Faculty Disclosure. Pharmacist Learning Objectives. Pharmacy e-hit: The Future of Pharmacy and Patient Care
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1 Pharmacy e-hit: The Future of Pharmacy and Patient Care 1 Faculty Disclosure Ms Spiro has no actual or potential conflicts of interest associated with this presentation. 2 Pharmacist Learning Objectives Describe at least two reasons e-prescribing adoption is on the rise Describe the benefits of using e-prescribing to exchange prescription information Describe the role of the pharmacist in the electronic exchange of clinical information in all practice settings Explain the Collaborative s focus and objectives related to pharmacist-provided patient care services and pharmacists contributions to the Office of the National Coordinator Health Information Technology (ONC) and Centers for Medicare and Medicaid Services (CMS) defined meaningful use (MU) of the electronic health record (EHR) 3
2 Pharmacy Technician Learning Objectives Describe at least two reasons e-prescribing adoption is on the rise Describe the benefits of using e-prescribing to exchange prescription information Describe the supporting role of the pharmacy technician in the electronic exchange of clinical information in all practice settings Explain the Collaborative s focus and objectives related to pharmacist-provided patient care services and pharmacists contributions to the Office of the National Coordinator Health Information Technology (ONC) and Centers for Medicare and Medicaid Services (CMS) defined meaningful use (MU) of the electronic health record (EHR) 4 Define Terms Relationships between Electronic Health Record (EHR) Electronic Medical Record (EMR) Electronic Medication Administration Record (emar) Electronic Prescribing (erx) Electronic Personal Health Record (ephr) Exchange Information Health Information Exchange (HIE) E-Prescribing Networks Overview of e-prescribing Two way prescription information between prescriber and pharmacy Three way exchange Elements of a prescription in electronic standards format Computer to computer between prescriber and pharmacy Use of network connector 6
3 Relationship to Electronic Health Record (EHR) EHR Components Financial Admission discharge & transfer information (ADT) Clinical Care plans Physician orders Electronic medication administration record (emar) E-prescribing Formulary and Benefit Medication History 7 Self Assessment Question 1 Electronic prescribing is not a component of the ambulatory electronic health record? (True or False) Answer: False 8 Benefits of e-prescribing Reduce healthcare costs Improves patient safety Increase efficiency 9
4 Quality and Safety Computerized Physician Order Entry (CPOE) Ancillary staff order entry Medication safety alerts Structured and Codified Sig RxNorm 10 Benefits of e-prescribing 11 Reasons for Increase in Adoption 12
5 EHR adoptions DEA regulations Adoption Hindrances March 2010 interim final rule Prescriber digital signature Pharmacy (import -store verify) Limited 2 factor authentication vendors Credentialing process Certified auditors 13 E-Prescribing Physician Incentives Medicare Improvements for Patients and Providers Act (MIPPA), passed in July 2008 Incentives Penalties 2009 (+) 2.0% 2010 (+) 2.0% 2011 (+) 1.0% 2012 (+) 1.0% 2013 (+) 0.5% 2012 (-) 1.0% 2013 (-) 1.5% 2014 (-) (and beyond) 2.0% Source: 14 Movement to EHR Incentives Health Information Technology for Economic and Clinical Health Act, or the "HITECH Act" Shift to EHR Incentives Jan 2011 Medicare EHR only Medicaid EHR and e-prescribing Meaningful use of EHR measurement goals 15
6 Finish Line E-Prescribing is reaching the finish line Connecting the community pharmacy Connecting the facility What s next? 16 Diffusing e-prescribing into the Pharmacists Practice Model The pharmacist s role in preventing e- Prescribing errors The pharmacist s role in e-prescribing beyond the prescription dispensing process The benefits of using e-prescribing to exchange medication-relating information 17 E-Prescribing Actors 18
