VPS Partner Sites FY15

¾ Collaborate with medical facility to develop “Guidelines for Prescription Processing” to include: 9 Points of contact at facility for Q&A 9 Pharmacist login instructions and menu pathways 9 VA healthcare system divisions 9 Prescriptions to skip 9 Restricted medications 9 Non-formulary medication 9 Drug information 9 Quantity and days’ supply rules 9 Controlled substance processing rules (if applicable)

¾ Request local access to VAMC VISTA (VA’s EHR system) for the virtual pharmacists processing prescriptions for that facility. All VPS pharmacists have completed VA background checks, are fully credentialed, and have completed all privacy and HIPPA training courses. VISTA access requests are submitted via paper or electronically through appropriate channels determined by each medical facility.

¾ Train VPS pharmacists on the policies and procedures of virtual prescription verification for the VAMC partner. After the VAMC provides user access and verify codes, each VPS pharmacist will validate their VISTA account. Training is then set up either with another VPS pharmacist on site or virtually for pharmacists at our location in Cheyenne, WY using Microsoft Office Lync.

¾ Develop VPS Scorecard to determine: 9 Impact on Compensation: The Scorecard queried the facility’s methods of compensation and associated costs including OT, CT, contract and fee basis staffing pre and post implementation of VPS. Collected data will determine the changes in the various types of compensation used.

9 Impact on Direct Patient Care Services: The Scorecard queried the likelihood of using VPS on the ability of the VAMC pharmacy to refocus staff on direct patient care services. The Scorecard asked each site to quantify the number of pharmacist hours per pay period that were redirected toward other pharmacy activities and then list those activities. The data collected will determine if utilization of VPS resulted in expanded/added clinical services such as pharmacist led clinics, pharmacist participation in PACT Teams, etc.

9 Customer Satisfaction Scores: The Scorecard queried the sites on satisfaction with implementation, MOU Renewal, guideline development, quality, timeliness, value and overall satisfaction. The data collected on this scorecard will present the satisfaction rating in the above named categories.

IntroductionIn second quarter FY 2015, more than 60 VA Medical Center (VAMC) pharmacies reported an average outpatient prescription fulfillment time greater than 7 days. VAMC pharmacies have used a number of strategies to reduce turn-around time on prescription fulfillment. These strategies include overtime pay, compensatory time, and the use of contract and fee basis pharmacists. These methods have proven costly to pharmacy budgets and pull pharmacists away from direct patient care activities. Virtual Pharmacy Service (VPS) is a component of Meds by Mail under Pharmacy Benefits Management within the Veterans Health Administration. VPS began as a pilot project in 2011 providing prescription verification service for one facility and has since grown to provide service to 18 facilities across the nation.VPS processed 76,855 prescriptions for 2 VAMC’s in the last 4 months of FY 2011. New sites were added over the next three years and in FY 2014 VPS processed 1.78 million prescriptions (a 2,212%increase) for 13 VAMC’s in 12 months. By the end of FY 2015 VPS expects to process over 2 million prescriptions for 18 VAMC’s. In July 2015 alone VPS processed over 225,000 prescriptions for our nations Veterans.

VPS Partner Sites FY15

VAMC's Serviced

Virtual Pharmacy Service: Partnering with VA Medical Centers to Reduce Outpatient Prescription Fulfillment Time

Authors: Susan Brooks, RPh; Carol Ludwig, RPh; Ronald Nosek MS, RPh; John Santell MS, RPh, Scott Jessup, HSS

Pharmacy Benefits Management Meds by Mail Program

Objectives � Improve the timeliness of outpatient prescription processing for VAMCs � Reduce pharmacist overtime (OT) and compensatory time (CT) used by VAMC’s, as well as contract and fee basis

pharmacists for processing pending file prescriptions � Enable outpatient pharmacies to redirect pharmacist resources toward direct patient care � Develop best practices for virtual prescription verification that can be used throughout the VA and possibly other

sectors of Federal Pharmacy � Improve customer satisfaction at the facility level

