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Role of pharmacy in Community Care of North Carolina
Pharmacists joined CCNC network teams in 2007 due to an increase of high-risk, blind, aged, and/or disabled patients with diverse medication profiles and prescribers, making them prone to multiple medication-related problems. Network pharmacy goals emphasize improving global patient outcomes and decreasing overall health care costs. Over time, pharmacists in CCNC have proven their ability to help reduce overall healthcare costs and decrease patient hospitalizations.
Most CCNC networks staff at least one full-time network pharmacist and a clinical pharmacist. These pharmacists manage highly complex patient populations and focus on improving healthcare outcomes.
- Pharmacists’ primary responsibilities include education, medication management services, coordination, roll-out, and oversight of pharmacy benefits.
- Network pharmacists spend about 40% of their time completing clinical tasks, whereas the clinical pharmacist spends about 95% of their time on clinical tasks.
- A network pharmacist is an employee of the network and is based within the network office.
Pharmacists, nurse-care managers, and physicians all work together to help provide patients the best care possible. Nurse-care managers can gather the patients’ reported lists of medications as well as the “brown bag” of medications for a medication reconciliation thereafter reviewed by a pharmacist. A pharmacist comprehensive medication review is reserved for patients who are more complex.
Pharmacists review medication reconciliations completed by care managers and perform comprehensive reviews to communicate medication issues to the patients' primary care provider with the goals of improving the quality of care, reducing preventable hospital readmissions and emergency department (ED) visits. Medication management is the main focus of the clinical pharmacist’s activities and is performed for both transitional care and identified chronic care patients.
- Transitional care medication management focuses on the identification of medication list discrepancies and updates after discharge from an acute care facility. This model serves as a “bridge” to transition the patient’s medication regimen when they go back home.
- Chronic care patients are identified and referred for medication management by their care manager, their primary care provider, or a pharmacist directly involved in the primary care practice.
- The pharmacist uses clinical information obtained from the nurse care manger, primary care provider, hospital or physical history, and/or discharge summary to conduct the medication review.
- Each patient is a part of a “Pharmacy Home.” This gives pharmacists and care managers access to pharmacy claims data, progress notes, lab data, medical history, and other patient information to help recognize potential drug interactions, declining health from adherence issues, and polypharmacy or drug cost issues.
- After a hospital discharge, primary care providers are faxed a copy of a patient’s medication reconciliation for use during the patient’s follow-up visit. The pharmacists’ work is both important and valuable to providers.