Group Specialty Pharmacy Brian Dotter… Tuality Healthcare TBD Washington County (Mental Health Services)

3 Shared Expectations & Questions What are you hoping to accomplish with collaboration? What questions do you have about the HSO? What questions do you have about working together as a workgroup? What do you think would make a great collaborative relationship?

4 Scope Collaborative workgroup of pharmacy staff from each HSO partner Goal is to demonstrate the power of collaboration using collective resources of the collaborative participants Indentify 3-5 cost-saving drug-therapy initiatives with savings measurable in 6-12 months

5 Possible Traits of a Successful Initiative Clear evidence or experience suggesting good chance of cost-savings (direct/indirect [high correlation]) Shovel Ready – Can be implemented in 3 months Collaborative partners can provide sufficient staff resource allocation to be successful Members and/or Providers likely are positively impacted (Triple Aim) – Tangible experience for the better Project can work in more than one setting/facility More than one HSO partner participates together – Even better to work across the system (Plan + Hospital + Clinic/Medical Group)

6 Some Cost-Saving Drug Utilization Levers That Can Be Pulled – Others? Improving PCP and office staff productivity – Formulary & prior-authorization standardization & unification – EMR best practice – formulary communication & individualized drug therapy plan documentation and updating (EPIC and other platforms) Ensuring success of drug treatment care plans for high-acuity individuals – Concurrent review/collaboration – hospitalization – Medication reconciliation/transition-of-care post-discharge drug treatment plan F/U (Handovers) Clinic Hospital Clinic – Monthly coordinated fills (Adherence packing, dispensing appointments, clinical pharmacist monitoring/updates of drug therapy care plan) Pro-active steps to protect at-risk members – Hepatitis C (readiness –to – treat, progress/refill monitoring) – Safe Opiate Use (standardizaton: dose ceilings & quantity limits, tapering protocols, instruments: D.I.R.E Score, applying prioritized list coverage/PA criteria) – Guideline Note 1 & 12 – best practice oncology & palliative care – Mental heath access issues ( PCP education on appropriate antipsychotic drug therapy & pearls, limiting off label/poor evidence use)

7 Project Idea Brainstorming Open Discussion – What projects would lend themselves towards a 6-12 month cost-saving (Triple Aim) objective?

8 Internal & External Communication Goal: Inspire/achieve orderly & effective team collaboration within the CCO and within the tri-county – How should we proceed with inside and outside interest to join the work? – What are key opportunities to consider in how we communicate our work? – What other groups of pharmacist should we consider to keep in the loop and what is the right juncture?

9 Project Implementation Ideas One page sponsor report created for each project to report up to HSO At least co-leads for each project (creates continuity and back-up to keep it moving) Roll-up dashboard to track progress for each project – regular reporting (monthly) LEAN/A3 API methodology encouraged to refine work on each project towards success

10 Timeline/Strategy (2012 – 2013) 3Q2012 – Form pharmacy workgroup and identify projects, 4Q2012 – Form sub-workgroups, interpret scope into actionable steps 1Q2013 – Monitor projects, CQI/Lean along the way, monthly progress reports 2Q2013 – Presentations to collaborative of success/learnings – Start working on next year objectives

11 TCMC Pharmacy Work Group Draft Sponsor Report Date Updated: Scope: Goals: Success Defined: Milestones: Barriers/Concerns: Key Learning's: Next Steps/Timeline: Key Stakeholders (KS),: Oversight Owner(s): Implementation Owner(s): Project Title: *Report Change **Process Change

12 VSMs and A3s for Project Management Current State VSMFuture State VSM Future State Plan New Current State VSM PDSA

13 Project Implementation Brainstorming Open Discussion – What project resources can we collectively contribute? – What training would help project teams be successful? – What infrastructure do we need to secure pathway towards project success?

14 Establish Pharmacy Director Workgroup with representation form each CCO Board Partner Orient workgroup to known CCO facts and workgroup goal Gather key questions and expectations from workgroup participants Agree on initial projects for first year. Define initial scope Create sub workgroups with CCO partner staff for each project Subgroups meet monthly and interpret scope to create actionable steps Report out progress or clarification needs to pharmacy director workgroup Pharmacy Workgroup Steps Conduct Ease & Impact exercise to help identify project ideas Report to HSO CMO workgroup progress

15 Medication Reconciliation Process Mapping Workshop

16 Thank You!


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