Methods ¾ Consult with prospective facility to determine:

9 Staffing shortages 9 Average daily number of prescriptions awaiting pharmacist verification (known as the “pending file”) 9 Daily number of prescriptions entered by providers in the electronic health record (EHR) 9 Threshold or number of prescriptions that VAMC pharmacy can process each workday (workload above threshold would signal need for VPS assistance)

Results � Outpatient Prescription Turn-Around Time:

All 13 original sites now maintain a prescription processing time of less than 2 days. Five additional pharmacies have partnered with Virtual Pharmacy Service since April 1, 2015. One month after implementation 4 of the 5 new sites have reduced their prescriptions awaiting pharmacist verification and now maintain a prescription processing time of less than 2 days. Data was tracked on the five new sites added in 2015 from a web enabled secure tracking tool. This pending file data is available to all VA Pharmacy Chiefs and ADPAC’s.

The number of days it takes to process prescriptions (i.e. turn-around time”) is intricately tied to the volume of written prescriptions (i. e. “pending file”). Each VAMC established a threshold regarding the number of prescriptions that VAMC staff can reasonably process on any given workday which approximates a one day turn-around time. For example, prescription volume for site 15 decreased from 3,000 (a 3 day turn-around) to approximately 1,000 - the threshold for that site to maintain a 1 day turn-around. Site 17 decreased their daily pending file volume from 900 (a 4.5 day turn-around) to an average of 300 (1.5 times the threshold of 200 for that site) to maintain a 1-2 day turn-around time.

� Compensation reduction:

Change in Overtime Hours Pre and Post VPS Implementation*Overtime Used (Average)† # Sites Prior # Sites Post

Zero hours per pay period 4 13

1-25 hours per pay period 6 0




Over 100 hours per pay period 2 0

*14 of 18 Sites Responded to VPS Scorecard† Sites provided estimates of the average number of OT hours

Data collected via the VPS scorecard shows 10 of 14 sites used overtime prior to VPS. After VPS implementation, the number of sites using overtime decreased to just one. Overall, the responding VAMCs had a 90% reduction in the number of sites using overtime to process pending file prescriptions.

Change in Compensation Time Hours Pre and Post VPS Implementation*Comp Time Used (Average)† # Sites Prior # Sites Post

Zero hours per pay period 3 10





Over 100 hours per pay period 0 0

*14 of 18 Sites Responded to VPS Scorecard† Sites provided estimates of the average number of CT hours

Data collected via the VPS scorecard showed 11 of 14 sites used comp time prior to VPS. Post VPS implementation, the number of sites using comp time decreased to four (a 63.6% reduction). One site sent data that it had used contract pharmacists at $99 per hour prior to VPS but no longer required contract pharmacist support post VPS implementation. One site sent data that it had used fee basis pharmacists at $1.50 per RX prior to VPS and still uses fee basis pharmacists post VPS implementation but to a lesser extent.

� Impact on clinical services:

Change in Resources Directed Toward Clinical Services

Site* Impact On Clinical Services? Hours Per Pay Period Re-Directed Clinical Services Implemented And/Or Expanded Due To Vps

#1 Very Likely 91-100 hours per pay period

#2 Neutral 31-40 hours per pay period

#3 Very Likely Over 100 hours per pay period Diabetes, Hypertension, Lipids, soon CHF

#4 Unlikely

#7 Likely 1-10 hours per pay period Decentralized CPS coverage

#8 Very Likely 11-20 hours per pay period Expanded CPS clinic grids, increased access to care for MTM

#9 Very Likely 91-100 hours per pay period Ambulatory Care Pharmacists have been able to shift to more clinical duties that were required

#11 Very Likely 11-20 hours per pay period PACT, Mental Health

#12 Likely 41-50 hours per pay period Review of Non Formulary & Restricted drug requests, Process Choice RXs

#13 Likely 11-20 hours per pay period

#14 Very Likely 11-20 hours per pay period Choice Faxed Prescriptions

#15 Unlikely 11-20 hours per pay period

#17 Very Likely Over 100 hours per pay period Expanded PACT Program

#18 Very Likely 11-20 hours per pay period Decentralizing an OPD pharmacist to the ED, Discharge Medication Del & Counseling IP

*Sites # 5, 6, 10, and 16 did not responded to VPS Scorecard

Data collected showed that 11 of 14 sites were likely or very likely to re-direct pharmacist staff hours each pay period to other pharmacy activities. Anywhere between 11 and 100 hours per pay period were utilized in direct patient care activities.

