The Atrius Health groups have a team of clinical pharmacists working with our physicians, nurse practitioners, physician’s assistants, nurses and support staff to optimize the effectiveness, safety and cost of medication therapy for all patients – including Accountable Care Organization (ACO) patients.
Each of our clinical pharmacists has an advanced degree and ambulatory care clinical training/experience, and practices within our Internal Medicine and Family Medicine departments. Here, they participate in team meetings to develop specific care plans for our most medically vulnerable patients. They provide drug therapy recommendations that include simplifying patient’s medication regimens, identifying less costly medications for patients, adjusting drug doses to bring patients’ blood pressure, blood sugar or cholesterol under control, minimizing drug interactions and side effects, and reducing the risk of medication-related falls.
Clinical pharmacists are also consultants to clinicians and nurses who review the medications of ACO patients newly discharged from a hospital stay. When a patient’s medication list is unclear or problematic, clinical pharmacists are there to step in and research any problems or make suggestions for drug or dosage changes.
Throughout every day, clinical pharmacists are available to answer drug questions from clinicians, such as:
Questions can be simple and quick to answer, or take considerable research.
Later in 2013, we will be piloting an official referral service at several Atrius Health practices to allow patients with complex medication regimens (especially those with a recent hospitalization) to see a clinical pharmacist at no charge to optimize their drug therapy. A special focus of these visits will be on helping patients identify reasons for not regularly taking their medications as prescribed, and developing a plan to improve their medication adherence.
Atrius Health clinical pharmacists also develop and maintain many tools within our electronic medical record system that help clinicians with medication prescribing. They develop quick ways of prescribing the most appropriate drugs by disease state, preference lists of the most commonly prescribed medications with pre-entered directions and quantities, After-Visit-Summary medication education phrases to teach patients about new drugs prescribed for them during a clinician visit, and pop-up alerts that let clinicians know if a drug has a high copayment, requires prior authorization or is not covered by a patient’s insurance.
When important new clinical research is released or a Food & Drug Administration bulletin is issued that changes what we know about the safety of a particular medication, our clinical pharmacists quickly develop a consensus recommendations together with expert specialty clinicians within Atrius Health to provide guidance to all Atrius Health clinicians and patients. As is necessary, patients on affected medications are identified so that clinicians can communicate directly with them, and patients’ drug therapy can be adjusted.
Finally, clinical pharmacists provide education to clinicians about the newest medications or the latest national guidelines for the effective use of specific drugs to treat specific conditions. Formal presentations or informal one on one “academic detailing” allow our clinical pharmacists to get evidence-based information to our clinicians, arming them with the facts to counter often-misleading information on the Internet or from pharmaceutical manufacturer advertising to patients. Each of our internal medicine and family medicine clinicians works closely with his/her clinical pharmacist to provide affordable, high quality care to all of our patients.