Integrating Pharmacy Performance Reporting and Quality Metric … · 2011-09-28 · Integrating...
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Integrating Pharmacy Performance Reporting and Quality Metric-Focused Interventions to Improve Medication Adherence for Health Plan Members Jesse McCullough, PharmD Clinical Services Manager Rite Aid 1
Transcript of Integrating Pharmacy Performance Reporting and Quality Metric … · 2011-09-28 · Integrating...
Integrating Pharmacy Performance
Reporting and Quality Metric-Focused
Interventions to Improve Medication
Adherence for Health Plan Members
Jesse McCullough, PharmD
Clinical Services Manager
Rite Aid
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Partnership History
Initiated in 2008 as part of a “Phase I” Pharmacy Quality Alliance (PQA) supported demonstration project.
Phase I Partners – CECity, Highmark, Rite Aid
University of Pittsburgh
School of Pharmacy (UPSOP) added to the partnership in 2009
Interventional expertise and project evaluation
Motivational interviewing training and tools
Relationship with RTI to conduct health-focused economic analyses
“Phase II” PQA-supported demonstration project underway (June 2010)
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Phase I Overview The Phase I study involved:
Measure calculation
Data aggregation
Development of a pharmacy quality report
Quarterly evaluation of quality measures
Identification of gaps relative to benchmarks and peer results
Pharmacist feedback
The Phase I study involved 50 Rite Aid locations in Western PA
Pharmacist training on Quality and Project Expectations
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Phase II Overview The Phase II study involves:
Continuous data aggregation
Continuous evaluation (monthly) of PDC quality measures
Identification of gaps relative to benchmarks and peer results
Dynamically linking interventions for performance improvement to quality measure gaps
Redesign of the dispensing process within Rite Aid to facilitate an interventional strategy developed by the UPSOP
The Phase II study expanded to 240 Rite Aid locations in Western & Central PA
Pharmacist training on Project Expectations and Interventions
Technical assistance teams, led by Rite Aid clinical staff & UPSOP, and supported by other project staff
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Each Stakeholder supports its role in the PI model
CECity.com, Inc. – PI & Reporting platform; Convener
PQA (Pharmacy Quality Alliance) – Quality metrics, communication
University of Pittsburgh School of Pharmacy (UPSOP) –
Intervention strategy, outcomes analysis & publication
Highmark BCBS – Data/Measure provider; Reimbursement Modeling
Rite Aid Corporation – Pharmacists & Training; Enterprise-wide
support for PI
Objectives
Evaluation of the impact of the pharmacist intervention on patient-health
outcomes & medical services utilization
Modeling of P4P or other reimbursement incentives for pharmacies,
based on performance improvement
The PA Collaborative
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Collaboration for Performance Improvement
Role: Data Provider
Claims Data Provided by
Highmark
Role: PI Platform & Service
Provider, Convener
Platform Powered by CECity
Role: Measure Provider
•National Measures by
PQA
•Additional measures by
Highmark
Role: Performance
Program Provider
Modeling P4PI Program
Role: Healthcare
Professional (Pharmacist)
Personal Account for PI
Role: Healthcare
Organization
Enterprise-Wide
Performance Improvement
Role: Intervention Provider •Interventions Provided by Pitt
•Interventions Provided by
CECity (multiple authors (e.g.
societies)
Reporting
&
Incentive
Programs
CPI &
Incentives
Continuous (Monthly)
Pharmacy Performance Platform
Transforming Pharmacy Practice & Optimizing Patient Outcomes
Secure log-in for the pharmacist
User friendly, easy to navigate
Performance Reporting with Peer Comparison
Access to Tools & Interventions
Personalized Portfolio
Enterprise Outcomes Reporting
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Continuous Performance Improvement
Monthly Medication Use
Quality Reports
Reporting by Pharmacy
Identification of Measures
& Goals - Drill down to
detail
Identification of Gap
Indication of Improvement
Access to Interventions
Analyze history & peer
comparison data
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How Do I Improve?
Links to Targeted Online
Interventions to Close Gaps
& Improve Performance
Adherence Screening Tools
Motivational Interviewing
Continuing Education
Patient Resources
Professional Tools
Ability to provide feedback
Impact on # of performance
measures
Effectiveness of the
Intervention
Ability to build an action
plan
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Build your Action Plan ePortfolio
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Assistance
Request for Personal
Assistance
Interpreting the
Performance Report
Use of Screening Tools
Pharmacist Resources
Checklists
Implementation
Strategy
FAQs
POLARS Card
ASPIRE Tutorial
New Prescriptions
Refill Prescriptions
Patient Feedback
Survey
Brief Intervention
New Prescription
Survey
Health & Wellness Survey
2-5 Minutes for Intervention
•Conversation
•Patient Resources
•Follow-Up
+ +
Implementation Diagram
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New Prescription Survey
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Health and Wellness Survey
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Permission
Open-ended questions
Listen reflectively
Affirmation
Roll with resistance
Summarize plans
“Is it OK to talk…”
“Tell me more about…”
“What I hear you say is…”
“I can see why you would…”
“We have agreed to….”
“What other choices….”
POLAR S FLOW
Use POLAR S to guide
Brief Intervention
Need more help? Visit ASPI℞E at www.rxaspire.com
Login: Username= RiteAid ID Password= Birthday (MMDDYYYY)
New Prescription
New Prescription Survey
Talk with patient if survey shows:
• Concern of harm • Lack of commitment • Cost of medication
Refill
Health and Wellness Survey
Score < 25
Patient Feedback Survey
• Shake hands
• Listen for change
• Let the patient lead
Fax surveys to 412-904-6130
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Patient Feedback Survey
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Steady State
Universal screenings
Field leadership engagement
CQI
Store visits
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Next Steps
Statistical analysis
Addition of new data partner
Specialized technician training
Implementation and evaluation of targeted
adherence strategies
PQA Beta Phase
Modeling of new reimbursement strategies
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Contact Information
Maureen Bieltz
Highmark BCBS
Annette Boyer
CECity.com
Jesse McCullough
Rite Aid
Janice Pringle
University of Pittsburgh School of Pharmacy
