Pharmacy's Role in Worksite and Community Wellness

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Presentation at the Alabama Department of Public Health's Worksite Wellness Conference by Rebecca Sterling on 6/28/12. Slides by Amy Robinson. More information at healthsterling.com.

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  • In 2007 The Center for HealthCare Economics @Milken Institutute released a report that Chronic illnesses cost the American economy ~ 1.3 trillion dollars . Costs of loss productivity at 1.1 trillion far exceeded the cost of treatment at 277 billion .
  • Productivity costs include absent workers as well as those who are present but not very functional. One of our groups of employees listed their work performance as under 50% when they attend work while ill
  • The Milken Institute also predicted that productivity and treatment costs will climb to $4.2 trillion by 2023 if no changes occur
  • Worksite wellness programs have been developed to change the trends. Many programs are helping and encouraging employees. A top executive quoted in The Innovators Prescription noted that they had setup wellness programs that focused on gyms and health facilities. After several years of operation , they evaluated their program and determined that only 15% of their employees used the facility and most of those were staying healthy vs getting healthy. Several of our employer clients have noted similar usage.
  • According to the Dept of Health and Human Services, 75% of US healthcare Costs stem from chronic conditions.
  • Managing lifestyles is even more important than ever for people with chronic diseases. The need for combining coaching skills with clinical skill in wellness is evident.
  • According to ahrq, 3.5 billion prescriptions are written annually
  • . Medications are involved in 80% of all treatments and impact all areas of a patients life.
  • Somehow we must reach the 85% who do NOT participate in worksite wellness offerings and who DO have a chronic illness diagnosis. Pharmacy services and improved health are intertwined.
  • We believe that pharmacists and their teams bring much to wellness . Pharmacy services programs can provide a clinically based continuum of care. Pharmacy services added to worksite or community wellness programs can help create or enhance a Patient Centered Medical Home. So.. Other than dispensing pills, what can a pharmacy team offer?
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  • Diagnostically trained pharmacy teams can conduct tests and read results. When an employee or dependent has questions, a pharmacist can provide clinical information .
  • We try to provide the information in a succinct and interesting manner using infographics. When the results look like this, we can simply encourage the person to keep up their work. Even this person may want clinical ideas or suggestions.
  • Someone whose data results portray more of a warning alarm may benefit from other available services . We can schedule a simple medication review or a more comprehensive medication management service.
  • A trained consulting pharmacist will review all medications- rx, legal, illegal , supplements, vitamins, samples. She will assess the patient to determine when the meds are taken, and how the patients take them
  • Then she will determine if the medications, dosing, and timing is appropriate and no interference with other meds or foods exist.
  • It is extremely important to determine the safety of meds and supplements . And to look for toxicity issues and adverse events.
  • Determine if the patient is adhering to treatment and medication plans as prescribed. If he has had issues or concerns, if he can afford and access the medication, if he has side effects, if he rememebers…
  • Adherence is a major concern -Lack of adherence leads to
  • Working with the provider, pharmacy team will intervene to solve medication issues. It is important to note that national guidelines exist for population goals;however, each person is different and deserves individualized attention and care plans.
  • The pharmacist will follow up to determine if pt is meeting goals and outcomes and revise the plan as needed to meet specific needs. She will continue to check for adherence and necessary dose or medication adjustments. The follow up may be via text, phone, or in person depending on the employees’ needs.
  • Lifestyle and behavior changes greatly affect outcomes of managing chronic illness and preventing disease. Patients have a responsibility. We owe it to them to provide appropriate tools and resources. Sometimes patients need their provider of wellness coaches recommendations reiterated in many ways . Look at your fist.
  • There re many tools available to help patients monitor calorie intake, bp, glucose, etc
  • Telling someone to eat better carries the responsibility of showing them how so much wonderful delicious food exists.
  • It all sounds great , right ? But pharmacy services can be expensive– is it worth it
  • When the plan comes together, everyone on the team benefits
  • The employee benefits with improved outcomes from the individualized, clinical attention to him, his medication regimen, and treatment plan. Our diabetespatients an dcv patients improved levels and opened up to meeting with us after several visits.
  • The employee benefits with improved outcomes from the individualized, clinical attention to him, his medication regimen, and treatment plan. Our diabetespatients an dcv patients improved levels and opened up to meeting with us after several visits.
  • The provider benefits by having a pharmacotherapeutic expert on hand to help manage complex drug therapies and reinforce treatment plans – thus allowing them more time for diagnostics, assessments, and pt care.
  • Most employers and plans benefit when pts are correctly taking medications that are safe and appropriate. They are seeing decrease in healthcare costs and increase in productivity.
  • And remember it’s not just cheaper drug cost. Thepharmacy costs may actually increase with appropriate meds and adherence BUT fewer visits to drs, hospitals, and er costs the most
  • And remember it’s not just cheaper drug cost. Thepharmacy costs may actually increase with appropriate meds and adherence BUT fewer visits to drs, hospitals, and er costs the most
  • The employee benefits with improved outcomes from the individualized, clinical attention to him, his medication regimen, and treatment plan. Our diabetespatients an dcv patients improved levels and opened up to meeting with us after several visits.
  • So the ROI is the bottomline. The landmark Ashville Project altered the wellness industry in 1996 was a patient centered payer driven initiative
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  • But to change the predicted future that we discussed eariler will require more than involving pharmacy in worksite programs.
  • It requires a paradigm shift to Community and Population Health
  • Pharmacies, providers, payers, and wellness consultants all have a responsibility to provide information on available resources for healthy foods, activities, and programs. Communities and members have a responsibility to participate
  • We are currently working with Healthy huntsville, a joint venture with city government and businesses to promote and encourage healthy behaviors
  • Free events
  • Awards and apps
  • Awards and apps
  • Communitypartnerimg
  • Working with existing programs in the community
  • Video for healthy huntsville
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  • Pharmacy's Role in Worksite and Community Wellness

