1. 7th Annual
Pharmacy Informatics Conference
Impact on Pharmacy of Patient Facing Apps Eric Spahn, Pharm D Clinical Analyst, PBM Clinical Informatics Rob Silverman, PharmD Program Manager, PBM Clinical Informatics
April 3, 2014

2. The Pharmacy “Environmental Scan”
7th Annual
Pharmacy Informatics Conference
The Pharmacy “Environmental Scan”
Rob Silverman, PharmD
Program Manager, PBM Clinical Informatics
April 3, 2014

3. What is the “Pharmacy Environmental Scan”?
It’s a spreadsheet
It’s an attempt to get the big picture of all medication-related development efforts across the VA, since PBM is, by definition, the business owner or designated subject matter expert(s).
It’s comprised of data from multiple sources:
New Service Requests
Existing projects in PMAS
Field Development Projects, including Class 3 to Class 1 Conversion Candidates
Mobile Application Projects
Innovations Projects

4. Additional information re: New Service Requests
PBM maintains a weekly log of those New Service Requests (NSRs) that we are tracking with a pharmacy-related interest.

5. How did the Environmental Scan get compiled, and… Where can I find the Environmental Scan information now?
Original source content was provided by the New Service Request tracking sheet, with additions for the other types of projects provided by:
National Alliance for Patient Medication Information Standardization (NAPMIS) 2010 White Paper report produced their environmental scan on patient med info/medication reconciliation projects being proposed or in development
AIM: Applied Informatics Management team, formerly Health Systems Portfolio Management, and
RDM: Requirements Development & Management
Now it is hosted by AIM, and will be on a SharePoint site,
Note: This is currently a restricted-access site, not yet open to all authenticated users within the VA Intranet.

6. Discussing some of the Mobile Apps…
Immunization Mobile App
Officially “Mobile Workflow Immunization Campaign App”
Initial implementation (Phase 1) for influenza vaccine only
Warfarin Monitor (formerly Coumadin Clinic)
Safe Women's Prescribing App

7. Discussing some of the Field Development Projects…
Non-VA Medications as Outside Prescriptions
NSR
Waiver Requests for sites to install
Multiple TIU and CPRS based local solutions
Unapproved abbreviations
TIU Data Objects and Health Summary components by “Drug Class”
Any project that modifies Class 1 nationally released routines will be evaluated as part of VistA Standardization, aka Gold Disk project.

8. Some of the problems that the Environmental Scan aims to address…
Pharmacy Benefits Management (PBM) needs to be aware of any medication-related projects
Example: innovation efforts related to management of remote prescriptions at other VA’s
PBM needs to manage the participation of subject matter experts for all of the identified projects
The Essential Medication Information Standards Directive defines medication information standards for sharing, management and review across all app development projects, (mobile, web and print) for both patient and staff facing information
recognizes PBM as the primary subject matter expert on any medication related project
A central repository of projects assists us in having a bird’s-eye view
PBM needs to connect various discussions about a single project
Often, the New Service Request name/title is the only common thread between discussions
Funding
Prioritization
Development

9. Health Recon/Med Review App
Potential workflow impact of the patient-facing app on the team-facing activities…
VPS Kiosk
Patient entry and update of medication list
Provider can then use the update during the clinic visit
Health Recon/Med Review App
Same workflow model … patient can update list; provider can use list during clinic visit

10. What’s next?
If you recognize a medication-related project that is NOT on the Environmental Scan, please notify PBM or AIM and it will be evaluated for addition
The Scan will be reviewed on a regular basis by PBM/AIM

11. VA Pharmacy & MyHealtheVet

12. …Access to Care
“A significant contribution to health reform by the pharmacy profession may be to increase access to patient care services,” USPHS Report to USSG
In order to meet the growing health care demands in the United States, pharmacists must continue to expand access to patient care services.

13. MHV Statistics VA Blue Button Rx Refill Ask A Pharmacist
Latest Releases
VA Open Notes
Up and Coming Features
VA CCD
Rx Refill
New User Interface
User statistics
Ask A Pharmacist
New Feature:
Rx Tracker
Secure Messaging statistics
My Medications
Mobile App Development
Enhancements to MHV Pharmacy
View/Edit My Medications
Add A Medication
Add A Medication Effect
My Medication Journal
Sharing My Medications Output

15. What's NEW with My HealtheVet?
My HealtheVet Release 12.8 – March 22, 2014
Secure Message Reassignment enhancement allows a message sent to one triage group to be reassigned to ANY other health care team member or triage group to a VA facility outside of the facility in which the message originated
Secure Messaging Attachments (first version) allows for attachments to be added to Secure Messages from Patients
My HealtheVet Release – February 22, 2014
Rx Refill sort change now displays the medication name before (on top of) the Rx number to allow alphabetical sorting. Change made to the Rx Refill page and Prescription Refill History page
My HealtheVet Release 12.7 – January 25, 2014
Secure Message reassignment enhancements allows a message sent to one triage group to be reassigned to ANY other health care team member or triage group within a facility

