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Utilization of PACT Clinical Pharmacy Technician (CPhT) in Population Health Management
Share PrintThe mission of this innovation was to develop a unique role for Clinical Pharmacy Technicians that optimized access for Veterans to comprehensive medication management and allowed for improvements in efficiency and employee satisfaction.
Origin:
August 2020, Kansas City VA Medical Center (Kansas City, Missouri)
Adoptions:
1 successful
Awards and Recognition:
Clinical Pharmacy Practice Office PACT Strong Practice Competition
Partners:
Clinical Pharmacy Practice Office
Recent Updates
Overview
Problem
Clinical Pharmacy Technicians (CPhT) are an added value to clinical pharmacy practice, however the best area to designate that support has not been clearly determined and is variable across the VA. Per American Society of Health-Systems Pharmacy (ASHP), the CPhT role may include serving as a point of contact for both patients and clinical staff to optimize a
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Clinical Pharmacy Technicians (CPhT) are an added value to clinical pharmacy practice, however the best area to designate that support has not been clearly determined and is variable across the VA. Per American Society of Health-Systems Pharmacy (ASHP), the CPhT role may include serving as a point of contact for both patients and clinical staff to optimize access to clinical pharmacy services, increasing the efficiency of interactions between patients, pharmacists, and other clinic staff, and decreasing administrative responsibilities performed by pharmacists to allow them to dedicate more time to direct patient care.
The Kansas City VA (KCVA) has approximately 3,500 veterans with Chronic Obstructive Pulmonary Disease (COPD), spanning across eight community-based outpatient clinics (CBOCs), up to 95 miles from the main facility. It is well established that reducing COPD readmissions and health care costs are often prioritized in quality metrics. KCVA identified a need for improved ACCESS and OUTCOMES related to COPD care and set out to expand PACT Clinical Pharmacist Practitioner (CPP) COPD services. See more
The Kansas City VA (KCVA) has approximately 3,500 veterans with Chronic Obstructive Pulmonary Disease (COPD), spanning across eight community-based outpatient clinics (CBOCs), up to 95 miles from the main facility. It is well established that reducing COPD readmissions and health care costs are often prioritized in quality metrics. KCVA identified a need for improved ACCESS and OUTCOMES related to COPD care and set out to expand PACT Clinical Pharmacist Practitioner (CPP) COPD services. See more
Solution
The CPhT role is well suited to lead population health efforts to recruit Veterans with COPD to be evaluated by a CPP. The CPhT utilizes population management tools such as the Academic Detailing Dashboard to identify and recruit Veterans that would benefit from COPD management in PACT CPP clinics. Veterans are identified and screened by the CPhT, who then
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The CPhT role is well suited to lead population health efforts to recruit Veterans with COPD to be evaluated by a CPP. The CPhT utilizes population management tools such as the Academic Detailing Dashboard to identify and recruit Veterans that would benefit from COPD management in PACT CPP clinics. Veterans are identified and screened by the CPhT, who then contacts them to offer care with the PACT CPP. The CPhT gathers baseline information from the Veteran, completes appropriate clinical reminders, and enters return-to-clinic orders based on Veteran modality preference.
The priority should be placed on utilizing VA Video Connect (VVC) appointments to improve Veteran access. The CPhT can coordinate with Medical Support Assistants (MSA) for scheduling and Telehealth Clinical Technicians (TCT) to perform VVC test calls prior to the CPP appointment.
While KCVA initially utilized the CPhT for population health efforts related to COPD to address the prioritized need, the CPhT can address all types of population health efforts to enhance the efficiency of the CPP in providing comprehensive medication management. See more
The priority should be placed on utilizing VA Video Connect (VVC) appointments to improve Veteran access. The CPhT can coordinate with Medical Support Assistants (MSA) for scheduling and Telehealth Clinical Technicians (TCT) to perform VVC test calls prior to the CPP appointment.