� Satisfaction Scores:VAMC Satisfaction with VPS Program*

VPS Scorecard Element Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

Implementation 10 4

MOU Renewal 7 3 4†

Guideline Development 9 3 2

Quality 8 6

Timeliness 11 3

Value 9 5

Overall Satisfaction 8 6

*14 out of 18 sites responded to VPS Scorecard.

† Neutral ratings are from new sites in first year of VPS partnership & have not been through MOU Renewal process

All 14 sites reported they were satisfied or very satisfied with implementation, quality, timeliness, value and overall satisfaction. Ten of 14 sites reported they were satisfied or very satisfied with MOU renewal. The 4 sites that responded as neutral were sites that were new in FY 2015 and have not been through the MOU renewal process. Twelve of 14 sites reported they were satisfied or very satisfied with guideline development. No sites reported dissatisfaction with any aspect of this program.

DiscussionVPS has provided 18 VA pharmacies a practical and efficient way to reduce turn-around time on their pending files, decrease use of OT/CT, allowing more time to focus on direct patient care services, and add or expand clinical pharmacy services offered at the site. There were many challenges to take an innovative idea from concept and turn it into a reality. Obstacles included, navigating the various site-specific MOU approvals, obtaining VISTA access codes for each site, facility variability in pharmacy drug files, numerous non-formulary approval rules, and differing guidelines for prescription processing at each site (example C-II, MUE, restricted medications, etc.). Since the VPS program began in 2011, numerous best practices have been developed in collaboration with existing sites to standardize prescription processing. These best practices have been shared and implemented with new sites as they join as VPS partners. VPS was built on the principle of providing a quality and value-added service for VAMCs who directly support and serve our nation’s Veterans. High customer satisfaction scores are a testament that we are succeeding in our goal of assisting VAMCs with providing timely outpatient prescription services.

ConclusionsThe VPS initiative demonstrates an innovative and collaborative approach that leverages existing technology and resources to help address an unmet need by many VAMC pharmacies. VPS was implemented with no additional equipment or space and remains cost neutral to VA. Implementation of VPS is a viable and novel solution for VAMC pharmacies to consider for assistance with outpatient prescription processing.

Primary ContactSusan E. Brooks, R.Ph. Supervisory Pharmacist

Meds by Mail/Virtual Pharmacy ServicePO Box 9000

Dublin, GA 31040Phone (478) [email protected]

VPS Rx Processed Per Year

Rx Processed

Department of Veterans AffairsNOTE: This form can also be used for 1VA+FUND.

INTERAGENCY CROSS-SERVICING SUPPORT AGREEMENT PAGE 1 OF 2 PAGES1A. VA AGREEMENT NO. 1B. OGA AGREEMENT NO. (If applicable) 2. AGREEMENT PERIOD (Month and Year)

10/01/2015 – 9/30/20163. SUPPLYING ORGANIZATION (Name, Mail routing symbol, and complete address)VA PHARMACY BENEFITS MANAGEMENT (PBM)VIRTUAL PHARMACY SERVICES (VPS)Through MEDS BY MAIL (MBM)

4. TYPE OF ACTION (Mark “X” as appropriate)

NEWREVISIONOTHER (Specify)

5. RECEIVING ORGANIZATION (Name, Mail routing symbol, and complete address) 6. PROJECT TITLEVIRTUAL PHARMACIST ORDER VERIFICATIONPending File Management

7. SUMMARY OF SUPPORT SERVICES (Attach detailed description of specific support resources to be provided)The VA PBM Virtual Pharmacy Services (VPS) will provide remote prescription pending file processing for the XXXXXX VA Medical Center when the pending file reaches an agreed upon threshold of XXXX prescriptions, with processing of up to XXXX prescriptions per week. Remote support in excess of XXXX prescriptions per week should be scheduled in advance. VPS pharmacists will review and verify pending prescriptions contained within the pending prescription file as required and in accordance with all Joint Commission requirements for pharmacist-level review and processing of medication prescriptions.