16. What's COMING with My HealtheVet?
Rx Tracker
Phase I, MHV release 12.9 (June 2014)
Modify existing MHV Pharmacy RX History and RX Refill pages to allow Track Deliveries.  This will include other RXs in the package but will not include images.
Phase II, MHV  release (Sept 2014)
Add new MHV Pharmacy RX Tracking page to allow for Track Deliveries.  This will include images and other requirements not addressed.
My Medications
Aiming for MHV (Sept 2014)
Blue Button User Interface redesign
Aiming for MHV v12.9 (June 2014)

17. Changes to MHV Pharmacy Landing Page
Current
September 2014

18. September 2014
Select the new Track My Deliveries icon on the new Pharmacy landing page of My HealtheVet which takes you to a new ‘VA Deliveries Summary’ page
This page shows all your VA prescriptions filled by a VA Mail Order Pharmacy and mailed in the last 45 days. A prescription sent by a VA Mail Order Pharmacy today, will not display until the next day or two.
Select a prescription record to track from the VA Prescription Tracking Summary table by clicking the Track Delivery button under the Prescription Tracking column
June 2014

19. Rx Refill Current

20. Rx Refill June 2014

21. Prescription History Current

22. Prescription History June 2014

23. Prescription Delivery Details
September 2014
HYDROXYZINE 25MG CAP
June 2014

24. Carrier Tracking Information Page June 2014

25. What's COMING with My HealtheVet?
Rx Tracker
Phase I, MHV release 12.9 (June 2014)
Modify existing MHV Pharmacy RX History and RX Refill pages to allow Track Deliveries.  This will include other RXs in the package but will not include images.
Phase II, MHV  release (Sept 2014)
Add new MHV Pharmacy RX Tracking page to allow for Track Deliveries.  This will include images and other requirements not addressed.
My Medications
Aiming for MHV (Sept 2014)
Blue Button User Interface redesign
Aiming for MHV v12.9 (June 2014)

26. Changes to MHV Pharmacy Landing Page
Current
September 2014

27. My Medications Current MHV Pharmacy: **New Medications MHV Pharmacy:
Pulls VA pharmacy medications from VistA
View VA medications
Enter/View Self-Entered medications and supplements
Current
MHV Pharmacy:
Medications
& Supplements
VA Medications
**New
MHV Pharmacy:
My Medications
** Includes link to MHV Pharmacy – RX Refill to request Medication Refills

28. Enhanced Features MHV Pharmacy: My Medications
View/annotate Non-VA medications VA entered (limited fields)
View/annotate VA Medication (limited fields)
View and Record when a medication is taken and amount taken
View and Record medication effects
Display VA medication images
Display patient centric label image for reference
Display dosage strength and frequency of medications
Recording of patient self discontinued medication
View Self-Entered Allergies on Medication List (Basic MHV Account holders)
View Self-Entered and VA Allergies and Adverse Reactions on Medication List (Premium and Advanced MHV Account holders)

29. Enhanced Features (cont.) MHV Pharmacy: My Medications
Enhanced instructional text
On screen via hover text and explanatory text
Downloadable Patient Educational Materials
Maintain history of past pharmacy prescribers
Provides field for patient to document if taking medication as prescribed or differently.

32. MRP My Medications: Add a Self-Entered Medication

35. MRP My Medications: Medication Effects

36. MHV Pharmacy: Add Medication Effect Entry Page

37. MRP My Medications: My Medications Output and Secure Messaging…??

38. What's COMING with My HealtheVet?
Rx Tracker
Phase I, MHV release 12.9 (June 2014)
Modify existing MHV Pharmacy RX History and RX Refill pages to allow Track Deliveries.  This will include other RXs in the package but will not include images.
Phase II, MHV  release (Sept 2014)
Add new MHV Pharmacy RX Tracking page to allow for Track Deliveries.  This will include images and other requirements not addressed.
My Medications
Aiming for MHV (Sept 2014)
Blue Button User Interface redesign
Aiming for MHV v12.9 (June 2014)

39. Difference between VA Blue Button and VA CCD?

45. Ask A Pharmacist and Secure Messaging

46. Pharmacy– Secure Messaging Stats
SQL Query into MHV Database using Triage_Group_Name like '%pharmacist%'
Date
Stations
Triage groups
Active Patients
Inbound messages in February
February 2012 22 26
15158
682
February 2014 42 84
92066
1853

47. Ask A Pharmacist Mobile App Development
Currently gathering requirements for
future development
Key requirements:
My HealtheVet Pharmacy Services
Pill Identifier
Trusted Medication Resources
Sending Secure Messages
About VA Pharmacies