scholarly journals Development of a centralized, remote clinical pharmacy service to enhance primary care

2021 ◽  
Vol 19 (1) ◽  
pp. 2348
Author(s):  
Rachel J. Finkelstein ◽  
Christopher P. Parker ◽  
Barcey T. Levy ◽  
Barry L. Carter ◽  
Korey Kennelty
Keyword(s):  
Primary Care ◽  
Clinical Pharmacy ◽  
Primary Care Providers ◽  
Clinical Pharmacy Service ◽  
Care Providers ◽  
Care Needs ◽  
Physician Practices ◽  
Private Physician ◽  
Large Patient ◽  
Primary Care Teams

More than 50% of Americans possess at least one chronic condition and another 25% suffer from two or more, leaving primary care teams tasked to care for the chronic, acute, and preventive care needs of their large patient panels. Pharmacists can reduce the burden on busy providers by effectively managing chronic diseases as members of health care teams. Many private physician practices lack the resources to include pharmacists on their teams.  A centralized, remote clinical pharmacy services model allows pharmacists to remotely manage chronic disease in patients in collaboration with primary care providers. The purpose of this report is to describe how a centralized, remote clinical pharmacy team was developed, trained, and effectively integrated into multiple, diverse primary care settings across the U.S.

Integration between primary care providers and the cancer system: Gaps and opportunities

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6584-6584
Author(s):  
J. Sussman ◽  
W. Evans ◽  
T. Whelan ◽  
D. Bainbridge ◽  
S. Schiff ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Patients ◽  
Primary Care Providers ◽  
Cancer Case ◽  
Care Providers ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Compensation Model ◽  
Cancer Program

6584 Background: A number of reports suggest that family physicians (FPs) are poorly integrated with the cancer care system. The specific gaps in care integration are poorly understood. In this study we examine specific processes of care associated with integration between FPs and regional cancer programs. Methods: Cross sectional survey of all identified primary care providers within a representative health region in Ontario, Canada. The survey instrument was created specifically for this study with items generated from published literature and expert input and pilot tested in a representative sample. A modified dilman method was used. Results: 500 physicians responded (response rate 60%). Overall 90% of respondants reported confidence in the workup of a new cancer case for the major disease sites but only half (54%) knew the process of referring to the regional cancer program. Only 57% felt investigations necessary could be done in a timely manner and 44% indicated that coordination of care needs to be improved. Most indicated preferance for an active navigation structure for newly diagnosed patients. Despite over 80% of respondents indicating use of the internet only 10% reported accessing cancer program web portals for information on the regional cancer program (such as waiting times). The majority of respondants (75%) indicated ongoing involvement in care during the active treatment phase, mostly for non cancer related medical issues but 20% indicated that they were not properly infomed of patients’ health status by the oncology program and only 57% indicated that they felt their role was valued by the cancer program during this phase in the care trajectory. In the follow up phase, 35% were unclear of their role specific to monitoring and surveillance. 60% felt their current compensation model was inadequate to support care of cancer patients. This did not vary by compensation model reported. Factors associated with better integration included attendance at educational sessions and years in practice. Conclusions: Cancer systems need to be more responsive to the needs of FPs to better integrate them and support optimal quality of care for cancer patients. Policies to clarify and support roles and responsibilites are necessary to ensure that FPs are integrated team members. No significant financial relationships to disclose.

Improving the Transition From Oncology to Primary Care Teams: A Case for Shared Leadership

2016 ◽  
Vol 12 (11) ◽  
pp. 1012-1019 ◽  
Author(s):  
Dominique Tremblay ◽  
Jean Latreille ◽  
Karine Bilodeau ◽  
Arnaud Samson ◽  
Linda Roy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Shared Leadership ◽  
Primary Care Providers ◽  
Shared Responsibility ◽  
Primary Therapy ◽  
Care Providers ◽  
Curative Intent ◽  
Detailed Case ◽  
Primary Care Teams