XXXX will grant access and pharmacist privileges to their VistA Pharmacy package to the designated VPS pharmacists for the purpose of processing prescriptions remotely. XXXX will provide the necessary training to the designated VPSpharmacists on the processing of pending prescriptions. XXXX will evaluate and document quality assurance monitors and performance measures and provide feedback to the VPS and XXXX VAMC as appropriate. The designated VPSpharmacists will remain assigned to the VPS and the VPS/MbM is responsible for all educational, competency, and performance records of those pharmacists. XXXX will allow the MbM Supervisory Pharmacist and selected pharmacists access to the daily prescription processed report function in VISTA to monitor only VPS pharmacists for purposes of VPS/MbM timekeeping and report functions.

Monthly invoices will be reviewed and approved by the MbM Program Director or designee and the Chief Pharmacist or designee prior to forwarding to Fiscal Service for final disposition.

Standard operating procedures (attached) include patient profile review for allergies, potential adverse reactions, drug-drug interactions and dose appropriateness for age and condition. VPS/MbM will remotely complete XXXX VAMCprescriptions in accordance with the attached procedures.

Fiscal Service: VPS/Meds by Mail will initiate an Expenditure Transfer (EB transaction in FMS) quarterly based on workload data provided by VPS/Meds by Mail. The workload data will be provided to Fiscal and Pharmacy Services, XXXX VA Medical Center, as above for validation. Any discrepancies will be resolved between the Chief, Fiscal Service, XXXX and the Program Director, Meds by Mail or designee.8A. FUNDING AND REIMBURSEMENT ARRANGEMENTS (Give complete information)

Pharmacist processing rate of $0.95 per prescription.

8B. COST (Actual or estimated)

Est. $XXXXX – based upon 52 weeks, XXXX prescriptions per week (at most) and a rate of $0.95 cents per prescription

8C. ACCOUNTING AND APPROPRIATION DATA

FCP: _

8D. METHOD OF PAYMENT (Mark “X” and indicate billing cycle, e.g., Monthly, Quarterly)

SF 1080 SF 1081 SF 1114

8E. DISBURSING OFFICE (Name, Mail routing symbol, and complete address)

Fiscal Service

9. ACCEPTANCE BY BOTH PARTIES TO THE AGREEMENT (Signature of authorized officials)9A. SIGNATURE OF SUPPLYING ORGANIZATION

Associate Chief Consultant, PBMDirector, Meds by Mail Program

9B. SIGNATURE OF RECEIVING ORGANIZATION

Director

TITLE OF SUPPLYING ORGANIZATIONVA PBM Virtual Pharmacy Services through Meds by Mail Program

TITLE OF RECEIVING ORGANIZATION

XXXX VA Medical CenterDATE

VA FORM 2269 (Automated)

10. GENERAL PROVISIONS

(The following general provisions, as set forth below, apply to this agreement unless otherwise specified in the “Remarks” block below.)

a. The authority to provide reimbursable support services to Government departments and agencies is contained in the Economy Act of 1932, as amended, (31 U.S.C. 1535). When other authority is applicable, enter such data in Block 11 below.

b. The requesting organization has determined that the applicability of Office of Management and Budget Circular A-76, Revised, was considered, as well as the requirements of FAR 17.502 and 17.503(a)(1) and (2).

c. Direct and indirect actual costs will be charged for reimbursable work and services. If funds advanced to the supplying organization are more than the actual cost of performing the work or services, the difference will be returned. If an estimate is less than the actual costs incurred, the requesting organization agrees to pay for the actual costs incurred.

d. This agreement or any of its specific provisions may be revised or amended only by the signature approval of the parties signatory to the agreement or by their respective official successors. Cancellation may be made upon 30 days written notice by either party, or their successors, to the other.11. REMARKS

Costs indicated will remain in effect for one year. After that time, XXXXX VA Medical Center Pharmacy will be notified in writing 30 days in advance of any change in cost. During computer downtime at XXXXX VA Medical Center is responsible for all manual contingency procedures.

