American Society for Automation in Pharmacy Annual Conference

Transcription

American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Thursday, January 21, 1:30 – 2:00 pm The Pharmacists’ Patient Care Process: Where Does Technology Fit? Anne Burns, R.Ph., Vice President, Professional Affairs, American Pharmacists Association ACPE #: 0207-9999-16-031-L04-P ACPE #: 0207-9999-16-031-L04-T Activity Type: Knowledge-Based
Following this presentation, attendees should be able to:
1. Describe the development of the Pharmacists’ Patient Care Process.
2. Describe the elements of the Pharmacists’ Patient Care Process.
3. Explain how the Pharmacists’ Patient Care Process is being incorporated into EHR tools
and resources for pharmacists.
4. List current strategies underway for implementation of the Pharmacists’ Patient Care
Process.
Disclosures:
Anne Burns is an employee of the American Pharmacists Association. The conflict
of interest was resolved by peer review of the slide content. She declares no other conflicts of
interest or financial interest in any product or service mentioned in this program, including
grants, employment, gifts, stock holdings, and honoraria.
ASAP’s and NCPA’s education staff declares no conflicts of interest or financial interest in any
product or service mentioned in this program, including grants, employment, gifts, stock
holdings, and honoraria.
NCPA is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program is accredited by NCPA for 0.05 CEUs (0.5 contact hours) of continuing education credit. Successful completion includes attending the session, signing the attendance sheet, and completion of the program evaluation forms.
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Learning Assessment Questions Thursday, January 21, 1:30 – 2:00 pm The Pharmacists’ Patient Care Process: Where Does Technology Fit? Anne Burns, R.Ph., Vice President, Professional Affairs, American Pharmacists Association ACPE #: 0207-9999-16-031-L04-P ACPE #: 0207-9999-16-031-L04-T Activity Type: Knowledge-Based
1. The pharmacist’s patient care process:
a. Is used solely for medication therapy management services.
b. Reflects contemporary pharmacy practice.
c. Was developed by the Joint Commission of Pharmacy Practitioners (JCPP).
d. B & C.
e. All of the above.
2. The Pharmacists’ Patient Care Process identifies three foundational components that apply to
all steps. They are:
a. Collaborate, communicate and document.
b. Communicate, measure, and report.
c. Interview, assess, and coordinate.
d. Medication reconciliation, counseling, and document.
3. Choose the most correct answer related to the pharmacists’ patient care process:
a. Determining the outcomes and value of pharmacists’ services requires a consistent
process of care.
b. The pharmacists’ patient care process requires the use of collaborative practice
agreements.
c. The pharmacists’ patient care process is facilitated by the use of health information
technology.
d. A & C.
4. Health information technology can enhance the pharmacists’ patient care process by:
a. Supporting documentation of patient care in user-friendly systems that meet
pharmacists’ documentation needs.
b. Facilitating exchange of clinical information between pharmacists and other providers.
c. Enabling quality measurement documentation and reporting.
d. All of the above.
The Pharmacists’ Patient Care Process:
Where Does Technology Fit?
Disclosures
Anne Burns is an employee of the American Pharmacists
Association. The conflict of interest was resolved by peer
review of the slide content. She declares no other conflicts
of interest or financial interest in any product or service
mentioned in this program, including grants, employment,
gifts, stock holdings, and honoraria.
2
Objectives
Following this presentation, participants should be ll be able
to:
• Describe the development of the Pharmacists’ Patient
Care Process.
• Describe the elements of the Pharmacists’ Patient Care
Process.
• Explain how the Pharmacists’ Patient Care Process is
being incorporated into EHR tools and resources for
pharmacists.
• Discuss current strategies underway for implementation of
the Pharmacists’ Patient Care Process.
3
Joint Commission of Pharmacy Practitioners
(JCPP)JCPP)
4
Pharmacists’ Patient Care Process
•  JCPP Strategic Plan: Consistent patient care
process identified as key driver for achieving the
JCPP vision
•  Supports the profession’s provider status activities
•  Needed to meet demands of evolving health care
system focused on triple aim
•  Collaboration of national pharmacy
organizations working to develop a standardized
pharmacist patient care process
•  Purpose: to stimulate consistency, predictability,
and measurability in pharmacists’ service delivery
JCPP Pharmacists’ Patient Care Process Workgroup
•  Activities: January 2012-May 2014
–  Workgroup meetings
–  Environmental scan
–  Testing among clinicians
–  Organizational feedback
Development
•  Review of key resources
– 
– 
– 
– 
– 
Pharmaceutical care – Strand & Cipolle
Profession’s MTM definition and MTM Core Elements
PCPCC Medication Management Resource Guide
ACA language
Nurse Practitioner’s Practice Standards
•  Should apply to the wide variety of patient care
services provided by pharmacists AND the
pharmacist’s medication expertise
–  Level of intensity varies depending on the service
–  One pharmacist might be responsible for all the steps in
some settings where in others more than one pharmacist
may be involved at different stages of the process.
Goals
•  Pharmacists’ Patient Care Process created to:
–  Promote consistency across the profession.
–  Provide a framework for delivering patient care in any
practice setting.
–  Be a contemporary and comprehensive approach to
patient-centered care delivered in collaboration with
other members of the health care team.
–  Be applicable to a variety of patient care services