While KCVA initially utilized the CPhT for population health efforts related to COPD to address the prioritized need, the CPhT can address all types of population health efforts to enhance the efficiency of the CPP in providing comprehensive medication management. See more
Results
Utilizing a CPhT to support PACT CPP population health recruitment efforts increased efficiency of this process resulting in a significant decrease in PACT CPP time spent. Not only was time saved in regard to population health efforts, the subjective information gathered during the CPhT recruitment call saved PACT CPP time during the initial encounter. This
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Utilizing a CPhT to support PACT CPP population health recruitment efforts increased efficiency of this process resulting in a significant decrease in PACT CPP time spent. Not only was time saved in regard to population health efforts, the subjective information gathered during the CPhT recruitment call saved PACT CPP time during the initial encounter. This allowed for the PACT CPP to focus on medication management. The PACT CPP time saved per Veteran recruited was estimated to be 38 minutes, an average of 10 minutes spent on population health recruitment and an averaged 28 minutes spent on CPhT recruitment call.
Utilization of CPhT in this role allowed for continued and expanded access to care for Veterans with COPD. PACT CPP COPD PharmD tool interventions increased 73% when comparing the four months pre and post-implementation. This increase in COPD interventions was driven by CPhT population health efforts. See more
Utilization of CPhT in this role allowed for continued and expanded access to care for Veterans with COPD. PACT CPP COPD PharmD tool interventions increased 73% when comparing the four months pre and post-implementation. This increase in COPD interventions was driven by CPhT population health efforts. See more
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Timeline
-
Pre-Implementation
Identify CPhT to support PACT population managementOutline current process for PACT CPP population management Veteran recruitment and schedulingReview PACT CPP established grids for face-to-face/telephone/VVC clinic capabilities based on PACT CPP Direct Patient Care timeEncourage leadership opportunity among frontline PACT CPP -
Week 1
Identify and evaluate opportunities for CMM based on facility needs -
Week 2
Choose 1-2 PACT CPP as lead(s) for CPhTEducate PACT CPP lead(s) on overall process and CMM activities targeted -
Week 3
Lead introductory meeting between PACT CPP lead(s) and CPhT to review training plan -
Week 4
Review PACT CPhT competency -
Weeks 5 - 6
Create non-count CPhT phone clinic and note titlesCreate CPhT disease-state specific templates -
Week 7
CPP lead(s) review dashboards and specific patient data with CPhT and determine appropriateness of patient for CPP management -
Weeks 8 - 9
CPhT completes templated notes in patient recordCPhT completes RTCs for appropriate CPP clinicSet target number of patients recruited for each CPP clinicSet go live date for roll out -
Week 10
Implement service by CPhT contacting patients for recruitment utilizingdashboard and track progressDevelop plan for communication between CPhT and CPPs -
Week 11 and Ongoing
Track number of patients contacted and scheduled for PACT CPP appointmentsTransition to next CPP clinics as target patient recruitment number metEnsure CPhT is meeting target recruitment goals per week through variouscheck in mechanismsObtain feedback from CPPs and gather recommendations for future diseasestate expansion
Departments
- Pharmacy
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
TOOLS |
|
Links
- Diabetes, Hypertension, Hyperlipidemia Dashboard PACT Profile Patient EQM
- VA National Academic Detailing Resources and Dashboards VA National Academic Detailing Services
- Utilization of PACT Clinical Pharmacy Technician (CPhT) in Population Health Management CPPO PACT Competition Strong Practice Implementation Guide
Risks and mitigations
| Risk | Mitigation |
|---|---|
| Resistance to change from CPPs | Engage PACT CPPs to be leads in process change. Ensure open discussion regarding the responsibilities of PACT CPPs and the CPhT's direct supervisor. |
| CPhT not meeting measured workload | Consider additional training and review CPhT's population management recruitment process. Evaluate measurable and achievable workload for CPhT. Ensure CPhT aware of recruitment goals and expected productivity. |
About
Original team
Suzy Burros, PharmD, BCACP
Clinical Pharmacist Practitioner Lead
Lauren Wilde, PharmD
Clinical Pharmacist Practitioner Lead
Amy Cummings, PharmD, BCACP
Clinical Pharmacist Practitioner Lead
Sarah Will, PharmD, BCPS, BC-ADM
Clinical Pharmacist Practitioner Lead
Comment
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