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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

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Integration of MTM in Primary Care 28FEB12

  1. 1. integration ofmedication therapy managementin primary carewayne pan, md, mbachief medical officersanta clara county ipa
  2. 2. how to incorporatecommunity pharmacists in apatient-centered medical homewayne pan, md, mbachief medical officersanta clara county ipa
  3. 3. settingexpectations
  4. 4. Have you seen ANSWERS? 6-month old lab mix well-trained to do old tricks, not so good with new tricks
  5. 5. healthplans
  6. 6. healthcareproviders
  7. 7. hospitals
  8. 8. physicians
  9. 9. NO
  10. 10. how will the patientbenefit from this? does this make it easier for the patient?
  11. 11. patient-centered medical home?
  12. 12. patient-centered medical community
  13. 13. patient-centered medical community
  14. 14. why?
  15. 15. patientascostdriver
  16. 16. patientbehavior
  17. 17. see the whole
  18. 18. see the holes
  19. 19. MIND THE GAP
  20. 20. carecoordination andtransitions
  21. 21. MEDICATION THERAPY MANAGEMENT
  22. 22. medicationreconciliation
  23. 23. systemsthinking
  24. 24. designthinking
  25. 25. designdoing
  26. 26. what got you here marshall goldsmith
  27. 27. wont get you there marshall goldsmith
  28. 28. WE ARE HEREFrom: Dan Roam, “American Healthcare: a 4-napkin explanation”www.slideshare.net/danroam/healthcare-napkins-all
  29. 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. 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. 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. 32. insanity: doing the samething over and over andexpecting different results
  33. 33. patient perspective
  34. 34. on average,there is a pharmacy within 2.5 miles of every US resident Source: National Association of Chain Drug Stores
  35. 35. Source: Gallop, November 28, 2011-December 1, 2011
  36. 36. get out of the rut?
  37. 37. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  38. 38. IPAhosspital onsitedischarge case planner manager hospitalist patient discharge planning thepatientjourney
  39. 39. hospitalist Rx patientdischarge medicationplanning reconciliation thepatientjourney
  40. 40. hospitalist discharge instructions patient outpatientdischarge medication physicianplanning reconciliation follow-up thepatientjourney
  41. 41. Rx discharge instructions family patient outpatientdischarge medication physician dischargeplanning reconciliation follow-up thepatientjourney
  42. 42. failsafe
  43. 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. 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. 45. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  46. 46. brainstorm
  47. 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. 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. 49. “put hottriggers inthe path ofmotivatedpeople”BJ Fogg, PhDDirector, Persuasive Technology LabStanford University
  50. 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. 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. 52. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  53. 53. what happened?
  54. 54. failfast
  55. 55. just one more thing....
  56. 56. alignment
  57. 57. engage
  58. 58. it’snotjustaboutdata
  59. 59. it’saboutthepatient
  60. 60. Thank you! wpan@ppmsi.comWWW.SNOOPY.COM

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