whatsinyouradherencetoolbox (june 2014) · 6/17/2014 7 paying for short fills • generics –...
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Getting StartedPart of the Simplify My Meds® Lunch & Learn Series
NCPA Adherence StaffJune 5, 2014
Dial In Number:(800) 944‐8766Passcode: 58643
Pharmacists: A Solution to the $290 Billion Non-Adherence Problem
• Training, expertise to improve adherence
• Trusted medication experts
• Maximize medication use for optimal outcomes
• Most accessible provider in community
• Key touch point throughout continuum of care
• Most effective communicator about meds
Dial In Number:(800) 944‐8766Passcode: 58643
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Win-Win-Win
• Business differentiator
• Improved patient outcomes
• Patient satisfaction/loyalty
• Increased business efficiencies and bottom line benefits
Dial In Number:(800) 944‐8766Passcode: 58643
NCPA’s Commitment: Pharmacists Advancing Medication Adherence
– Pharmacists: To provide pharmacists with tools to increase patient medication adherence
– Academia: Work with academicians to produce pharmacist graduates who embrace pharmacists’ role as medication adherence counselors
– Policy Makers: To inform legislators, regulators, and payers about the importance of patient medication adherence in lowering overall costs
– Patients: To engage with consumer groups to support pharmacists’ role in improving patient adherence.
Dial In Number:(800) 944‐8766Passcode: 58643
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Tool #1: Simplify My Meds
• NCPA Member Benefit
• Based on “refill synchronization”
– Eliminates the gaps between refills
– Reduces medication‐related hospital readmissions
– Provides mechanisms to identify non‐adherence
• Improves pharmacy operations by:
– Changing dispensing from reactive to proactive
– Picking up new scripts (first fills, polypharmacy)
– Increasing volumeDial In Number:(800) 944‐8766Passcode: 58643
How to Implement Simplify My Meds
• Three main elements
– Start‐up procedures
– Refill synchronization process
– Ongoing program operations
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Step 1: Identify a Program Manager
• Dedicate a staff member tasked with coordinating the program
– Will be pulling patient files, calling the patient to discuss and review medications, and making notes for the pharmacist
– Lead technician may be a good candidate
• Organizational skills are important
• Should have solid understanding of medications
Step 2: Determine Space Needs
• Space required
– Office‐type environment
– Should not be where prescriptions are filled
– Quiet, private space best
• Recommended equipment
– Phone and fax machine
– Computer
– Printer
– Filing system (expandable file)
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Step 3: Identify Patients
• Potential Targets– Patients who are on complex drug regimens
– Patients with simple drug regimens who forget to request refills
– Elderly patients with difficulty driving
– Busy professionals who can’t get to the pharmacy
– Caregivers
– Home‐bound patients/deliveries
– New medication starts
Step 4: Enroll Patients
• Enroll the patients:
– Voluntary, opt‐in program
– Patient signs Patient Agreement
– Complete Patient Enrollment Form
– Be sure to comply with all HIPAA guidelines
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Step 5: Determining the Pick-Up Date
• Refill synchronization
– All of the patient’s prescriptions are coordinated to be refilled on the same date each month
– This date becomes the patient’s assigned pick‐up date at the pharmacy
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Synchronization: How It Works
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Action Example
1. Determine and list the chronic monthly prescriptions the patient will be taking.
Lisinopril 20mg QD (due 5th)Crestor 20mg QD (due 16th)Metformin 500mg BID (due 22nd)
2. The medication with the highest copayshould become the anchor prescription.
Crestor 20mg (due 16th)
3. Calculate the quantity needed for each medication to synchronize it with the anchor prescription.
Lisinopril 20mg (12 tablets)Metformin 500mg (50 tablets)
4. Contact the patient’s prescriber, explain your coordinated refill program, and request two prescriptions for each “synchronized” medication:
• One for the quantity required for synchronization•A second for the normal monthly quantity
5. Short fill the appropriate prescription(s) to synchronize with the anchor prescription. Document on the hard copy the one‐time short fill was for adherence program at request of patient.
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Paying for Short Fills
• Generics
– Patient pays out of pocket or pharmacy may waive copay if the patient’s insurance allows
• Brands
– Patient pays out of pocket to cover ingredient cost
– ALTERNATIVE: Refill early for 2‐3 months to bring in synch with anchor medication
• Changes to Medicare Part D program in 2014
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Step 6: Developing a Filing System
• Assign each patient an identification number.
Example: 012303
01 = Store ID (if more than one store)
23 = Assigned pick‐up day
03 = Third patient assigned to that day
• Make a file folder for each patient using the identification number.
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Step 7: Call Patient/Review Meds
7 Days Prior
– Pull all of the patient files 7 daysahead of their refill date.
– Use the Patient Contact Form and Patient Refill Form to call the patient.
• Review all medications with patient to make sure they need to be filled.
• Use script to ask patient other medication questions.
• Remind patient of pick‐up date.
– Make notes of any changes for pharmacist review.15
Step 8: Check for Refill Requests
3‐7 Days Prior
• Review for prescriptions with zero refills
– Fax, phone, or electronically request refill from prescriber
• Update the patient profile in the dispensing system
• Place completed Patient Contact Form and Refill Form in accordion file for pharmacist review.
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Step 9: Order Inventory
1‐2 Days Prior
• Final Fill Procedure
– Pharmacist pulls all pending orders from next 1‐2 days’ slots and:
• Reviews orders and resolves any clinical issues identified by the program manager
• Reviews inventory on hand
• Orders drug if needed
– Patient is called and reminded to come into pharmacy and pick up their prescriptions
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Step 10: Prepare/Verify Refills
Pick‐Up Date
• Technician and pharmacist prepare and verify the day’s refills
• After the prescription is picked up, the Patient Contact and Refill Forms are returned to program manager and placed back in accordion file.
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SMM Operations Manual
• Program Materials– Training Manual
– Patient Enrollment Forms
– Patient Refill Forms
– Physician Outreach
• Receive when join the program
Training and Support
NCPAnet.org/adherence (log‐in required)
Available Tools:
– Pharmacy Operations Manual
– Recorded Lunch and Learn webinars
– Customizable Program Forms
– Tutorial
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Marketing Materials
• FREE Starter Kit
• Custom materials available to order
NEW Resources
• Available Tools:
– June America’s Pharmacist(Special Adherence Issue)
– NCPA Annual Convention
• Adherence Institute
• Early Bird Registration available until June 30
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How do I sign up?
• Download Pharmacy Participation Agreement
from ncpanet.org/smm.• Fax it to NCPA
• Will receive an email within 5 business days with instructions to order your free starter kit.
• This is NCPA member benefit.
NCPA Membership Department: 1‐800‐544‐7447
Questions?
Email [email protected]
Web Sites:
• www.ncpanet.org/adherence
• www.ncpafulfillment.com