Clinical Pharmacy Integration Part 1
It came to me in a vision. The proverbial AHA moment. The curling of toes, the . . . you get the idea.
It occurred to me that almost *all* of the high yield Quality initiatives in our institutions (and by default all institutions, as these tend to be national measures) are inextricably linked to Pharmacy.
SCIP / Med Rec / Transitions of Care / Re-admissions / Medication errors / CORE Measures, etc. The list goes on.
This represents a top down approach to the oncoming challenges that we face in an increasingly regulated environment. Technology is only one small piece of the puzzle. As leaders, it falls to us to effectively deploy technology and systems to meet these requirements, but also be sensitive to provider workflows.
I believe that forcing workflow changes that could possibly make the practitioner less efficient is an inelegant solution. A rework of our system, deploying domain experts to add a layer of intelligence may not only alleviate workflow bottlenecks, but also possibly invigorate it also! This to me, is the essential premise behind the term, Clinical Integration – aligning incentives so that domain experts are adequately positioned to do the most good, every step of the way.
Who is best equipped to obtain medicine reconciliation information?
Who is best equipped to make sure that the Med Rec list is the closest thing to the source of truth, using calls to Pharmacy, access to the Sure Scripts database and, sometimes, just plain common sense?
Who is best equipped to make recommendations with regards to stopping / continuing medications on the inpatient setting, based on the proposed plan of care and the admission medications?
Who is best equipped to answer questions about all of the above to all the stakeholders – the nurse, the physician, and most importantly, the patient?
Well duh – it’s the clinical pharmacist, and my aha moment was the realization that this individual holds the proverbial keys to the castle in terms of managing the transition from a paper to an electronic medicine reconciliation process. Over the course of the next few posts, I hope to share how we came to this realization.