delivered by pharmacists, including medication
management
•  Foundational Components:
-  Establishment of patient-pharmacist relationship
-  Engagement and effective communication with patient,
family, caregivers
-  Continually collaborate, document, and communicate
with physicians and other health care providers
-  Process enhanced by interoperable information
technology systems that facilitate effective and
efficient communication
•  " !$
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http://www.pharmacist.com/sites/default/files/JCPP_Pharmacists_Patient_Care_Process.pdf
Collect
The pharmacist assures the collection of necessary subjective and
objective information about the patient in order to understand the
relevant medical/medication history and clinical status of the patient.
Information may be gathered and verified from multiple sources.
Collect:
• A current medication list and medication use history for prescription and
nonprescription medications, herbal products, and other dietary
supplements
• Relevant health data that may include medical history, health and
wellness information, biometric test results, and physical assessment
findings
• Patient lifestyle habits, preferences and beliefs, health and functional
goals, and socioeconomic factors that impact access to medications and
other aspects of care
Assess
The pharmacist assesses the information collected and analyzes the
clinical effects of the patient’s therapy in the context of the patient’s
overall health goals in order to identify and prioritize problems and
achieve optimal care.
Assess:
• Each medication for appropriateness, effectiveness, safety, and patient
adherence
• Health and functional status, risk factors, health data, cultural factors,
health literacy, and access to medications or other aspects of care
• Immunization status and the need for preventive care and other health
care services, where appropriate
Plan
The pharmacist develops an individualized patient-centered
care plan, in collaboration with other health care professionals
and the patient or caregiver that is evidence-based and costeffective.
The plan:
• Addresses medication-related problems and optimizes medication therapy
• Sets goals of therapy for achieving clinical outcomes in the context of the
patient’s overall health care goals and access to care
• Engages the patient through education, empowerment, and selfmanagement
• Supports care continuity, including follow-up and transitions of care as
appropriate
Implement
The pharmacist implements the care plan in collaboration
with other health care professionals and the patient or
caregiver.
The pharmacist:
• Addresses medication- and health-related problems, and engages in
preventive care strategies, including vaccine administration
• Initiates, modifies, discontinues, or administers medication therapy as
authorized
• Provides education and self-management training to the patient or
caregiver
• Contributes to coordination of care, including the referral or transition
of the patient to another health care professional
• Schedules follow-up care as needed to achieve goals of therapy
Follow-up: Monitor and Evaluate
The pharmacist monitors and evaluates the
effectiveness of the care plan and modifies the
plan in collaboration with other health care
professionals and the patient or caregiver as
needed.
Monitor and evaluate:
• Medication appropriateness, effectiveness, and safety and
patient adherence through available health data, biometric
test results and patient feedback
• Clinical endpoints that contribute to the patient’s overall
health
• Outcomes of care, including progress toward or the
achievement of goals of therapy
Application Examples: Service/
Setting
•  •  •  •  •  17
The Pharmacists’ Patient Care Process and
Technology
•  Need for technology that supports efficient and
effective delivery of patient care services
–  User-friendly documentation and billing
–  Seamless electronic information exchange
between pharmacists and other providers
–  Quality measurement documentation and
reporting
Advances in HIT and Pharmacist-Provided Care
•  Development
of billing codes (CPT Codes)
• 
•  Development of documentation codes (SNOMED CT
Codes)
•  Medicare Part D Enhanced MTM Program
•  Guidelines and processes for Health Information
Exchanges
•  Development of Structured Electronic Document
Templates using HL7 Standards
•  Pharmacy Care Note
•  Transitions of Care
•  EHR system functionality for pharmacists providing
patient care
http://pharmacyhit.org/pdfs/workshop-documents/WG3-Post-2014-03.pdf
Implementation
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Questions and Discussion
Anne Burns
[email protected]
202-429-7522
Website: www.pharmacist.com
9:
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key 1. D. “
Reflects contemporary pharmacy practice” and “Was developed by the Joint
Commission of Pharmacy Practitioners (JCPP).”
2. A.
Collaborate, communicate and document.
3. D. “
Determining the outcomes and value of pharmacists’ services requires a consistent
process of care” and “The pharmacists’ patient care process is facilitated by the use of
health information technology.”
4. D.
All of the above.
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Thursday, January 21,
2:30 – 3:00 pm Copay Cards: Ubiquitous and Challenging Don Dietz, R.Ph., M.S., Vice President, Pharmacy Healthcare Solutions, Inc. ACPE #: 0207-9999-16-032-L04-P
ACPE #: 0207-9999-16-032-L04-T
Activity Type: Knowledge-Based
1. Describe the history and background of copay cards.
2. List the various types of copay cards and patient savings opportunities.
3. Explain the major differences between copay cards and patient assistance programs.
4. Describe challenges facing copay cards with electronic prescribing.
Disclosures:
Don Dietz
is an employee of
Pharmacy Healthcare Solutions, Inc
. The conflict of
