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Integration of MTM in Primary Care 28FEB12

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Presentation given at the Medical Home Summit IV in Philadelphia on 28FEB12

Presentation given at the Medical Home Summit IV in Philadelphia on 28FEB12

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  • 1. integration ofmedication therapy managementin primary carewayne pan, md, mbachief medical officersanta clara county ipa
  • 2. how to incorporatecommunity pharmacists in apatient-centered medical homewayne pan, md, mbachief medical officersanta clara county ipa
  • 3. settingexpectations
  • 4. Have you seen ANSWERS? 6-month old lab mix well-trained to do old tricks, not so good with new tricks
  • 5. healthplans
  • 6. healthcareproviders
  • 7. hospitals
  • 8. physicians
  • 9. NO
  • 10. how will the patientbenefit from this? does this make it easier for the patient?
  • 11. patient-centered medical home?
  • 12. patient-centered medical community
  • 13. patient-centered medical community
  • 14. why?
  • 15. patientascostdriver
  • 16. patientbehavior
  • 17. see the whole
  • 18. see the holes
  • 19. MIND THE GAP
  • 20. carecoordination andtransitions
  • 21. MEDICATION THERAPY MANAGEMENT
  • 22. medicationreconciliation
  • 23. systemsthinking
  • 24. designthinking
  • 25. designdoing
  • 26. what got you here marshall goldsmith
  • 27. wont get you there marshall goldsmith
  • 28. WE ARE HEREFrom: Dan Roam, “American Healthcare: a 4-napkin explanation”www.slideshare.net/danroam/healthcare-napkins-all
  • 29. Source: Organisation for Economic Co-operation and Development (2010), "OECD Health Data", OECD Health Statistics (database). doi: 10.1787/data-00350-en(Accessed on 14 February 2011).Notes: Data from Australia and Japan are 2007 data. Figures for Belgium, Canada, Netherlands, Norway and Switzerland, are OECD estimates.
  • 30. Cumulative Increases in Health Insurance Premiums, Workers’ Contributions to Premiums, Inflation, and Workers’ Earnings, 1999-2011 200% 150% 100% 50% 0% 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Health Insurance Premiums Workers Contribution to Premiums Workers Earnings Overall InflationSource: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,1999-2011. Bureau of Labor Statistics, Consumer Price Index, U.S. CityAverage of Annual Inflation (April to April), 1999-2011; Bureau of LaborStatistics, Seasonally Adjusted Data from the Current EmploymentStatistics Survey, 1999-2011 (April to April).
  • 31. Exhibit ES-1. Overall Ranking Country Rankings 1.00–2.33 2.34–4.66 4.67–7.00 AUS CAN GER NETH NZ UK US OVERALL RANKING (2010) 3 6 4 1 5 2 7 Quality Care 4 7 5 2 1 3 6 Effective Care 2 7 6 3 5 1 4 Safe Care 6 5 3 1 4 2 7 Coordinated Care 4 5 7 2 1 3 6 Patient-Centered Care 2 5 3 6 1 7 4 Access 6.5 5 3 1 4 2 6.5 Cost-Related Problem 6 3.5 3.5 2 5 1 7 Timeliness of Care 6 7 2 1 3 4 5 Efficiency 2 6 5 3 4 1 7 Equity 4 5 3 1 6 2 7 Long, Healthy, Productive Lives 1 2 3 4 5 6 7 Health Expenditures/Capita, 2007 $3,357 $3,895 $3,588 $3,837* $2,454 $2,992 $7,290Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008 International HealthPolicy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care Physicians; Commonwealth Fund THE COMMONWEALTH FUNDCommission on a High Performance Health System National Scorecard; and Organization for Economic Cooperation andDevelopment, OECD Health Data, 2009 (Paris: OECD, Nov. 2009).
  • 32. insanity: doing the samething over and over andexpecting different results
  • 33. patient perspective
  • 34. on average,there is a pharmacy within 2.5 miles of every US resident Source: National Association of Chain Drug Stores
  • 35. Source: Gallop, November 28, 2011-December 1, 2011
  • 36. get out of the rut?
  • 37. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 38. IPAhosspital onsitedischarge case planner manager hospitalist patient discharge planning thepatientjourney
  • 39. hospitalist Rx patientdischarge medicationplanning reconciliation thepatientjourney
  • 40. hospitalist discharge instructions patient outpatientdischarge medication physicianplanning reconciliation follow-up thepatientjourney
  • 41. Rx discharge instructions family patient outpatientdischarge medication physician dischargeplanning reconciliation follow-up thepatientjourney
  • 42. failsafe
  • 43. hosspitaldischarge IPA onsite hospitalist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 44. hosspitaldischarge IPA onsite hospitalist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 45. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 46. brainstorm
  • 47. hosspitaldischarge IPA onsite hospitalist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 48. hosspitaldischarge IPA onsite pharmacist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 49. “put hottriggers inthe path ofmotivatedpeople”BJ Fogg, PhDDirector, Persuasive Technology LabStanford University
  • 50. Santa Clara County IPA (SCCIPA)Medication Reconciliation Pilot Project How to find the medication list for patients using AccessExpress1. Go to the PPMSI AccessExpress provider portal (http://ppmsi.com/accessexpress.html):2. Select Santa Clara County IPA:3. Enter USER NAME and PASSWORD, click on “SUBMIT”:
  • 51. Your SCCIPA doctor wants to help you withyour medications, after you leave the hospital. Michael Lam, RPh pharmacist Samaritan Medical Center Pharmacy 2505 Samaritan Drive San Jose, CA (408) 356-7111Please visit the Samaritan Medical Center Pharmacy to pick upyour new prescriptions and have a pharmacist review yourmedications with you. SCCIPA A Pacific Partners Medical Group
  • 52. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 53. what happened?
  • 54. failfast
  • 55. just one more thing....
  • 56. alignment
  • 57. engage
  • 58. it’snotjustaboutdata
  • 59. it’saboutthepatient
  • 60. Thank you! wpan@ppmsi.comWWW.SNOOPY.COM