No abstract

The Patient Protection and Affordable Care Act (PPACA) has considerably transformed the approaches being used to deliver health care in the United States. It was enacted to expand health insurance access, improve funding for health professions education, and reform patient care delivery. The traditional fee-for-service payment system has been criticized for overspending and providing substandard quality of care. The Accountable Care Organization (ACO) was developed as a payment reform mechanism to slow rising health care costs and improve quality. Under this concept, networks of clinicians and hospitals share responsibility for a population of patients and are held accountable for the fi nancial and clinical outcomes. Due to high rates of medication misuse, nonadherence to therapeutic medication regimens, and preventable adverse drug events, pharmacists are in an ideal position to manage drug therapy and reduce health care expenditures; as such, they may be valuable assets to the ACO team. This article discusses the role of the pharmacist in the era of ACOs specifi cally and health care reform globally. It outlines pharmacy-related quality of care measures, medication therapy management (MTM) programs (which may provide the foundation for pharmacist involvement in ACOs), and pharmacist functions in patient-centered medical homes (through which ACO services may be organized). The article concludes with a description of successful ACO models that have incorporated pharmacists into their programs.

Clinicians should routinely identify and treat IDA, thereby decreasing its negative impact on health and quality of life of women.

No abstract

This had the inherent limitations associated with a retrospective chart review; because data was initially collected for clinical rather than research purposes, certain information may have been absent, incomplete, or missed by data abstractors.

No abstract

No abstract

Purpose: To assess the first 6 years of documented clinical interventions and activities by a health care system pharmacy department after implementation of a Web-based documentation tool. Methods: Saint Barnabas Health Care System (SBHCS) implemented the Quantifi Web-based documentation tool in October of 2002. Nine global intervention categories were developed, and the activities of SBHCS's pharmacists were tracked from January 2003 to December 2008. The following data were monitored: total number of interventions per category, number of interventions per category stratified by year, total cost savings, cost savings by global category, top 5 activities documented each year, top 5 cost-saving interventions documented each year, and top 5 intervened medications each year.Results: A total of 760,555 clinical activities were documented during the study period, with the greatest number of interventions being from the order clarification category (30%) from 2003 through 2005 and the laboratory analysis category (25% to 30%) from 2006 to 2008. The total number of documented activities trended upward each year, as a whole and in nearly every individual category. The total documented direct cost savings during the study period was $6,169,593, with the therapeutic interventions category ($1,993,490) being the most influential. The total cost savings generally trended upward over the 6-year period. Conclusions: Implementation of the Web-based documentation tool had a positive impact on pharmacists' documentation rates. The tool is a practical and convenient method for documenting clinical activities and interventions in real-time, with corresponding cost-savings information, for a pharmacy department within an integrated health care system.