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Population Health: Expanding the Role of Pharmacy Technicians

By Patrick Gregory posted 11-17-2017 13:24

  

Over the past few years, the term population health has been a buzzword within the pharmacy profession. Population health and related terminology have been defined by utilizing multiple definitions.1 Specifically, population  health management can be defined as programs targeted to a defined population that use a variety of individual, organizational, and societal interventions to improve health outcomes.2

Health care systems are increasingly looking for ways to improve population health and provide higher quality care at a lower cost.3-4Duke Health, often through value-based agreements with various payers, strives to improve both the quality and cost of care for patients managed by the Duke Population Health Management Office (PHMO) DukeWELL care management services.

The Duke PHMO Pharmacy Technician Home Visit Program was implemented in March 2017. The program is aimed at supporting the PHMO cost and quality improvement goals by identifying medication discrepancies and improving care coordination for higher risk patients that often have multiple chronic conditions and polypharmacy.

As the importance of population health management continues to grow, pharmacists and pharmacy technicians are providing expanded services in health care systems.1,5 With the unique drug knowledge pharmacists have, they are positioned to address adverse drug reactions, evaluate high risk medications, and provide medication counseling and reconciliation, among other roles.5 The role of pharmacy technicians has also expanded in recent years to obtain medication histories, connect patients to medication assistance programs, and work with physician teams on medication prior authorizations.5-6

Medication histories are a time intensive process taking around 15-30 minutes per patient.6 Only a handful of articles exist describing the utilization of pharmacy technicians to conduct home visits, however, their beneficial role for identifying medication discrepancies and improving care coordination has been demonstrated.7,8

Currently, Duke’s PHMO uses one certified pharmacy technician throughout the program to conduct home visits two days per week for patients located in specific zip codes in the Raleigh-Durham region in North Carolina. During each visit, the technician obtains a medication history and conducts a needs screening. The needs screening includes questions related to functional status and social determinants of health.

Healthcare reform and incentives to participate in accountable care agreements are driving change to provider reimbursement models. Institutions will find it financially advantageous to focus on population health and improve the overall health of the community.

We are curious to hear creative ways other institutions are utilizing pharmacy technicians to support population health initiatives. Please leave any feedback and messages in the comments section.

Patrick Gregory, PharmD, BCPS, CDE
Ben Smith, PharmD, BCACP, CPP, BCGP


References

  1. Swarthout M, Bishop MA. Population health management: Review of concepts and definitions. Am J Health-Syst Pharm. 2017;74:1405-11.
  2. Felt-Lisk S, Higgins T. Exploring the promise of population health management programs to improve health. Washington, DC: Mathematica Policy Research; 2011 Aug.
  3. Berwick DM, Nolan TW, Whittington J. The triple aim: Care, health, and cost. Health Aff. 2008;27(3):759-769.
  4. Richman EL, Lombardi BM, Zerden L. The accountable care workforce: Bridging the health divide in North Carolina. N C Med J. 2017;78(4):262-266.
  5. Bush PW, Daniels R. Health care systems and transitions of care: Implication on interdisciplinary pharmacy services. N C Med J. 2017;78(3):177-180.
  6. Irwin AN, Ham Y, Gerrity TM. Expanded roles for pharmacy technicians in the medication reconciliation process: a qualitative review. Hosp Pharm. 2017 Jan;52(1):44-53.
  7. Bailey JE, Surbhi S, Bell PC, et al. SafeMed: Using pharmacy technicians in a novel role as community health workers to improve transitions of care. J Am Pharm Assoc. 2016;56(1):73-81.
  8. Surbhi S, Munshi KD, Bell PC, et al. Drug therapy problems and medication discrepancies during care transitions in super-utilizers. J Am Pharm Assoc. 2016 56(1):633-42.
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11-25-2017 10:14