interest was resolved by peer review of the slide content. He declares no other conflicts of
interest or financial interest in any product or service mentioned in this program, including
grants, employment, gifts, stock holdings, and honoraria.
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Learning Assessment Questions Thursday, January 21,
2:30 – 3:00 pm Copay Cards: Ubiquitous and Challenging Don Dietz, R.Ph., M.S., Vice President, Pharmacy Healthcare Solutions, Inc. ACPE #: 0207-9999-16-032-L04-P
ACPE #: 0207-9999-16-032-L04-T
1. Which of the follow is not a type of copay card?
a. Pay no more than $x.
b. Differential copay based on refill number.
c. Differential copay based on plan tier.
d. All are types of copay cards.
2. Copay cards information sent in the notes section of an e-RX is often ignored by the
pharmacy.
True/False
3. Which of the following is false in regards to copay cards and patient assistance
programs?
a. Copay cards are usually ineligible for patients covered by Medicare or Medicaid.
b. Copay cards are frequently sponsored by nonprofit groups.
c. Patient assistance programs usually require financial verification.
d. Patients using assistance programs do not usually receive the medication at their
retail pharmacy.
4. Only large manufacturers can afford to utilize copay cards.
True/False
23/33/25
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American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key 1.
2.
3.
4.
D. All are types of copay cards.
True.
B. Copay cards are frequently sponsored by nonprofit groups.
False.
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Thursday, January 21,
3:00 – 3:45 pm How Much of Pharmacy’s Physical Product Sales Will Amazon Eat, and by When? Bruce Merrifield, M.B.A., President, Merrifield Consulting Group ACPE #: 0207-9999-16-033-L04-P ACPE #: 0207-9999-16-033-L04-T
1. Explain the amazing build out rate of AMZ’s Same-Day DC infrastructure.
2. Describe AMZ’s innovations for warehouse best-ever warehouse efficiencies.
3. Explain AMZ’s “Prime Flywheel” platform that has snowballing allure for marketing
partners.
4. Describe AMZ’s math for increasing faster deliveries an increasingly lower delivery costs.
5. Describe AMZ’s ability to identify and profitably underprice retailers most, excessively
profitable items.
6. Explain How 1-5 add up to a big threat for retailers with high-cost per square feet space.
Disclosures:
Bruce Merrifield
is an employee of
Merrifield Consulting Group
. The conflict of
interest was resolved by peer review of the slide content. He is receiving an honorarium for this
presentation. He declares no other conflicts of interest or financial interest in any product or
service mentioned in this program, including grants, employment, gifts, and stock holdings.
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Learning Assessment Questions Thursday, January 21,
3:00 – 3:45 pm How Much of Pharmacy’s Physical Product Sales Will Amazon Eat, and by When? Bruce Merrifield, M.B.A., President, Merrifield Consulting Group ACPE #: 0207-9999-16-033-L04-P ACPE #: 0207-9999-16-033-L04-T
1. Why is AMZ’s delivery infrastructure most-economical for online sales?
2. Why are AMZ’s Prime Buyers, the most profitable customers a retailer can lose?
3. What are the characteristics of a retailers most profitable items? How will AMZ pursue
them?
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American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key 1. It is the only infrastructure being built from scratch to fulfill just that mission. All other
competitors have legacy infrastructures designed for a go-to-store world that locks
them into having their most profitable items poached.
2. Prime Buyers are the: most wired, educated, affluent, biggest-spending customers who
will pay up for: speed, convenience and variety.
3. Most profitable items are picked most often (consumables) with the greatest amount of
Gross Margin dollars in the unit of purchase (a higher price total). AMZ averages 5%
lower prices on the most profitable, popular items.
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Friday, January 22,
9:45 – 10:30 am The Wellness Data Revolution: Opportunities and Threats Bruce Merrifield, M.B.A., President, Merrifield Consulting Group ACPE #: 0207-9999-16-034-L04-P ACPE #: 0207-9999-16-034-L04-T
1. Explain why retail pharmacies need Profit-Core solutions to finance new “adjacency”
opportunities solutions also enabled by the pharmacy system vendor community.
2. Describe why strategic scenario planning + vigilant agility + rapid prototyping + joint
ventures are necessary tools for chaotic times.
3. Describe how Big Data will create affordable, new solutions for old wellness problems.
4. List the best-odds threats and opportunities for your firm to prepare for.
Disclosures:
Bruce Merrifield
is an employee of
Merrifield Consulting Group
. The conflict of
interest was resolved by peer review of the slide content. He is receiving an honorarium for this
service mentioned in this program, including grants, employment, gifts, and stock holdings.
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Learning Assessment Questions Friday, January 22,
9:45 – 10:30 am The Wellness Data Revolution: Opportunities and Threats Bruce Merrifield, M.B.A., President, Merrifield Consulting Group ACPE #: 0207-9999-16-034-L04-P ACPE #: 0207-9999-16-034-L04-T
1. What are disruptive market conditions?
2. What is a business’ “profit core”?
3. What is a “best adjacency” for strong “profit core” operators?
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American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key 1. When interdependent, forces of change become too many and strong, the future
becomes more fractured, turbulent and unknowable.
2. The intersection of the most profitable customers who are buying the most profitable