This article discusses the case of a 47-year-old woman who underwent primary therapy with curative intent for breast cancer. The case illustrates a number of failure events in transferring information and responsibility from oncology to primary care teams. The article emphasizes the importance of shared leadership, as multiple team members, dispersed in time and space, pursue their own objectives while achieving the common goal of coordinating care for survivors of cancer transitioning across settings. Shared leadership is defined as a team property comprising shared responsibility and mutual influence between the patient and the patient’s family, primary care providers, and oncology teams, whereby they lead each other toward quality and safety of care. Teams, including the patient-family, should achieve leadership when their contribution is relevant in managing task interdependence during transition. Shared leadership fosters coordinated actions to enable functioning as an integrated team-of-teams. This article illustrates how shared leadership can make a difference to coordinate interfaces and pathways, from therapy with curative intent to the follow-up and management of survivors of breast cancer. The detailed case is elaborated as a clinical vignette. It can be used by care providers and researchers to consider the need for new models of care for survivors of cancer by addressing the following questions. Who accepts shared leadership, how, with whom, and under what conditions? What is the evidence that supports the answers to these questions? The detailed case is also valuable for medical and allied health professional education.

scholarly journals Vanderbilt Health Affiliated Network Statin Outreach Service

2020 ◽  
Author(s):  
Christopher Terry ◽  
Erin B. Neal ◽  
Katelynn Daly ◽  
Donna Skupien ◽  
Michelle L. Griffith
Keyword(s):  
Primary Care ◽  
Health Systems ◽  
Medical Center ◽  
Tertiary Care ◽  
Primary Care Providers ◽  
Care Group ◽  
Care Providers ◽  
Physician Practices ◽  
Outreach Service ◽  
Academic Center

The Vanderbilt Health Affiliated Network (VHAN) is a collaborative alliance of physicians, health systems, and employers driving a new level of clinical innovation and teamwork to enhance patient care, contain costs, and improve the health of communities in Tennessee and surrounding states. The network includes more than 5,000 clinicians, 60 hospitals, 12 health systems, and hundreds of physician practices and clinics who work together to strengthen communities and improve quality of life across the Southeast through better health. The statin outreach service was piloted in one VHAN practice, the Vanderbilt Medical Group, a large primary care group at Vanderbilt University Medical Center (VUMC). VUMC is a tertiary care academic center. VUMC primary care providers (PCPs) are located in several practice locations, and one location was chosen to pilot this intervention. The PCPs included internal medicine residents and attending physicians. Before this project, there was no clinical pharmacy presence in this practice.

scholarly journals Vanderbilt Health Affiliated Network Statin Outreach Service

2020 ◽  
Author(s):  
Christopher Terry ◽  
Erin B. Neal ◽  
Katelynn Daly ◽  
Donna Skupien ◽  
Michelle L. Griffith
Keyword(s):  
Primary Care ◽  
Health Systems ◽  
Medical Center ◽  
Tertiary Care ◽  
Primary Care Providers ◽  
Care Group ◽  
Care Providers ◽  
Physician Practices ◽  
Outreach Service ◽  
Academic Center

The Vanderbilt Health Affiliated Network (VHAN) is a collaborative alliance of physicians, health systems, and employers driving a new level of clinical innovation and teamwork to enhance patient care, contain costs, and improve the health of communities in Tennessee and surrounding states. The network includes more than 5,000 clinicians, 60 hospitals, 12 health systems, and hundreds of physician practices and clinics who work together to strengthen communities and improve quality of life across the Southeast through better health. The statin outreach service was piloted in one VHAN practice, the Vanderbilt Medical Group, a large primary care group at Vanderbilt University Medical Center (VUMC). VUMC is a tertiary care academic center. VUMC primary care providers (PCPs) are located in several practice locations, and one location was chosen to pilot this intervention. The PCPs included internal medicine residents and attending physicians. Before this project, there was no clinical pharmacy presence in this practice.

scholarly journals Distance Education to Improve the Quality of Asthma Treatment in Primary Health Care

2019 ◽  
Vol 14 (41) ◽  
pp. 2065 ◽  
Author(s):  
Rudi Roman ◽  
Karine Margarites Lima ◽  
Maria Angela Fontoura Moreira ◽  
Roberto Nunes Umpierre ◽  
Lisiane Hauser ◽  
...  
Keyword(s):  
Primary Care ◽  
Distance Education ◽  
Primary Care Providers ◽  
Control Group ◽  
Asthma Treatment ◽  
Care Providers ◽  
Inhaled Corticosteroid ◽  
Doctor Visits ◽  
Primary Care Teams ◽  
Secondary Results

