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
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/learning’s
Start working on next year objectives

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

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

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. Pharmacy Workgroup Steps
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 1 2 3
Conduct Ease & Impact exercise to help identify project ideas
Agree on initial projects for first year. Define initial scope
Create sub workgroups with CCO partner staff for each project 4 5 6
Report to HSO CMO workgroup progress
Report out progress or clarification needs to pharmacy director workgroup
Subgroups meet monthly and interpret scope to create actionable steps 7 8 9

15. Medication Reconciliation Process Mapping Workshop 12-17-2012

16. Thank You!