items/services is a company’s “Profit Core”. The core typically involves about 20% of all
active regular customers and 20% of all active, selling items/services. The core profits
will be 120 to 200% of the operating income to pay for: losing customers and items and
a residual profit.
3. An adjacency is a new directional business offshoot of the Profit Core that builds on
existing company strengths. The “best” is the tangential option(s) which are statistically
assessed as most likely to have the highest return for the least risk.
10:30 – 11:00 am The Wisconsin Quality Collaborative: Expanding Medication Management Services Jeff Kirchner, R.Ph., CEO and Owner, Streu’s Pharmacy ACPE #: 0207-9999-16-035-L04-P ACPE #: 0207-9999-16-035-L04-T
1. Describe how WPQC could serve as a national model for medication therapy
management services.
2. Explain the differences between level 1 interventions and level 2 interventions.
3. Explain the importance of technology in helping pharmacies build medication
management services into their daily workflow.
Disclosures:
Jeff Kirchner
is an employee of
Streu’s Pharmacy
. The conflict of interest was
resolved by peer review of the slide content. He declares no other conflicts of interest or
financial interest in any product or service mentioned in this program, including grants,
employment, gifts, stock holdings, and honoraria.
10:30 – 11:00 am The Wisconsin Quality Collaborative: Expanding Medication Management Services Jeff Kirchner, R.Ph., CEO and Owner, Streu’s Pharmacy ACPE #: 0207-9999-16-035-L04-P ACPE #: 0207-9999-16-035-L04-T
1. WPQC was able to build a large network of pharmacies and pharmacists to participate in
the program.
True/False
2. The CMS Innovation grant enabled the Pharmacy Society of WI to add infrastructure
that includes:
a. Clinical and operations manager.
b. Academic evaluation team.
c. Clinical advisory group.
d. Regional implementation specialists.
3. For WPQC to have long term success, it’s essential that streamlined workflow continued
to be developed and implemented in the pharmacies within the network.
True/False
Together, We’re Building a Better
Way to Care – For Everyone
Disclosures
Jeff Kirchner is an employee of Streu’s
Pharmacy. The conflict of interest was
resolved by peer review of the slide
content. He declares no other conflicts of
interest or financial interest in any product
or service mentioned in this program,
including grants, employment, gifts, stock
Learning Objectives
• Describe how WPQC could serve as a
national model for medication therapy
management services.
• Explain the differences between level 1
interventions and level 2 interventions.
• Explain the importance of technology in
helping pharmacies build medication
management services into their daily
workflow.
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2. E. All of the above.
3. True.
11:30 am – 12:00 pm
The Challenges of Analytics in Retail Pharmacy
Jeff Pitts, Director of IT, Fruth Pharmacy
ACPE #: 0207-9999-16-036-L04-P
ACPE #: 0207-9999-16-036-L04-T
1. Describe the importance of personalized marketing to the success of retail pharmacies.
2. Describe the struggle of developing a "complete picture" of a customer without a link
between the various systems/databases in use in a pharmacy.
3. List some of the various methods of classifying customers used in database marketing.
Disclosures:
Jeff Pitts is an employee of
Fruth Pharmacy
. The conflict of interest was resolved
by peer review of the slide content. He declares no other conflicts of interest or financial
interest in any product or service mentioned in this program, including grants, employment,
gifts, stock holdings, and honoraria.
11:30 am – 12:00 pm
The Challenges of Analytics in Retail Pharmacy
Jeff Pitts, Director of IT, Fruth Pharmacy
ACPE #: 0207-9999-16-036-L04-P
ACPE #: 0207-9999-16-036-L04-T
1. The best method of reaching a customer today is with:
a. Blanket social media content.
b. Blast e-mails.
c. Customized content in e-mail/social media.
d. Letters to the customer.
2. Customized content involves:
a. Using RFM techniques to target specific customers.
b. Analyzing lifetime-value of a customer.
c. Using similar customers to predict/recommend items the customer may want.
3. There is a classification system similar to GPI for OTC products.
True/False
4. Which of these are not a useful method of classifying a customer for marketing
purposes?
a. RFM analysis.
b. Lifetime value.
c. Customer profiles.
d. Time as a customer.
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American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key 1.
2.
3.
4.
C. Customized content in e-mail/social media.
D. All of the above.
B. False.
D. Time as a customer.
12:00 – 12:30 pm Geriatric Pharmacy Practice: Innovative Care Strategies Kevin Bain, Pharm.D., M.P.H., VP, Medication Risk Mitigation, CareKinesis ACPE #: 0207-9999-16-037-L04-P ACPE #: 0207-9999-16-037-L04-T
1. Identify the leading cause of adverse drug event-related hospitalizations in geriatric
patients.
2. Explain how pharmacogenomics can help healthcare professionals personalize
medication regimens for geriatric patients.
3. Describe how connecting the data aids with medication decision-making for geriatric
patients.
Disclosures:
Kevin Bain
is an employee of
CareKinesis
. The conflict of interest was resolved by
peer review of the slide content. He declares no other conflicts of interest or financial interest
in any product or service mentioned in this program, including grants, employment, gifts, stock
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Learning Assessment Questions
Friday, January 22,
12:00 – 12:30 pm Geriatric Pharmacy Practice: Innovative Care Strategies Kevin Bain, Pharm.D., M.P.H., VP, Medication Risk Mitigation, CareKinesis ACPE #: 0207-9999-16-037-L04-P ACPE #: 0207-9999-16-037-L04-T
