Advancing Pharmacist Collaborative Care within Academic Health Systems

Abstract

Introduction: The scope of pharmacy practice has evolved over the last few decades to focus on the optimization of medication therapy. Despite this positive impact, the lack of reimbursement remains a significant barrier to the implementation of innovative pharmacist practice models. Summary: We describe the successful development, implementation and outcomes of three types of pharmacist collaborative care models: (1) a pharmacist with physician oversight, (2) pharmacist–interprofessional teams and (3) physician–pharmacist teams. The outcome measurement of these pharmacist care models varied from the design phase to patient volume measurement and to comprehensive quality dashboards. All of these practice models have been successfully funded by affiliated health systems or grants. Conclusions: The expansion of pharmacist services delivered by clinical faculty has several benefits to affiliated health systems: (1) significant improvements in patient care quality, (2) access to experts in specialty areas, and (3) the dissemination of outcomes with national and international recognition, increasing the visibility of the health system.

Dose adjustment of antidiabetic medications in chronic kidney disease

“…This is a missed opportunity as collaborative care between pharmacists and physicians improves pharmacotherapeutic outcomes and provides increased value and efficiency to the health-care system. [ 24 ] The three types of pharmacist collaborative care models: (1) a pharmacist with physician oversight, (2) pharmacist–interprofessional teams, and (3) physician–pharmacist teams that are being suggested for physician–pharmacist collaborative drug therapy management have demonstrated the positive impact in patients with chronic conditions, including DM and CKD. [ 24 ]…”

Expansion and Evaluation of Pharmacist Services in Primary Care

“…These activities transition workload from providers, and can be directly associated with improving measurable patient health outcomes. As health systems transition to value-based payment models, pharmacists can positively impact quality measures for chronic disease states where medication optimization is key for disease control and prevention of poor outcomes, such as cardiovascular disease [ 35 , 36 , 37 , 38 ].…”

Empowering Public Health Pharmacy Practice—Moving from Collaborative Practice Agreements to Provider Status in the U.S.

“…Examples of innovative applications of CPAs have extended to telehealth where community pharmacists play key roles in hypertension management [ 28 ]. Likewise, Awdishu et al discussed the importance and the positive effect of the CPAs on the pharmacy practice in academic health systems [ 29 ]. A qualitative study exploring medical doctors’ perspective towards pharmacists’ delivery of clinical services in Utah revealed that the healthcare system needs to develop protocols to nurture a more robust collaborative practice between medical doctors and pharmacists.…”

“…The CDC, NASPA, and Change Lab Solutions developed a toolkit for pharmacists as a resource to help in developing CPAs [ 35 ]; practitioners may find the toolkit useful in developing new CPAs, or enhancing existing ones [ 36 ]. While CPAs are demonstrated to improve collaboration and recognize pharmacist expertise, they are impeded by lack of cognitive reimbursements for pharmacists [ 29 ]. Hence, the next step would be to consider moving beyond CPAs to conferring provider status to pharmacists that would enable them to freely collaborate and work with physicians and other healthcare providers and be reimbursed for their services.…”