    1. 1. A Pharmacy Perspective onWorksite and Community Wellness Rebecca Sterling Sterling Health and Wellness, Inc. MTM Compounding Pharmacy healthsterling.com
    2. 2. $1.1 Trillion Lost Productivity$2.77 Billion Treatment Cost
    3. 3. $4.2 Trillion 2023 $1.3 Trillion 2003Increasing Cost of Chronic Disease Source: Center for Healthcare Economics at The Milken Institute
    4. 4. 15%of employees used on-site wellness. Source: The Innovator’s Prescription
    5. 5. 75% of US Healthcare Costsstem from chronic conditions. Source: US Department of Health and Human Services
    6. 6. 3.5 Billionprescriptions written annually in US.Source: Agency for Healthcare Research and Quality
    7. 7. 80%treatments include a prescription.Source: Pharmaceutical Care Practice: The Clinician’s Guide
    8. 8. Reach the85%who do notparticipate.
    9. 9. Our GoalsCreate Value for Our Customers• Reduce Total Healthcare System Costs• Decrease Hospitalization and Re-Hospitalization Rates• Return on InvestmentIncrease Adherence – Decrease Total CostUse of in-home medical technology and telecommunication devices,integrates home monitoring and reporting/notification with motivationalinterviewing to achieve desired adherence outcomes.Achieve Optimal OutcomesThrough real-time intervention achieving higher adherence and healthierpatient choices through a process of education, intervention, andmotivational interviewing for patients with Congestive Heart Failure (CHF),Diabetes, Hyperlipidemia, and Hypertension.
    10. 10. Other than dispensing pills, what can a pharmacy do?1. Biometric Health Screenings2. Comprehensive Medication Therapy Management Services3. Community Resources and Individual Education
    11. 11. Medication Review
    12. 12. Primun non nocere. First do no harm.
    13. 13. 50 – 65 % medication adherence rate.Source: Michael C. Sokol, MD, MS, Kimberly A. McGuigan, PhD, Robert R. Verbrugge, PhD,and Robert S.Epstein, MD, MS, Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost, Medical Care
    14. 14. Result: • Symptoms and Complications Worsen • Utilization of Inpatient Medical Services Increases • Total Healthcare Costs IncreaseSource: Michael C. Sokol, MD, MS, Kimberly A. McGuigan, PhD, Robert R. Verbrugge, PhD,and Robert S.Epstein, MD, MS, Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost, Medical Care
    15. 15. Individualized.
    16. 16. Follow UpYour health, your way
    17. 17. Self-Management:• Education• Tools• Resources
    18. 18. Make Education Interesting
    19. 19. Pharmacy is Expensive. Is it worth it?
    20. 20. Clinical Management Strategy and Clinical Value Customer Value Improved Adherence = ROI Optimal Clinical Outcomes• Care Planning and Real Time Monitoring• Patient Coaching and Motivational Interviewing• Medication Adherence• Condition Adherence• Medication Therapy Management• Reduced Costs from Complications• Reduced Hospital Admissions or Readmissions• Facilitating a Comprehensive Continuum of Care
    21. 21. Happy, Healthy, Productive Employees
    22. 22. Happy, Healthy, Productive Employees 15% 85% 75% Empower
    23. 23. Employers and Plans Outcomes: • Safe, effective drugs • Higher productivity • Decreased costs • Healthier employees
    24. 24. It’s more complex than justcheaper drug costs.
    25. 25. 3.5 Billion 75.4% Healthcare costscontinue to spiral.
    26. 26. Happy, Healthy, Productive Employees Right medication. Right dose. Right time.
    27. 27. Asheville, NC
    28. 28. Average benefit of $4 to $8.48 in reduced healthcare costs per dollar spent. Source: The Asheville Project
    29. 29. $1,200 Decreased Diabetes cost per patient. $18,000Increase in productivity per employee. Source: The Asheville Project
    30. 30. Chronic Disease Cost to Alabama 2003: $4.7 B 2023: $12.1 Billion Source: GE
    31. 31. Healthy CultureHealthy Huntsville, Sterling Health and Wellness
    32. 32. Healthy Huntsville• 100 free events• Free iPhone App• Crowd-sourced• Gamified
    33. 33. 100 free events | Free iPhone App | Crowd-sourced | Gamified
    34. 34. Take action.Make progress. Get rewards.
    35. 35. Alabama’s Largest Yoga ClassHealthy Huntsville, Sterling Health and Wellness
    36. 36. Engage Community. Empower Citizens. Change Lives.
    37. 37. Other than dispensing pills, what can a pharmacy do?1. Biometric Health Screenings2. Comprehensive Medication Therapy Management Services3. Community Resources and Individual Education
    38. 38. Healthy Communities Healthy Employees Better Lives
    39. 39. Live Well. Be Happy. Life is fun!www.healthsterling.com Rebecca Sterling rebecca@healthsterling.com MTM Compounding Pharmacy

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