Improvement and Team Members

Improvement: Increased utilization of

generic medications through therapeutic

substitution. Department of Family Medicine, Ohio State University Wexner Medical

Center.

Emily Vrontos, PharmD, CDE

Bella Mehta, Pharm.D. Director, Clinical Partners Program

Randy Wexler MD MPH FAAFP. Clinical Vice Chair

The Ohio State University Health Plan

Bruce Wall MD, Medical Director of The Ohio State

University Health Plan

Plan

Co-creation between a health plan and

providers of a clinical program that adds

value to the member/patients it serves (value

defined as the quality of care divided by the

overall cost of care).

Identify and maximize the respective

strengths among both organizations to realize

maximum efficiency and effectiveness.

Plan-actionable data/Providers-relationship

with patient

Do

Pharmacist reviewed therapeutic cost savings opportunities

Recommended to prescriber if appropriate

PCN data:

46% of claims recommended to physician, 61% accepted,

45% documented change

Clinical Partners data:

Gahanna: 63% of claims recommended to physician, 91%

accepted by physician, 41% accepted by patients

Lewis Center: 44% of claims recommended to physician,

29% accepted by physician, 0% accepted by patients

Study

Lessons learned

Prepare providers ahead of time.

Provide the names of those who will be contacting providers

Inform staff as well as physicians

Ensure complete documentation present in patient

chart

Reduces unnecessary time that can be dedicated to other

pursuits

– Include intolerances/adverse effects in allergies or specialty

comments

Act

Understand variance of uptake by site

Expand process to multiple payers

Enhance evaluation and management of high

risk patients

Improve medication regimen concordance

following hospital and ED discharge