1. The leading cause of adverse drug event-related hospitalizations in geriatric patients is
unintentional overdoses.
True/False
2. When personalizing medication regimens for geriatric patients, pharmacogenomics can
help with:
a. Medication selection.
b. Medication dosing.
c. Both of the above.
3. Patient-related factors and medication-related factors are components of connecting
the data to make decisions for personalizing medication regimens for geriatric patients.
True/False
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8
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key 1. True.
2. C. Both of the above.
3. True.
1:45 – 2:15 pm Legislative Update: What to Expect in 2016 Brad Kile, Ph.D., President, Dumbarton Group, LLC ACPE #: 0207-9999-16-038-L03-P ACPE #: 0207-9999-16-038-L03-T
1. Identify key health care legislative issues and their role in the 2016 elections.
2. Compare health care policies under consideration by Congress and the Centers for
Medicare and Medicaid Services.
3. Identify how the pharmacy “lock-in” policy will impact pharmacy choice.
4. Describe opportunities for measuring outcomes and quality in post-acute care.
Disclosures:
Brad Kile
is an employee of
Dumbarton Group
. The conflict of interest was
resolved by peer review of the slide content. He is receiving an honorarium for this
service mentioned in this program, including grants, employment, gifts, stock holdings, and
honoraria.
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Learning Assessment Questions
Friday, January 22,
1:45 – 2:15 pm Legislative Update: What to Expect in 2016 Brad Kile, Ph.D., President, Dumbarton Group, LLC ACPE #: 0207-9999-16-038-L03-P ACPE #: 0207-9999-16-038-L03-T
1. Congress is seeking to require a pharmacy “Lock-in” policy for Medicare Part D
beneficiaries due to:
a. Concerns about recent mergers and acquisitions among pharmacy benefit
managers (PBMs) and pharmaceutical manufacturers.
b. Sharp increases in prescription drug abuse and misuse.
c. Concerns about too many plan options for beneficiaries.
d. The low number of plan options for beneficiaries in rural areas.
e. All of the above
2. The IMPACT Act will standardize patient assessments for which settings:
a. Skilled Nursing Facilities.
b. Home Health.
c. Long-term Care Hospitals.
d. Inpatient Rehabilitation.
3. Which of the following is NOT true regarding the Medicare Bundled Payments for Care
Improvement Initiative:
a. Organizations enter into payment arrangements that include financial and
performance accountability for an episodes of care.
b. Providers in 48 geographic areas are required to participate.
c. Four models being tested.
d. Organizations choose up to 48 clinical episodes of care to test.
e. All of the above are true.
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Brad Kile, PhD
Dumbarton Group, LLC
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Medicare Part D 2017
• Enhanced MTM model test in 5 Part D regions:
Region 7 (Virginia); Region 11 (Florida); Region 21
(Louisiana); Region 25 (Iowa, Minnesota, Montana,
Nebraska, North Dakota, South Dakota, Wyoming);
and, Region 28 (Arizona).
• Details at: http://innovation.cms.gov/initiatives/
enhancedmtm/
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Brad Kile, PhD
[email protected]
(850)212-8127
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key 1. B. Sharp increases in prescription drug abuse and misuse.
2. E. All of the above.
3. B. Providers in 48 geographic areas are required to participate.
2:30 – 3:00 pm Healthcare Quality Standards: Aiming For Quality, Safety, and Accessibility Donna Bohannon, R.Ph., C.P.P.S., Scientific Liaison, U.S. Pharmacopeial Convention (USP) ACPE #: 0207-9999-16-039-L04-P
ACPE #: 0207-9999-16-039-L04-T
1. Provide an overview of the Healthcare Quality Standards Division.
2. Describe new and revised USP standards.
3. Explain USP Standards to the Digital Environment.
4. Describe the work plan of the Healthcare Quality Expert Committee.
Disclosures:
Donna Bohannon
is an employee of
U.S. Pharmacopeial Convention (USP)
. The
conflict of interest was resolved by peer review of the slide content. He declares no other
conflicts of interest or financial interest in any product or service mentioned in this program,
including grants, employment, gifts, stock holdings, and honoraria.
2:30 – 3:00 pm Healthcare Quality Standards: Aiming For Quality, Safety, and Accessibility Donna Bohannon, R.Ph., C.P.P.S., Scientific Liaison, U.S. Pharmacopeial Convention (USP) ACPE #: 0207-9999-16-039-L04-P
ACPE #: 0207-9999-16-039-L04-T
1. What are the revisions to General Chapter <17>, Prescription Container Labeling?
2. What Expert Committees are within the Healthcare Quality Standards Division?
3. What is the resolution that guides the work of the Expert Committees within the
Healthcare Quality Standards Division?
4. What are the four “buckets” of standard development that fuels the Healthcare Quality
work plan?
Disclosures
Healthcare Quality Standards
2015-2020 Work Plan
Presentation Objectives
Donna Bohannon is an employee of U.S.
Pharmacopeial Convention (USP). The conflict of
interest was resolved by peer review of the slide
content. He declares no other conflicts of interest
or financial interest in any product or service
mentioned in this program, including grants,
Donna Bohannon,R.Ph., CPPS
Scientific Liaison
Healthcare Quality Expert Committee
2
1. 
Provide an overview of the Healthcare Quality
Standards Division
2. 
Describe new and revised USP standards
3. 
Explain USP Standards to the Digital
Environment
4. 
Describe the Workplan of the Healthcare Quality
Expert Committee.
3
Healthcare Quality Standards –
Assessment Questions
Healthcare Quality Standards Group
1. 
What are the revisions to General Chapter <17>,
Prescription Container Labeling?
  Explore
2. 
What Expert Committees are within the
Healthcare Quality Standards Division?
 