VPS/Meds by Mail or XXXX retain the right to cancel this agreement at any time during the contract period, with a 30 dayadvance notification and/or extend for option year one.

VA FORM 2269 BACK (Automated)

VISN 18

Phoenix Healthcare System

• Chief of Pharmacy, Associate Chief of Operations, Pharmacy Service [email protected] (123) 456-7890 ext. 5456

• Supervisory Pharmacist, Outpatient Pharmacy Supervisor ([email protected]) (123) 456-7890 ext. 5457

How to Logon to Phoenix

Main Pharmacy Menu/ Prescription Processing Menu

1. Be sure cap lock is on2. Press ENTER one time3. Select ^COM to complete prescriptions using Complete Orders from OERR24. At Division prompt, type 644

1 644 PHOENIX VA HCS(119C) 644 2 644BY SE CLINIC 644BY 3 644GA NW CLINIC 644GA 4 644GB SHOW LOW 644GB 5 644GC SW CLINIC (BUCKEYE) 644GC 6 644GD PAYSON CLINIC 644GD 7 644GE THUNDERBIRD CLINIC 644GE 8 644GF GLOBE CLINIC 644GF

5. Select the Ordering Institution you have been assigned6. Press ENTER two times7. At next prompt, OK to assume label alignment is correct?, press ENTER two times8. At prompt “Do you want an Order Summary? NO//, press ENTER two times9. Message may be displayed concerning flagged orders for division. This is irrelevant.10. At next prompt “Select By: <PA/RT/PR/CL/FL/E>: PATIENT//” press ENTER11. At next prompt “All Patients or Single Patient: <A/S/E>: SINGLE//” type A for ALL and

this will make the program roll to the next patient with pending prescriptions after each patient is completed

12. At prompt “Do you want to see Medication Profile? Yes//” press ENTER13. At this point you will view the first patient with the oldest pending order for this division.14. Be aware that there are certain points where the system pauses before bringing up the

next screen so do not press the ENTER key more than once at each prompt.

Phoenix VA Healthcare System

Southeast CBOC

Sun City, AZ CBOC (Northwest)

Phoenix VAMC

Payson CBOC

Globe Health Care Clinic

Thunderbird VA CBOC

Northeast VA Clinic

Prescriptions to Skip: Phoenix

Medications Requiring Periodic Monitoring – Skip prescriptions if this is the first prescription (baseline labs needed) or if the prescription reflects an annual renewal (annual labs needed):

• Biologics (adalimumab, etanercept, golimumab)• Canagliflozin• Clopidrogel• Colchicine• Dalfampridine• Dofetilide• Glyburide

Medications Requiring Routine Monitoring – Skip ALL prescriptions every time• Amiodarone• Anticoagulants, oral (apixiban, dabigatran, rivaroxaban, warfarin)• Anticoagulants, injectable (enoxaparin, dalteparin, fondaparinux)• Antimicrobials (antibiotics, antivirals, antifungals) that do NOT fall into these categories:

o Dental antimicrobial pre-medso Antivirals for routine HSV outbreakso Long-term antibiotics

• Antipsychotics, injectable (haloperidol, fluphenazine, paliperidone, risperidone)• Anti-retrovirals• Atypical antipsychotics, oral (aripiprazole, olanzapine, risperidone, quetiapine)• Azathioprine• Buprenorphine/naloxone• Chemotherapy agents (EXCEPTION: anastrozole, bicalutamide, flutamide, nilutamide

(NF), hydroxyurea, lestrozole, tamoxifen)

