Presentation on theme: "Health Share Pharmacy Workgroup Experience"— Presentation transcript:
1 Health Share Pharmacy Workgroup Experience Jim SlaterFacilitator
2 Workgroup Pharmacist Participants Janice Hogue…Adventist HealthJim Slater, Dean Haxby…CareOregonSandy AndersonCentral City ConcernTBDClackamas County (Mental Health Services)Steve Logan, Nancy Louie Lee…Kaiser Foundation Health Plan of the NorthwestKathy Stoner, Cory Huot…Legacy Health SystemCarol Richmond, Michele Koder…Multnomah CountyYen Pham, Amy Szczukowski…Oregon Health & Science UniversityPriyesh Patel…Steve Stoner…Helen Noonan-Harnsberger/Greg Dietzman…Terri Bianco…Providence Health & ServicesHospitalHealth PlanMedical GroupSpecialty PharmacyBrian Dotter…Tuality HealthcareWashington 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 participantsIndentify 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 monthsCollaborative partners can provide sufficient staff resource allocation to be successfulMembers and/or Providers likely are positively impacted (Triple Aim) – Tangible experience for the betterProject can work in more than one setting/facilityMore than one HSO partner participates togetherEven 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 productivityFormulary & prior-authorization standardization & unificationEMR 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 individualsConcurrent review/collaboration – hospitalizationMedication reconciliation/transition-of-care post-discharge drug treatment plan F/U (Handovers) Clinic ↔ Hospital ↔ ClinicMonthly coordinated fills (Adherence packing, dispensing appointments, clinical pharmacist monitoring/updates of drug therapy care plan)Pro-active steps to protect at-risk membersHepatitis 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 careMental heath access issues ( PCP education on appropriate antipsychotic drug therapy & pearls, limiting off label/poor evidence use)
7 Project Idea Brainstorming Open DiscussionWhat 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-countyHow 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 HSOAt 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) 3Q2012Form pharmacy workgroup and identify projects,4Q2012Form sub-workgroups, interpret scope into actionable steps1Q2013Monitor projects, CQI/Lean along the way, monthly progress reports2Q2013Presentations to collaborative of success/learning’sStart 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 VSMFuture State VSMPDSANew Current State VSMFuture State Plan
13 Project Implementation Brainstorming Open DiscussionWhat 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 PartnerOrient workgroup to known CCO facts and workgroup goalGather key questions and expectations from workgroup participants123Conduct Ease & Impact exercise to help identify project ideasAgree on initial projects for first year. Define initial scopeCreate sub workgroups with CCO partner staff for each project456Report to HSO CMO workgroup progressReport out progress or clarification needs to pharmacy director workgroupSubgroups meet monthly and interpret scope to create actionable steps789
15 Medication Reconciliation Process Mapping Workshop 12-17-2012