HRSA fosters programs that integrate pharmacy services

A federally sponsored collaborative to help local healthcare entities integrate pharmacy services to improve care of "high-risk, high-cost, complex patients," is entering its fourth year, with 160 teams participating nationwide.

Tailored to local needs

The federal Health Resources and Services Administration (HRSA) offers regular learning opportunities and guidance for teams seeking to undertake projects under the auspices of the Patient Safety and Clinical Pharmacy Services Collaborative.

Anyone can initiate a partnership, although the anchor members of the work are community-based healthcare providers, including health centers, Ryan White HIV/AIDS programs, poison control centers, and rural health centers. According to HRSA, each team tailors its work to the need of its patient population.

"We have also had schools of pharmacy initiate a team and then go out and work with a doctor's office or with the community health center to get together and forge a partnership," said Linda Kwon, MPH, a HRSA public health analyst.

Community teamwork

In 1 example of how teams work, the University of Mississippi Pharmacy Partnership began offering clinical pharmacy services at the Family Health Center in Yazoo City, Miss. Under an agreement with the university's pharmacy faculty, pharmacists will provide services of clinical pharmacists and manage diabetes, hypertension, and cholesterol.

In the Primary Care Coalition of Montgomery County, Maryland, pharmacists developed an interprofessional team that provided clinical pharmacy services and care transitions among providers. There has been "an increasing number of patients referred and scheduled for medication therapy management and diabetes" training sessions, HRSA noted.

How it works

Teams join the program for each "collaborative year," and the agency puts on a series of webinars and other activities to help them progress, including 3 annual on-site "learning sessions," usually for 2 days, during which the teams learn from each other and from a faculty with various backgrounds, Kwon said.

HRSA does not provide funding for the work in the localities. Some teams have obtained funds from foundations or local organizations to provide the clinical pharmacy services, she noted.

Many teams are starting to build or have built a business case to help sustain or even enhance the services and bring on additional providers, according to Kwon.

She added that some teams don't have a pharmacist on site, but they partner with a school of pharmacy that provides a pharmacist on a part-time basis.

Other regional initiatives

The program's "Change Package" document, issued in October, notes that the Holyoke Health Center in Massachusetts has partnered with the Boston Medical Center Health Net Plan, a Medicaid managed care organization, to track pre- and post-medication therapy management per member spending and healthcare outcomes for 50 medical center patients.

In an example of integrated care delivery action, Health Partners of Western Ohio educated support staff and providers on a universal method for medication reconciliation in their electronic health record, the document stated.

Under the category of patient-centered care, the University of Colorado School of Pharmacy and the Denver Health Eastside Clinic determined that reaching out to diabetes patients by phone saved costs, co-pays, and the need to make transportation arrangements. By calling patients when it was convenient, including some nights and weekends, the management helped encourage patient engagement, the document noted.

Tracking progress

Composition of the teams varies. Some are led by pharmacists, some by health educators or other professionals, Kwon said.

The teams track outcome data and analyze the benefits of the clinical pharmacy services to the patient and to the practice, "so they see what they are doing and where they would like to go next," she said. HRSA is now working to analyze some of the information that teams have shared with the agency.

According to Kwon, HRSA welcomes inquiries from organizations that would like to be involved in the collaborative program. She said that the collaborative's fourth year has just started, but new members may be able to catch up. The fifth year is due to begin in fall 2012.

Information on the program, including the Change Package document, other resources pertaining to quality, and the program's e-mail address, is available at the HRSA collaborative's website (http://www.hrsa.gov/publichealth/clinical/patientsafety/index.html).

Kathryn Foxhall is a healthcare journalist based in the Washington, D.C. area.