Having pharmacists collect, document and share medication-related services with providers, payers, and care givers (as well as the patients themselves) will help validate the pharmacist’s role in patient care. Capturing clinical data is a new way payers are using to reimburse providers for value-based payment models for programs like chronic care management.
Community pharmacists participating in the North Carolina CPESN will soon?develop electronic care plans for high risk patients. These plans are designed to improve outcomes related to medication use and are coordinated with other care team members. This?effort uses?existing HL7 standards adopted by medical providers in electronic medical records to develop an electronic pharmacist care plan (or Pharmacist?eCare Plan), a shared document detailing a patient’s current medication regimen and health concerns – including drug therapy problems and medication support needs, the pharmacy's interventions and the patient's health outcomes over time.
Being able to efficiently and effectively create and share care plans is crucial to both integration with the larger care team and into community pharmacy workflow.?The?Pharmacist eCare Plan standard?allows pharmacists to create care plans within the technology?already in use in the pharmacy and utilizes existing HL7 standards for data exchange that were enhanced to add the necessary components to extract information pertinent to the pharmacist’s role such as documentation of medication therapy problems and capturing of prescription fill history. This new HL7 Pharmacist Care Plan standard is currently in draft and will go to ballot this September.
Care management services provided locally by a community-based pharmacy in close coordination with other care team members, including other care managers that focus on optimal drug use is called Community Pharmacy Care Management (or CPCM). The objective of CPCM is to procure, update and re-enforce a team-based, patient-centered pharmacy care plan over time. This service line is longitudinal and coordinated with the rest of the care team.
Role of technology organizations that are implementing Pharmacist eCare Plan during the pilot project
Organizations are going through training to have a global understanding of the Pharmacist Care Plan HL7 implementation guide. This consists of understanding concepts for C-CDA and FHIR implementation as well as using value sets from Snomed CT, RX Norm and LOINC, so that data transmitted can be codified. This will contribute to improved, structured documentation. A key component is the user interface development that is needed to collect the documentation that will be required for the Pharmacist Care Plan. Key components consist of patient demographics, payer information, health concern information (allergies and medication therapy problems), medication history, interventions, care coordination, referral information, patient centric medication related goals, and outcomes.
Screenshot courtesy of Creative Pharmacist
Impact to pharmacy
The pharmacy profession is closely watching the pilot of Pharmacist eCare Plan. This standard way of sharing pharmacist-provided clinical data will give pharmacists a way to validate their services for these new emerging quality-based payment models. The movement to new payment models parallels the same movement for physician groups.
If you are a pharmacy owner and want your pharmacy management system to be include in Pharmacy eCare Plan training, please let us know! You can email us at firstname.lastname@example.org. Give us the name of your pharmacy management system and any contact information you might have. We'll do the rest. Submissions received before May 19, 2017 will be included in our Phase III training sessions.