7 Pharmacists Role in e-prescribing Two way prescription information between prescriber and pharmacy Facilities and health-systems three way communication Preventing e-prescribing errors Adverse drug events Pharmacists are the last check before dispensing Bi-directional communication 19 Electronic Exchange of Medication Related Information Continuity of care document (CCD) Allergies Medication list Immunization Family history Social history (e.g. smoking) Functional status CDA Content Modules Component (C83) meric=83 20 Relationship to Electronic Health Record (EHR) E-Prescribing is a component of the EHR Pharmacist/Pharmacy Provider EHR Functional Profile or the Pharmacist EHR (PP-EHR) Developed and balloted by Health Level 7 (HL7) and National Council for Prescription Drug Program (NCPDP) Exchanging clinical information Medication reconciliation at transition of care Medication therapy management (MTM Patient centered medical home model 21
8 Self Assessment Question 2 A Pharmacist electronic health record has been defined by two standards development organizations (HL7 and NCPDP). (True or False) Answer: True 22 HL7 EHR Functional Profile 23 Pharmacist EHR Functionality Example HL7 EHR Work Group Pharmacist/Pharmacy Provider EHR Functional Profile Project Work Document, August
9 HL7 EHR Work Group Pharmacist/Pharmacy Provider EHR Functional Profile Project Work Document, August HL7 EHR Work Group Pharmacist/Pharmacy Provider EHR Functional Profile Project Work Document, August HL7 EHR Work Group Pharmacist/Pharmacy Provider EHR Functional Profile Project Work Document, August
10 Pharmacist/Pharmacy Provider EHR (PP-EHR) Process 28 MU of EHR CMS Incentives for Eligible Professionals (EP) and Eligible Hospitals (EH) 29 CMS/ONC Defined MU of EHR 30
11 Medication Management Value Set 31 Pharmacist EHR Information Exchange Model Cultural Diffusion 33
12 Diffusion Hindrances Cost Regulations Uncertainty with change Lack of awareness 34 Diffusion Benefits Care coordination Quality of patient care Patient safety Pharmacist s recognition as EP 35 Summary E-Prescribing adoption trends E-Prescribing benefits Payer, physician, pharmacy, and patient E-Prescribing hindrances EHR incentives Future of Pharmacists in Patient Care What s next? 36
13 The Collaborative s s Role in the Future of Patient Care Collaborative Members Self Assessment Question 3 The Pharmacy e-health Information Technology Collaborative (Collaborative) represents pharmacists and the services they provide in all practice settings? (True or False) Answer: True 39
14 Primary Goal Why the Collaborative Exists 40 Self Assessment Question 4 Getting the Pharmacist/Pharmacy Provider Electronic Health Record (PP-EHR) functionality certified and adopted by system vendors is a low priority for the Collaborative? (True or False) Answer: False 41 Education and Outreach
15 Medical Neighborhood 43 Pharmacists Activities in InterProfessional Patient Care E-Prescribing Pharmacist/Pharmacy Provider EHR (PP-EHR) Bi-directional exchange of clinical information Meaningful Use (MU) of EHR measurement goals Immunizations Patient Care Services The 10 Steps to Achieve Comprehensive Medication Management Medication reconciliation at transitions of care Quality/outcomes performance measures MTM Value Set Pharmacists MTM Process Source: Medication Therapy Management in Pharmacy Practice: CoreElements of MTM Service Model; Version 2.0; March 2005; 45
16 The 10 Steps to Achieve Comprehensive Medication Management Source: "Integrating Comprehensive Medication Management to Optimize Patient Outcomes Section 4 page The 10 Steps to Achieve Comprehensive Medication Management Source: "Integrating Comprehensive Medication Management to Optimize Patient Outcomes Section 4 page
17 Pharmacists Impact on the Future of Pharmacy and Patient Care E-Prescribing adoption PP-EHR adoption Bi-directional exchange of clinical information Meaningful Use (MU) of EHR measurement goals Recognition of Pharmacists as Eligible Professionals (EP) 49 Self Assessment Question 5 The Collaborative is focused on the pharmacists role in using HIT to impact the future of patient care in all practice settings? (True or False) Answer: True 50 Questions 51
18 Slides Produced By: Shelly Spiro Director, Pharmacy e-hit Collaborative 52
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