CareTriage: Recognizing Pharmacists as Valuable Members of the Healthcare Team Troy Trygstad PharmD MBA PhD – CCNC VP Pharmacy Programs Joe Moose PharmD – CCNC CPESN Coordinator

Improving care through shared knowledge Learning Objectives (for CE) Be able to identify various "actor-setting" combinations that contribute to patient-centered medication optimization within the Medical Neighborhood. Understand the role of community pharmacy as an advantageous point of capture in a population management strategy. Identify strategies to match interventionists to patients based on patient specific medication management needs.

The Challenge

The Opportunity

“Create a Pharmacy Home, virtual or otherwise, where drug use information from multiple sources* is gathered to better inform prescribing and intervention strategies”

Medication Optimization is a Team Sport

What does the Medical Neighborhood look like? PCP & Clinic Team Quality Improvement Teams Care Management Team Prospective and Retrospective Quality Data Patient Panel HH/Rehab/SNF Hospital Community Resources Specialty Providers Pharmacy

“It Takes a Village”

Diversity of Participants in Medication Management PHARMACeHOME Participation patient count (in past 30 days):

What’s the role of community pharmacy?

CCNC Focus Population(s)

Value Added Services

Required Services Standard Services Included within TECCA Participation Agreement Exhibit C Proactive waste management program Patient counseling and adherence coaching Assist with medication reconciliation **Although not required, all current pharmacies have also indicated availability of comprehensive medication review services

Incremental Benefit of a Multi-Credential, Multi-Setting Pharmacy Care Team to Transitional Care Process

How can all of this activity be done efficiency and with a high level of coordination? (who, what, when, where, and how)

Product Overview Population Population To Touch How To Touch Them Need Generalized Med Management Some Have More Specific Needs Patient Needs Adherence/Coaching Intervention Selection Therapeutic Discrepancies Actors-Settings Therapeutic Considerations Interventions Prioritize Patients with most need Identify best intervention based on data Deliver intervention guidance Logistics Engine

CareTriage and Prescriptive Analytics CareTriage identifies patients at risk for negative outcomes, and provides intervention guidance for the right providers in the appropriate setting and time. Motivational Interviewing to Improve Adherence Nurse Care Manager Pharmacy General Medication Education Social Worker Home TEAM MEMBER RIGHT CARE RIGHT INTERVENTION RIGHT TIMING/PRIORITY RIGHT PATIENT RIGHT SETTING Comprehensive Medication Therapy Management Pharmacy Technician HH/Rehab /SNF Medication Reconciliation Post Hospital Discharge Pharmacist Hospital Telephone CareTriage can be used to guide a wide array of interventions including transitional care services, critical follow-up appointment prioritization, and medication reconciliation services.

Conventional Approach Next Generation Approach Data Engine Alert Claims Clinical Any Problems? Yes/No Next Generation Approach Data Engine Guidance Claims Clinical Program Lists Model Outputs User Imputation Workforce Status Intervention Status Any Problems? How Important? What Should be Done? Who Should do It? Where Should it be Done? When Should it be Done? Should there be Follow-Up? Answer: Credential: Pharmacist Setting: Community Dwelling Task: Help Afford Meds Rec: Pt. Assistance Program

High Positive Predictive Value

Population View

The Value Proposition at the End of the Day What are patients, employers, taxpayers paying for? Some expenditures are investments, others are the result of lack of investment

Visit us on the web at communitycarenc.org For more information contact Troy Trygstad at ttrygstad@n3cn.org or 919.260.5241 Visit us on the web at communitycarenc.org