Beth S. Williams, Pharm.D.; Molly T. Hinely, Pharm.D., BCPS, CPP; Tiffany J. Sherod-Harris, Pharm.D.; Candace M. Dixon, Pharm.D., MSCR, BCACP, CPP; Jennifer E. Tryon, Pharm.D., MS, FASHP; Brian A. Marlow, Pharm.D., MBA
Wake Forest Baptist Health, Winston-Salem NC
With healthcare facing constrained financial resources and an accountability to demonstrate better outcomes for lower cost, it is imperative to define the pharmacy team’s role on the care coordination team. Currently, there is limited research regarding the role of pharmacists in value-based care (VBC). As a result, this team set out to design, implement, evaluate and describe the role of the pharmacist in a population health model at a large regional health system.
Wake Forest Baptist Health (WFBH) is currently participating in 11 VBC contracts with approximately 59,000 covered lives. These contracts include over 50 unique benchmarks with 22 of these being medication-related, uniquely positioning pharmacists to improve quality measure performance through the application of medication management expertise. From the beginning (2015), pharmacists were identified as integral members of the multidisciplinary team to enhance the health system’s coordinated care model for VBC patients. The team was challenged to establish scalable tools and resources that prioritize pharmacist interventions necessary for health system success with advanced VBC contracts.
EHR-based tools were developed including a Pharmacy ACO Dashboard with Pharmacy Risk Score to identify impactable patients for comprehensive medication reviews, as well as the Best Practice Advisory to facilitate provider communication. The Virtual Pharmacy Population Health Team was created to allow for expansion of services covering a critical mass of the VBC population. The virtual team was formed by reallocating incremental time from 22 pharmacists including PGY1 residents (Community and Ambulatory-focused), community pharmacists, and ambulatory care pharmacists. In addition, Embedded Pharmacists were deployed to support rural communities with a large number of attributed or high risk patients. One year after implementation of the virtual pharmacy model, an evaluation of the team’s effectiveness was completed. Specifically, provider acceptance rates of pharmacist recommendations were measured and categorized. As a result, the Pharmacy Population Health Center was created to house the various members of the team, utilize more targeted strategies, and triage patient care services as needed throughout the health system.
Through the innovation of technology, the WFBH pharmacy population health model provides a method to improve medication-related quality measure performance, prioritize patient-centered care for patients most in need, and increase financial gains without significant addition of new FTE by leveraging the diverse skill sets of different groups of pharmacists.