3. 
4. 
What is the resolution that guides the work of the
Expert Committees within the Healthcare Quality
Standards Division?
What are the 4 “buckets” of standard
development that fuels the Healthcare Quality
workplan?
4
USP 2015-2020 RESOLUTION 8
Development of Quality
Standards of Value to
Practitioners and the Public
USP will collaborate with
stakeholders to develop,
strengthen, revise, and promote
adoption of healthcare quality
standards that address quality and
safety related to the use of
medications and that are of value to
patients and practitioners.
2015-2020 Council of Experts
Healthcare
Practitioners
and Public
Standards
Setting
Expert Committee /
Expert Panels
Data Analysis / Research
Drug Information
Medical Error/
ADR Data Collection
 
 
 
Similar number of Expert Committees
Retain Expert Panels in advisory capacity
Joint Standards-Setting Subcommittees work across Expert Committees
(reference standards, global standards, modernization…)
6
Healthcare Quality Standards Expert
Committee
  Expert
Committees (2015-2020)
USP Standards: Ensuring Quality Medicine
Reaches Every Patient
Suppliers
Suppliers
Manufacturers
Manufacturers
Compounding
Wholesale/
Distributors
Nomenclature and Labeling
Wholesale/
Distributors
Pharmacies/
Hospitals
Pharmacies/
Hospitals
Healthcare
Healthcare
USP STANDARDS
Healthcare Quality
Patients
7
8
  General Notices
  General Chapters
  Monographs and Reference Standards
Patients
9
Suppliers
Suppliers
Manufacturers
  General Chapters
(e.g., Packaging and
Distribution, Dosage Forms)
  Nomenclature and Labeling
 
 
 
 
 
 
 
 
 
 
 
 
Manufacturers
Compounding – Sterile and Nonsterile
Model Guidelines for Formularies
Safe Medication Use
Prescription Labeling
Hazardous Drugs – Practitioner Handling
Wholesale/
Distributors
Pharmacies/
Hospitals
Healthcare
USP HEALTHCARE
QUALITY STANDARDS
Suppliers
Compounding – Sterile and Nonsterile
Model Guidelines for Formularies
Safe Medication Use
Prescription Labeling
Hazardous Drugs – Practitioner Handling
Wholesale/
Distributors
Pharmacies/
Hospitals
USP STANDARDS
USP HEALTHCARE
QUALITY STANDARDS
Manufacturers
Wholesale/
Distributors
Pharmacies/
Hospitals
Healthcare
Healthcare
Patients
Patients
Patients
10
11
12
 Current public health issues are fueling the work of this group
•  Safe sterile compounding of medicines
13
14
15
•  Increased focus on healthcare quality and health informatics
•  Increased globalization of drug nomenclature and associated
chemical information
16
17
18
 
Biosimilar Naming - USP comments
 
Monograph System
 
Unintended Consequences
 
Formation of Joint Subcommittee –Biologics and Nomenclature to
address Final rule
 USP healthcare quality standards are recognized in federal law
and are increasingly adopted by other federal and state agencies
 USP healthcare quality standards are recognized in federal law
and are increasingly adopted by other federal and state agencies
 USP is being sought as a thought leader and key contributor to
emerging opportunities
19
20
21
Healthcare Quality Expert Committee
Workplan
Medicare Modernization Act (MMA) 2003
Section 1860D-4(b)(3)(C) defines role of USP:
Classification
“(ii) MODEL GUIDELINES- The [HHS] Secretary shall request the United
States Pharmacopeia to develop, in consultation with pharmaceutical benefit
managers and other interested parties, a list of categories and classes that may
be used by prescription drug plans under this paragraph and to revise such
classification from time to time to reflect changes in therapeutic uses of covered
part D drugs and the additions of new covered part D drugs.”
Health
Literacy
Medical Model
Guidelines
Expert Committee
Allergies and
Intolerance
Guidelines
US marketed
Products
Prescription
Container
labeling
USP
Pictograms
After Visit
Summary
Electronic
Environments
Section 1860D-11(e)(2)(D) creates “safe harbor”:
EHR
Patient
Portals
Consumer
Applications
Parenteral
Nutrition
“(ii) USE OF CATEGORIES AND CLASSES IN FORMULARIES.- The Secretary
may not find that the design of categories and classes within a formulary violates
clause (i) if such categories and classes are consistent with guidelines (if any) for
such categories and classes established by the United States Pharmacopeia.”
Safety
Emerging
Issues
23
Classification: USP Medicare Model
Guidelines Development
 