Objective: The mere dissemination of standard care recommendations has been insufficient to improve clinical results in patients with asthma. The objective of the present study was to evaluate the clinical effectiveness of a multifaceted asthma distance education for primary care providers. Methods: Cluster randomized controlled trial. Full primary care teams were included if they had access to telehealth support and free basic asthma treatment. Before randomization, selected teams indicated asthma patients between 5-45 years old for inclusion. The intervention group received three interactive online sessions, printed educational material, reminders, booklet for patients, and frequent stimulus to use consulting services. The control group received no intervention. Symptomfree days per two weeks was the primary result. Controlled asthma, unscheduled asthma doctor visits, and preventive inhaled corticosteroid use were the secondary results. Six months after intervention, the results were compared with baseline data using generalized estimating equations for repeated measures and clustering effect. Results: Were enrolled 71 primary care teams and 443 individuals. Most patients (60.3%) were female, and 44% were younger than 12 years old. The attendance of interactive sessions by the teams was 50%. The odds ratio (OR) for additional symptom-free day was 1.31 (95%CI 0.61-2.82; p=0.49). For the secondary results, the results were: controlled asthma OR 1.29 (95%CI 0.89-1.87; p=0.18); unscheduled asthma doctor visits OR 0.81 (95%CI 0.60-1.10; p=0.17); and preventive inhaled corticosteroid use OR 1.02 (95%CI 0.71-1.47; p=0.91). Conclusions: Multifaceted distance education in asthma care for primary care providers was not effective to improve patients’ results. Telemedicine needs to deal with significant obstacles in professional education. ClinicalTrials.gov registry: NCT01595971. 

ECHO Autism

2016 ◽  
Vol 56 (3) ◽  
pp. 247-256 ◽  
Author(s):  
Micah O. Mazurek ◽  
Rachel Brown ◽  
Alicia Curran ◽  
Kristin Sohl
Keyword(s):  
Primary Care ◽  
Self Efficacy ◽  
Pilot Project ◽  
Primary Care Providers ◽  
Autism Spectrum ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Care Needs ◽  
Community Healthcare ◽  
Screening Guidelines

Children with autism spectrum disorder (ASD) have complex medical problems, yet they are at high risk for unmet health care needs. Primary care providers are perfectly positioned to meet these needs; however, they often lack training in ASD. This pilot project developed and tested a new model for training primary care providers in best-practice care for ASD using the Extension for Community Healthcare Outcomes (ECHO) framework. The 6-month ECHO Autism pilot project consisted of 12 biweekly clinics focused on screening and identification of ASD symptoms and management of medical and psychiatric comorbidities. Participants completed measures of practice behavior and self-efficacy in screening and management of children with ASD at baseline (pretest) and after 6 months of ECHO Autism (posttest). Statistically significant improvements were observed in self-efficacy, in adherence to ASD screening guidelines, and in use of ASD-specific resources. Participants also reported high satisfaction with the program.

Primary Care Medical Practices: Are Community Health Care Providers Ready for Disasters?

2018 ◽  
Vol 13 (02) ◽  
pp. 128-132 ◽  
Author(s):  
Rachel M. Peters ◽  
Thomas J. Hipper ◽  
Esther D. Chernak
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Care Providers ◽  
Special Health Care Needs ◽  
Health Care Needs ◽  
Care Providers ◽  
Care Needs ◽  
Special Health Care ◽  
Special Health

AbstractObjectiveThis study seeks to determine the capacity of community primary care practices to meet the needs of patients during public health emergencies and to identify the barriers and resources necessary to participate in a coordinated response with public safety agencies.MethodsThe self-administered web-based survey was distributed in January 2014 via e-mail to primary care providers in Pennsylvania using the listservs of several professional societies.ResultsA total of 179 primary care providers participated in the survey. In total, 38% had practice continuity of operations plan in place and 26% reported that they had a plan for patient surge in the outpatient setting. Thirty percent reported that they were registered on the state Health Alert Network and 41% said they were able to communicate with patients during disasters. Only 8% of providers reported that they believed that their patients with special health care needs were prepared for a disaster, although over two-thirds of responding practices felt they could assist these patients with disaster preparedness. Providers indicated that more information regarding government agency plans and community resources, patient education materials, and more time to devote to counseling during patient encounters would improve their ability to prepare their patients with special health care needs for disasters. Providers also reported that they would benefit from partnerships to help the practice during emergencies and communications technology to reach large numbers of patients quickly.ConclusionsCommunity-based primary care practices can be useful partners during public health emergencies. Efforts to promote continuity of operations planning, improved coordination with government and community partners, as well as preparedness for patients with special health care needs, would augment their capabilities and contribute to community resilience. (Disaster Med Public Health Preparedness. 2019;13:128–132).

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