261290 At the Wrong End of Meaningful Use: The role of Community Pharmacists on Integrated Care Teams

Tuesday, October 30, 2012 : 10:30 AM - 10:50 AM

Paloma Luisi , Health Policy and Management, CUNY School of Public Health at Hunter College, New York, NY
Sonia Rupcic, MPH, MIA , Research Department, Healthcare Innovation and Technology Lab, New York, NY
Backgound: There is growing recognition that chronic conditions require highly integrated healthcare teams for ongoing disease management. Technology plays a critical role in care coordination. CMS has demonstrated leadership in this area by incentivizing use of EHRs. However, the guidelines for demonstrating “meaningful use” of EHRs exclude community pharmacists, a critical component of the clinical support team.

Objectives: This paper presents findings of a pilot program to enhance the role of the pharmacist in the PCMH model. We describe challenges to implementation that arose from inadequate IT infrastructure. Looking to meaningful use requirements, we present a structural argument for these challenges and for how they may be surmounted.

Methods: This research was conducted during a pilot study on the impact of an enhanced role for the community pharmacist in the PCMH model. We draw on two interviews with pharmacists, one focus group discussion with clinicians and more than 50 hours of observation, conducted at site and via teleconference, that occurred during the course of project management of the pilot. Transcripts and notes were uploaded into ATLAS.ti and analyzed using an inductive approach based on grounded theory.

Results: We found that community pharmacists play a valuable role in improving medication compliance. Unfortunately, they are on the wrong end of a one-way e-prescribing system that makes it difficult to share findings about adherence with integrated care teams.

Discussion/conclusions: We propose stronger meaningful use guidelines. Core requirements concerning e-Prescribing should require technologies capable of exchanging information between pharmacists and physicians.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describes contribution of community pharmacists to integrated care teams. Explains how existing IT systems constrain the participation of community pharmacists in integrated healthcare teams. Discusses how current meaningful use guidelines present healthcare providers with disincentives for adopting IT systems that integrate feedback from community pharmacists, which ultimately undermines efforts at improving care coordination

Keywords: Health Information Systems, Pharmacists

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Research Coordinator of the Healthcare Innovation and Technology Lab and I was intimately involved in writing up the findings of this study. I have two years of programmatic experience in the field of public health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.