Formulary guidance and transparency from P&T to point of care

Perspectives on Integrated Associations in Healthcare (Continued)

Posted by Matt Breese on Jun 7, 2016

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Last week, we shared some initial perspectives on integrated healthcare associations and how they affect payers, providers and pharma manufacturers. Today's post highlights the point-of-care integration, and provides some action items based on what we've learned. Check out the first post here.

Pharmacies as team members

The AMCP sees pharmacies as integrated members of the healthcare team. While community pharmacies rely on pharmacy management systems to fill prescriptions, many of them do not have a consistent process for documenting clinical information, such as immunizations, medication therapies and co-morbidities. Currently, there is no widely-used standard for collecting, documenting and exchanging clinical information between hospitals and clinical practices and pharmacies.

Community pharmacies face many challenges in adopting an HIT solution to better integrate into the healthcare delivery process, including:

  • Cost
  • Limited value-based payment models that account for community pharmacy services
  • Quality measures
  • Lack of regulatory incentives

Those challenges are offset, however, by the value an HIT solution can bring to interprofessional communication, which is equally beneficial to community pharmacists, payers, providers, pharmacy benefit managers and, most importantly, to patients. This type of health information integration is particularly important as reimbursement is increasingly tied to patient outcomes. Full integration of all aspects of healthcare delivery, including pharmacy, not only supports improved patient outcomes by reducing the risk of adverse medication interactions or errors, but also enhances patient outcomes documentation and reporting.

Adapting for the future

At a recent AMCP forum, a diverse group of healthcare stakeholders, including pharmaceutical companies, managed care organizations, academia, healthcare providers and patient advocates, reached agreement on recommendations to be submitted to the U.S. Food and Drug Administration (FDA) to clarify the 1997 Food and Drug Administration Modernization Act (FDAMA) and enhance information sharing. The recommendations included:

  • Expand dissemination of information to healthcare decision makers beyond health plan formulary committees, including those making coverage decisions in accountable care organizations and integrated delivery networks, and organizations that evaluate pharmacoeconomic information or develop value frameworks and compendia
  • Ensure healthcare economic information is truthful, transparent, reproducible, accurate and non-misleading, and be based on the expertise of professionals in the relevant area.

The group’s desired outcome is to have the FDA include the recommendations in guidance on FDAMA Section 114, which is expected later this year.

Community pharmacies that embrace interoperable HIT solutions have a rare opportunity to reinforce their continued existence in a rapidly changing healthcare environment. Neighborhood pharmacists have developed long-standing trusted and personal relationships with their patients. They also play a critical role in disease management. This respected and appreciated community resource should not be lost due to a lack of communication via an interoperable HIT solution.

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Topics: Industry Trends, Market Access, Provider