Integration of MTM in Primary Care 28FEB12

integration of medication therapy management in primary carewayne pan, md, mbachief medical officersanta clara county ipa

how to incorporate community pharmacists in apatient-centered medical homewayne pan, md, mbachief medical officersanta clara county ipa

settingexpectations

Have you seenANSWERS?

6-month old lab mixwell-trained to doold tricks, not so

good with new tricks

healthplans

healthcareproviders

hospitals

physicians

NO

how will the patient benefit from this?

does this make it easier for the

patient?

patient-centered medical home?

patient-centered medical community

patient-centered medical community

why?

patientascostdriver

patientbehavior

see the whole

see the holes

MIND THE GAP

carecoordinationandtransitions

MEDICATION THERAPY MANAGEMENT

medicationreconciliation

systemsthinking

designthinking

designdoing

what got you here

marshall goldsmith

won't get you there

marshall goldsmith

From: Dan Roam, “American Healthcare: a 4-napkin explanation”www.slideshare.net/danroam/healthcare-napkins-all

WEARE

HERE

Source: Organisation for Economic Co-operation and Development (2010), "OECD Health Data", OECD Health Statistics (database). doi: 10.1787/data-00350-en (Accessed on 14 February 2011).Notes: Data from Australia and Japan are 2007 data. Figures for Belgium, Canada, Netherlands, Norway and Switzerland, are OECD estimates.

Cumulative Increases in Health Insurance Premiums,

Workers’ Contributions to Premiums, Inflation, and Workers’ Earnings, 1999-2011

0%

50%

100%

150%

200%

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Health Insurance Premiums Workers' Contribution to PremiumsWorkers' Earnings Overall Inflation

Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2011. Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 1999-2011; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 1999-2011 (April to April).

THE COMMONWEALTH FUND

Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008 International Health Policy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care Physicians; Commonwealth Fund Commission on a High Performance Health System National Scorecard; and Organization for Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009).

AUS CAN GER NETH NZ UK US

OVERALL RANKING (2010)OVERALL RANKING (2010) 3 6 4 1 5 2 7

Quality CareQuality Care 4 7 5 2 1 3 6

Effective CareEffective Care 2 7 6 3 5 1 4

Safe CareSafe Care 6 5 3 1 4 2 7

Coordinated CareCoordinated Care 4 5 7 2 1 3 6

Patient-Centered CarePatient-Centered Care 2 5 3 6 1 7 4

AccessAccess 6.5 5 3 1 4 2 6.5

Cost-Related ProblemCost-Related Problem 6 3.5 3.5 2 5 1 7

Timeliness of CareTimeliness of Care 6 7 2 1 3 4 5

EfficiencyEfficiency 2 6 5 3 4 1 7

EquityEquity 4 5 3 1 6 2 7

Long, Healthy, Productive LivesLong, Healthy, Productive Lives 1 2 3 4 5 6 7

Health Expenditures/Capita, 2007Health Expenditures/Capita, 2007 $3,357 $3,895 $3,588 $3,837* $2,454 $2,992 $7,290

Country RankingsCountry Rankings

1.00–2.33

2.34–4.66

4.67–7.00

Exhibit ES-1. Overall Ranking

insanity: doing the

same thing over and over

and expecting different

results

patient perspective

on average,there is a pharmacy

within 2.5 milesof every US resident

Source: National Association of Chain Drug Stores

Source: Gallop, November 28, 2011-December 1, 2011

get out of the rut?

from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)

thepatientjourney

dischargeplanning

hosspitaldischargeplanner

IPA onsitecase

manager

hospitalist

patient

thepatientjourney

Rx


patient

hospitalist

dischargeplanning

thepatientjourney

dischargeplanning

dischargeinstructions


outpatientphysicianfollow-up

patient

hospitalist

thepatientjourney

dischargeplanning



discharge

patient

family

dischargeinstructionsRx

failsafe

thepatientjourney

dischargeplanning


IPA onsitecase

manager

hospitalist

patient




discharge

patient patient patient

hospitalist hospitalist

family


thepatientjourney

dischargeplanning


IPA onsitecase

manager

hospitalist

patient




discharge



family



brainstorm

thepatientjourney

dischargeplanning


IPA onsitecase

manager

hospitalist

patient




discharge



family


thepatientjourney

dischargeplanning


IPA onsitecase

manager

hospitalist

patient




discharge


pharmacist hospitalist

family


“put hot triggers in the path of motivated people”BJ Fogg, PhDDirector, Persuasive Technology LabStanford University

Santa Clara County IPA (SCCIPA)Medication Reconciliation Pilot Project

How to find the medication list for patients using AccessExpress

1. Go to the PPMSI AccessExpress provider portal (http://ppmsi.com/accessexpress.html):

2. Select Santa Clara County IPA:

3. Enter USER NAME and PASSWORD, click on “SUBMIT”:

Your SCCIPA doctor wants to help you with your medications, after you leave the hospital.

Please visit the Samaritan Medical Center Pharmacy to pick up your new prescriptions and have a pharmacist review your medications with you.

Michael Lam, RPhpharmacist

Samaritan Medical Center Pharmacy2505 Samaritan DriveSan Jose, CA(408) 356-7111

SCCIPAA Pacific Partners Medical Group


what happened?

failfast

just one more thing....

alignment

engage

it’snotjustabout data

it’saboutthepatient

[email protected]

Thank you!

WWW.SNOOPY.COM

Health & Medicine

Integration of MTM in Primary Care 28FEB12