USP MMG v1.0 (2005)
involved:
– 
– 
– 
– 
 
USP Medicare Model Guidelines v6.0
Expert Committee
Environmental scan
Public advisory meetings
Public comment process
 
Available on the USP
website: www.usp.org
 
February 4, 2014
Classification: USP Medicare Model
Guidelines and the ACA Essential
Health Benefits
 
ACA requires health plans to cover “Essential Health Benefits” (EHB)
within 10 benefit categories, including prescription drugs
 
HHS Final Rule (Feb 25, 2013) cites USP Medicare Model Guidelines
(MMG)
“…in order to comply with the requirement to cover EHB, a plan would
cover at least the greater of:
(1) One drug in every USP category and class; or
(2) the same number of drugs in each category
and class as the EHB-benchmark plan. “
 
For 2014-2015, HHS makes use of
USP Medicare Model Guidelines v5.0
Revision from “time to
time”
– 
– 
– 
– 
– 
USP MMG v2.0 (2006)
USP MMG v3.0 (2007)
USP MMG v4.0 (2008)
USP MMG v5.0 (2011)
USP MMG v6.0 (2014)
Arch Intern Med 2006; 145:448-453.
25
26
27
Classification: Allergy and Intolerance
Value Set in the EHR
Health Literacy: <17> Prescription
Container Labeling
  The
purpose of this Expert Panel will be to create
an initial set of classes of known drug crossallergies and cross-intolerance, and to assign drug
codes to support electronic health record (EHR)
documentation.
Health Literacy: Prescription Container
Labeling
 
Purpose
–  To develop standards for prescription container labels as they are the
patient’s best source. The prescription container label must be able to
fulfill the professional obligations of the healthcare provider to give
the patient all the information needed to understand how to safely
use the medication
 
Official May 2013
 
Revision to be published February 2016
 
At a minimum, a prescription container shall be labeled in a patient-centered
manner. The label shall contain essential information that is important for the
patient’s safe and effective use of the medicine. Labels should be designed and
formatted to improve readability and understanding.
 
Example of Prescription Container Labeling:
–  Access for visually impaired
–  Endorsement of the Universal Medication Schedule
–  Endorsement of metric units and associated dosing components for oral liquids
 
28
1 in 5 Americans have access to a patient –centered label
29
30
Related Additions to USP Standards
“A Spoonful of Sugar makes the
medicine go down”….no more
When oral liquid dosage forms are prescribed, the
appropriate dosing component (e.g., oral syringe,
dosing cup) shall be provided to the patient or
caregiver to accurately measure and administer the
oral medication. The graduations on the component
shall be legible and indelible, and the associated
volume markings shall be in metric units and
limited to a single measurement scale that
corresponds with the dose instructions on the
prescription container label (see Packaging and
Storage Requirements <659>).
31
Health Literacy: USP Pictograms
 
The teaspoon definition has been removed from the USPNF
 
Public comments related to delayed implementation only
  Standardized
graphic images that help convey medication
instructions, precautions, and/or warnings to patients and consumers.
– Deliver important information to patients with a lower level reading ability and
patients for whom English is a second language.
– Reinforce printed or oral instructions.
  Currently
USP offers 81 pictograms
– Tested for comprehension
  Available
for download (free of
charge)
– http://www.usp.org/usp-healthcareprofessionals/related-topics-resources/
usp-pictograms
32
33
<1066> Physical Environments that
Promote Safe Medication Use
 
 
Safety: Ratio Expression Changes
Electronic Environments that Promote
Safe Medication Use
Purpose
–  To describe optimal physical environment standards to promote
accurate medication use and improve performance since the work
environment has been identified as one of the most commonly
reported factors contributing to medication errors
  Allergy
and Intolerance Value sets
  Parenteral
Nutrition Safety
  Electronic
Health Record
–  Interoperability
–  Usability
Physical Environments addressed:
–  Illumination
–  Sound and Noise
–  Interruptions and Distractions
–  Physical Design and Organization
of Workspace
 
General Chapter <7> Labeling
 
Single entity drug products that
can also be expressed as a ratio
such as epinephrine shall be
labeled only in terms of strength
per mL.
–  Ratio expression such as
1:1000 is an unacceptable
format for single entity drug
products.
–  Official: May 1,2016
34
35
Copyright © USP. All rights reserved.
36
HQ EC Workplan Initiatives
 
Subcommittees
–  Medicare Model Guidelines
–  Safety
–  IV Concentration
Standardization
 