• CII narcotic• Clozapine• Dimethyl fumarate [Tecfidera]• Dual Benzodiazepine prescriptions (i.e., current active benzodiazepine and provider is

ordering another benzodiazepine)• Erlotinib• Erythropoiesis stimulating agents (erythropoietin and darbepoetin) • Hepatitis C antivirals (sofosbuvir, simeprevir, ledipasvir/sofosbuvir [Harvoni],

ombitasvir/paritaprevir/ritonavir with dasabuvir [Viekira pak], ribavirin)• Hyaluronate injections• Imatinib• Isotretinoin• Leflunomide• Lenalidomide• Lithium• Metformin if the Scr value was outside the recommended guideline and/or Scr date was

more than 12 months ago• Methotrexate• Prednisolone ophthalmic kits• Sulfasalazine• Thalidomide• Tofacitinib• Varenicline

Restrictions and Criteria for Approval – Skip prescriptions if it is the first prescription for:• Non-Formulary (NF) drugs unless there is clear approval in the narrative or patient has

been receiving; no comments about a trial approval• Restricted drugs unless there is clear approval in the narrative or patient has been

receiving; no comments about a trial approval

Requires Review of Medical Record or Contacting Provider – Skip prescriptions for:• Compounded drugs (CMPD)• Critical Drug Interactions for New prescriptions (NOT for Renewal prescriptions) • Contract Nursing Home Patients• Discharge prescriptions• Flagged prescriptions• Mental Health Intensive Case Management (MHICM) prescriptions• MRI Pre-meds (lorazepam, etc.)• If provider comments do not match sig• If provider has entered two prescriptions for the same medication and same strength, but

with differing directions• Injectable meds if not clear if given in clinic or to be mailed (i.e., goserelin – usually

given in clinic).• If the patient narrative states: DO NOT MAIL

• Inpatients “Do you want to continue? NO//”• If there is No Allergy Assessment• If warning appears in patient profile: The patient address is indicated as a bad address

(UNDELIVERABLE) or no address.• Investigational/Research Study drugs (INV)• Risk Evaluation Mitigation Strategy Drugs (isotretinoin, thalidomide, lenalidomide)• Window orders less than 5 days old; otherwise, route to MAIL for routine, maintenance

prescriptions

Phoenix Guidelines

Finish the order but do NOT PRINT (QUEUE) A LABEL if it states under provider comments “Administered in Clinic”

Drug InformationFollow guidelines in drug messaging.If patient has a long-acting beta-2 agonist MDI, there must be a short-acting on profile.

Quantities and Days’ Supply• Days’ supply for topical products should be one regular size tube or bottle per month (unless

different in drug dispense message or previous history of use.)• Ophthalmic products should be calculated at 20 drops per mL and then adjust the days’

supply accordingly.• Supply items (diapers, bandages, catheters, non-CMOP refrigerator items, and nutritional

tube feeds) remain at 30 days’ supply. You may skip if not sure about the item.• You should change quantity to match days’ supply and CMOP quantities unless it’s a

controlled substance.

Match Quantity Dispensed to Dispense MessageExample: Aspirin comes in different quantities per bottle based on drug’s strength.Aspirin Tab, EC 81 mg comes in bottles of 120s. Aspirin Tab 325 mg comes in bottles of 100s.

Testosterone Cyprionate 200mg IM every other week.Dispense Message: “200mg=6/84d” referring to quantity of 6 vials for 84 days’ supply“100mg=3/84d” referring to quantity of 3 vials for 84 days’ supply

Controlled Substances• Controlled substances III-V can be filled for 30 days only with a maximum of 5 refills.

¾ Create inter-agency servicing agreement (Memorandum of Understanding) between facility and VPS based on level of need.

VPS Scorecard We appreciate partnering with you in achieving your pharmacy services mission. We certainly value our veterans and want to provide the best possible support to you. If you could fill out this support scorecard for us it would help us in our mission to provide the best service to our VPS partners. Responses will be kept confidential and will only be used for statistical purposes. Individually identified responses will not be shared with any outside agencies. Thank you in advance for your participation.

