Impact of a veterans affairs primary care collaboration to provide remote team‐based care and telehealth introductory pharmacy practice experiences

Abstract

Introduction: Developing remote team-based care and telehealth introductory pharmacy practice experiences (IPPEs) in primary care is desirable. The Department of Veterans Affairs (VA) endorses interdisciplinary teams to provide primary care services for Veterans and utilizes clinical dashboards to support population management. Pharmacy students, during IPPEs, can perform several patient care activities typically done by VA team members.Objective: The primary objective was to describe the economic impact of a collaboration between a VA health care system and a school of pharmacy to provide remote IPPEs. Methods: During Fall 2019, activities of second-year pharmacy students in a required VA population health IPPE were tracked. Select population management activities typically conducted by nurses, clinical pharmacy specialists (CPS), or primary care providers were assigned to pharmacy students. Students were granted remote access privileges to VA's electronic health record (EHR) and precepted by VA CPS at the university. Students performed prescription drug monitoring program (PDMP) activities, reviewed outside medical records for laboratory results, ordered laboratory tests, conducted telephone pain assessments, and documented progress notes. The average time to complete each function and the average salary for the team member who typically completed the function was used to perform a cost-benefit analysis. Results: During the semester, 58 students spent 2 hours per week in the IPPE. Students wrote 2118 PDMP progress notes, ordered 1723 laboratory tests for provider signature and sent patients laboratory reminder letters, entered 171 outside laboratory results into VA's EHR, and conducted 183 pain assessments.

The addition of women’s health initiatives to an established remote population health introductory pharmacy practice experience

“…Student self-assessment results were similar to those observed in previous cohorts with similar population health initiatives. 6,20 Practice implications According to the Accreditation Council for Pharmacy Education, the ability to advance population health is a key element within a pharmacy graduate's foundational knowledge. 21 Within the Clinical Sciences required elements of the With pharmacy experiential programs affected by COVID-19, the course's remote capability enabled continuation of the IPPE from students' private residences.…”

“…Implementing a remote experience in population management addresses these limitations and may be cost-effective depending on the activities the students complete. 6 In an effort to improve VA's performance on clinical measures, VA developed population management dashboards that identify veterans who require clinical interventions. Elements within the primary care dashboard include influenza and pneumococcal immunizations, monitoring for patients with diabetes or hypertension, screening for cancers, and screening for mental health concerns.…”

Exploring Quantitative Methodologies for Assessing the Environmental, Social, and Economic Impacts of Telemedicine: A Literature Review

“…Specifically, within the socio-economic article cluster, two papers implemented costutility analyses [75,76], eight studies employed cost-effectiveness surveys [52,58,60,64,[77][78][79][80], eight conducted cost-benefit analyses [57,74,[81][82][83][84][85], and one utilized the classic cost accounting technique [56]. Cost-benefit analyses were also detected in articles included in the economic cluster [86][87][88][89][90][91][92][93]. In this case, costs and benefits were defined in monetary terms, including via the Net Present Value (NPV), Internal Rate of Return (IRR), and Quality of Service (QoS).…”