Tracking the value of pharmacy interventions

Results from a study recently released by the Veteran’s Administration offers a roadmap for hospital pharmacists looking to explain their value to their administration.

Beginning in 2012, VA pharmacists began recording their patient interactions for their most common interventions in the health system’s electronic health records (EHR) using a pharmacist-specific template. These encounters were most often for diabetes management, hypertension, dyslipidemia, heart failure, anticoagulation management.

Results from the Pharmacists Achieve Results with Medications Documentation (PhARMD) Project were reported earlier this summer in the American Journal of Health System Pharmacy.

As the program matured, the hospitals began to add pharmacist-related activities including diseases such as hepatitis C, osteoporosis/bone health, tobacco cessation, anemia, mental health, pain management, antimicrobial stewardship, total parenteral nutrition and nutrition support, asthma, chronic kidney disease, chronic obstructive pulmonary disease, gout, human immunodeficiency virus, hypothyroidism, transplantation, and women’s health.

Interventions were categorized within the template to include medication management activities such as initiating, adjusting a dosage, changing, or discontinuing a medication; managing an adverse drug reaction or drug-on-drug interaction; and documenting treatment goals and goal attainment status.

General pharmacotherapy and nonpharmacologic activities were also documented using the template, such as medication reconciliation, improving compliance and adherence to therapy, identifying therapeutic duplications, patient education sessions, and referrals for additional care.

While the VA, as the country’s largest integrated health system has the advantage of working with one EHR, other hospitals with less robust electronic capabilities still may capture pharmacy intervention data using an Excel spreadsheet template.

In just one example of how data capture can benefit patients and the health system alike,  a CompleteRx hospital used its pharmacist intervention data to create a renal dosing and pharmacokinetics automatic substitution protocol that reduced telephone calls to doctors to initiate therapy. This simple protocol helped streamline processes and saved money, while also increasing satisfaction with physicians, administration and patients alike.

Some key takeaways from the VA’s clinical intervention documentation:

  • Pharmacists must be prepared to demonstrate how their services add value and contribute to patient care outcomes.
  • Linking pharmacy data with facility performance measures can demonstrate the value of clinical pharmacy specialists to their healthcare system.
  • Linking clinical and economic outcomes solidifies the growing body of literature that supports the expansion of the clinical pharmacist role in a variety of patient care settings.
  • The data captured in electronic records or spreadsheets can help you develop strong-evidence based cost–benefit models.
  • Data may be trended to assess differences in practice models and determine cost-benefit and cost-effective use of clinical pharmacy services.
  • Your data may be used in national benchmarking of clinical pharmacy interventions and contribute to the profession’s overall benefit and expertise.

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Jennifer Seagle is an area clinical pharmacy manager for CompleteRx.