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NHIT Week Blog Series - Pharmacy HIT Collaborative: A Partner for Provider Status

By Samm Anderegg posted 10-08-2018 16:17

  

The Pharmacy HIT (PHIT) Collaborative is a coalition of pharmacy associations and stakeholders aligned to drive technology standardization across the pharmacy industry and integrate pharmacists as patient care providers.  ASHP is a founding member of the Pharmacy HIT Collaborative.


Why?  As a profession, we need our vendors to align with standards that enable us to participate in value-based care models.  Consider the Merit-Based Incentive Payment System (MIPS). Clinicians report quality measures so Medicare can benchmark their performance across all providers.  Exemplary performers earn more reimbursement, poor performers are penalized by a reduction in payment. Pharmacists participate in these program, but are unable to collect on financial incentives even when we contribute to improved outcomes.  


Why?  Most pharmacy systems are not capable of producing data that feed into quality measure reporting, because pharmacists were not eligible for Meaningful Use incentives.  Through Meaningful Use, providers and hospitals were financially incentivized to adopt “certified” EHR software in their practice settings. To be deemed “certified,” EHR vendors were required to adopt technical specifications (e.g., SNOMED CT for clinical documentation) that enable the exchange of information over HIE networks and quality measures (eCQMs) reporting.  Pharmacists were unable to collect provider financial incentives. Likewise, pharmacy technology vendors were not incentivized to adopt technical specifications similar to certified EHRs. Even if you use an EHR at your practice site, you don’t have an army extracting documentation codes from your progress notes, or have privileges to update areas of the patient profile your physician colleagues do, or have a way to demonstrate it was actually you, the pharmacist, who was responsible for getting that A1c to goal.  And here we are today.


To close this gap, we must ensure our vendors meet the requirements to participate in programs like MIPS as individual providers.  This is where the PHIT Collaborative comes in. The PHIT Collaborative has monitored health IT standards since the launch of Meaningful Use, ensuring our profession is “tech-ready” for value-based care models (and provider status).  Most value-based incentive programs have been hospital and provider specific. However, there are pharmacy payment programs popping up all over the country.


The Enhanced MTM (EMTM) Model is a pilot program through the Center for Medicare and Medicaid Services (CMS) Innovation Center focused on determining if payment incentives and regulatory flexibilities lead to better patient outcomes.  CMS is studying the success of the Enhanced MTM Model using SNOMED CT clinical documentation codes as the “interventions” for intervention group and will compare cost and quality outcomes to a control group.


The EMTM Model builds on the original MTM program and determine which pharmacist interventions improve outcomes and reduce cost the most.  Likewise, the technology requirements to participate in this program drive Part D plans, pharmacists, and pharmacy technology vendors to adopt functionality (e.g., SNOMED CT) that will set us up to participate in other federally-sponsored quality programs (hint, hint...MIPS).


Creating the Section of Pharmacy Informatics and Technology (SOPIT) was forward-thinking, but it will take collaboration among the entire profession to bridge technology gaps on the path to provider status.  ASHP is a founding member of the Pharmacy HIT Collaborative and appoints representatives to participate in various work groups and committees through the Section of Pharmacy Informatics and Technology (SOPIT).


If you are interested in participating on these committees, contact Amey Hugg (ahugg@ashp.org).


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