Expert Panels
–  Allergy and Intolerances Value
Sets
–  US marketed drug products
–  Health Literacy
–  Parenteral Nutrition
Copyright © USP. All rights reserved.
37
Healthcare Quality Standards –
Assessment Questions- Answer Key
1. 
1. a.Best practices for the visually impaired,b. Endorsement of
the Universal Medication Schedule, c. Endorsement of the use
of metric and associated components
2. 
2. a. Compounding, b. Nomenclature and Labeling c.
Healthcare Quality
USP will collaborate with stakeholders to
develop, strengthen, revise, and promote adoption of
healthcare quality standards that address quality and
safety related to the use of medications and that are of
value to patients and practitioners
4.  4. a.Classification b. Health Literacy c. Electronic
environments d. Safety
3. 
3. Resolution 8 -
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key 1. A. Best practices for the visually impaired, B. Endorsement of the universal medication
schedule, C. Endorsement of the use of metric and associated components.
2. A. Compounding, B. Nomenclature and labeling C. Healthcare quality.
3. Resolution 8 - USP will collaborate with stakeholders to develop, strengthen, revise, and
promote adoption of healthcare quality standards that address quality and safety
related to the use of medications and that are of value to patients and practitioners.
4. A. Classification B. Health literacy C. Electronic environments D. Safety.
3:00 – 3:30 pm
Beyond the Counting Tray: Current and Emerging Pharmacy Automation and Technologies
Christopher Thomsen, President, The ThomsenGroup Inc.
ACPE #: 0207-9999-16-040-L04-P
ACPE #: 0207-9999-16-040-L04-T
1. Explain what factors drove the rapid development and use of pharmacy automation and
technology in retail and outpatient pharmacy.
2. Identify market and profession changes that, over the past 15 years, are driving
wholesale changes to how pharmacy automation and technology systems are being
designed, implemented and used in retail and outpatient pharmacy.
3. Describe how the implementation and use of pharmacy automation and technology has
been able to enhance and improve productivity, efficiency and patient safety in the
pharmacy.
4. Provide examples of recent pharmacy automation and technology studies that
examined productivity, efficiency and patient safety in the pharmacy.
5. Describe the needs and expectations of pharmacy automation and technology, two,
five, and 10 years from now; and take a look at new and emerging pharmacy
automation and technology that is either currently in development, is being tested, or is
ready for release to the market.
Disclosures:
Christopher Thomsen
is an employee of
The ThomsenGroup Inc. and Kirby Lester
.
The conflict of interest was resolved by peer review of the slide content. He declares no other
conflicts of interest or financial interest in any product or service mentioned in this program,
including grants, employment, gifts, stock holdings, and honoraria.
3:00 – 3:30 pm
Beyond the Counting Tray: Current and Emerging Pharmacy Automation and Technologies
Christopher Thomsen, President, The ThomsenGroup Inc.
ACPE #: 0207-0000-16-040-L04-P
ACPE #: 0207-0000-16-040-L04-T
1. The average distance that a technician travels to fill 150 prescriptions per day:
a. 12 miles.
b. 120 feet.
c. 1.2 miles.
d. 2.1 miles.
2. One of the most significant aspects of an Automated Workflow System is the fact that it can:
a. Reduce staffing costs.
b. Increase productivity by a factor of 50%.
c. Dispenses both oral solids and liquid medications.
d. Bring the reality of standardization to the prescription filling process.
3. An automated table-top counting system, with barcode scan verification and drug images, can
help to reduce:
a. 3.14 prescription dispensing errors per week.
b. 2.7 prescription dispensing errors per week.
c. 27 prescription dispensing errors per week.
d. No prescription dispensing errors per week.
4. The most significant and current need for pharmacy automation and technology to address is:
a. Collation, tracking and verification of the completed prescriptions.
b. Two-way interfacing between the PMS and automated counting and dispensing
systems.
c. Will call inventory, tracking and delivery systems.
Disclosures
Christopher Thomsen is an employee of The
ThomsenGroup Inc. and Kirby Lester. The conflict
of interest was resolved by peer review of the slide
content. He declares no other conflicts of interest
or financial interest in any product or service
mentioned in this program, including grants,
Learning Objectives
• Explain what factors drove the rapid development and use of pharmacy
automation and technology in retail and outpatient pharmacy.
• Identify market and profession changes that, over the past 15 years, are
driving wholesale changes to how pharmacy automation and technology
systems are being designed, implemented and used in retail and outpatient
pharmacy.
• Describe how the implementation and use of pharmacy automation and
technology has been able to enhance and improve productivity, efficiency
and patient safety in the pharmacy.
• Provide examples of recent pharmacy automation and technology studies
that examined productivity, efficiency and patient safety in the pharmacy.
• Describe the needs and expectations of pharmacy automation and
technology, two, five, and 10 years from now; and take a look at new and
emerging pharmacy automation and technology that is either currently in
development, is being tested, or is ready for release to the market.
1
Market Segment Focus
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Automation and Technology Related Studies
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Major Changes in the Marketplace - 2003
Major Changes in the Marketplace
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Major Changes in the Marketplace - Today
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Market Survey Summary
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E-prescribing, not yet 100%, but we will get there.
! 9
American Society for Automation in Pharmacy Annual Conference • January 2123, 2016 • Kiawah Island, SC Answer Key
1.
2.
3.
4.
D. 1.2 miles.
D. Bring the reality of standardization to the prescription filling process.
B. 2.7 prescription dispensing errors per week.
D. All of the above.

American Society for Automation in Pharmacy Annual Conference

Transcription

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