1. Prior to implementation of VPS please indicate the following methods of compensation your facility used to process pending file prescriptions.

Overtime (OT Pay)

Please estimate the average # of OT hours per pay period dedicated to pending file

Compensation time (CT)

Please estimate the average # of CT hours per pay period dedicated to pending file Select...

Contract Pharmacist Please indicate the hourly contract rate:

Fee Basis Please indicate the cost per RX: 2. After implementation of VPS please indicate the following methods of compensation your facility used to process pending file prescriptions.

Overtime (OT Pay)

Please estimate the average # of OT hours per pay period dedicated to pending file

Compensation time (CT)

Please estimate the average # of CT hours per pay period dedicated to pending file Select...

Contract Pharmacist Please indicate the hourly contract rate:

Fee Basis Please indicate the cost per RX:

3.Afterimplementation of VPS please indicate the number of pharmacist hours per pay period were you able to re-direct to other pharmacy activities.

4.Afterimplementation of VPS, how likely did VPS impact your ability to add/expand clinical services?

Please list the clinical services that your pharmacy has been able to implement/expand as a result of VPS implementation. (example Diabetic clinic, Glaucoma clinic, etc.)

5. In general, how satisfied are you with VPS site implementation / start-up process?

Very Satisfied

Satisfied

Neutral

Dissatisfied

Very Dissatisfied 6. In general, how satisfied are you with the Memorandum of Understanding (MOU) renewal process?

Very Satisfied

Satisfied

Neutral or N/A

Dissatisfied

Very Dissatisfied 7. In general, how satisfied are you with VPS "Guidelines for Prescription Processing" development?

Very Satisfied

Satisfied

Neutral

Dissatisfied

Very Dissatisfied 8. In general, how satisfied are you with the quality of the VPS program?

Very Satisfied

Somewhat Satisfied

Neutral

Somewhat Dissatisfied

Very Dissatisfied 9. In general, how satisfied are you with the timeliness of the VPS program?

Very Satisfied

Satisfied

Neutral

Dissatisfied

Very Dissatisfied 10. In general, how satisfied are you with the value of the VPS program?

Very Satisfied

Satisfied

Neutral

Dissatisfied

Very Dissatisfied 11. Overall, how satisfied are you with the Virtual Pharmacy Services program for your facility?

Very Satisfied

Satisfied

Neutral

Dissatisfied

Very Dissatisfied 12. Would you recommend VPS program to another VAMC pharmacy?

Yes

No 13. Please provide any additional comments or suggestions for the VPS Program?

14. What is your preferred method of communication with VPS staff?

¾ Measure Turn-Around Times – The VA issued a memorandum “VHA Handbook 1108.05 requires that the Chief of Pharmacy send a report to the medical facility Director when a prescription backlog exceeds 7 days. When backlog reports are submitted to the medical facility director for more than 4 consecutive weeks, VHA Handbook 1108.05 requires the medical facility Director to submit a report to the VISN Director and to the VHA Central Office Pharmacy Benefits Management (PBM) Service noting deficiencies…”

0

1000

2000

3000

4000

5000

6000

Site #18 (threshold=500)

Site #17 (threshold=200)

Site #16(threshold=1000)

Site #15(threshold=1000)

Pending File Volume Post VPS Implementation for New Sites

9/2/2015

8/26/2015

8/19/2015

8/12/2015

8/5/2015

7/29/2015

7/22/2015

7/15/2015

7/8/2015

7/1/2015

6/24/2015

6/17/2015

6/10/2015

6/3/2015

5/27/2015

5/20/2015

5/13/2015

5/6/2015

4/29/2015

4/22/2015

AcknowledgementsHenry N. Josey, Clinical Pharmacist,

Meds by Mail/Virtual Pharmacy Services, Dublin, GARichard Desjarlais, Chief Business Officer,

Meds by Mail, Gray, TNBarbara Magyar, Visual Information Specialist,

Communications, Denver, CO

Thinkstock/Moodboard Thinkstock/iStock

VPS Partner Sites FY15

Documents

Transcript of VPS Partner Sites FY15