3-minute case study: EHR & On-Site Pharmacy improve outcomes for PCP

Across the athenahealth network and beyond, healthcare organizations are designing and implementing interventions with outsized impact on patient and provider satisfaction, along with clinical and financial outcomes. Here’s one of them.

The challenge

Patients being prescribed several medications by multiple clinicians is common, but that increases the odds for complications with interactions and incorrect dosages. Clive Fields, M.D., chief medical officer of VillageMD, and Brent Asplin, M.D., president of Village Medical, repeatedly noticed that multiple clinicians across patients’ care continuum were not on the same electronic health record, which had exponential risk factors when it came to selecting prescriptions and to medication adherence. “We know that one of the major drivers of adverse outcomes, hospitalizations, and emergency department visits for patients with chronic conditions is problems with their meds,” said Asplin.

Finding a solution meant formulating a new care model that not only solved this problem, but kept the same spirit behind the hands-on, personalized primary care that Dr. Fields’  father founded as a family practitioner in Houston more than 50 years ago.

The solution

VillageMD was able to find physical and cloud-based solutions. The introduction of Village Medical at Walgreens, which offers comprehensive primary care services next to pharmacies, makes the patient experience more of a “one-stop-shop.” The suite of services integrates pharmacists, nurses, and social workers for adult care, including at-risk senior citizens.

Village Medical primary care physicians and Walgreens pharmacists work together to provide care for chronic health conditions, preventive services and treatment of everyday illnesses and injuries. Within the same visit, patients have access to care from clinicians while also ensuring their prescriptions, medication refills and affordable substitution options are readily available. Ordering prescriptions online can involve a waiting period and is difficult for those with limited internet access.

For Dr. Fields, the on-site pharmacy partnership fosters better relationships and communication within the healthcare continuum. “For a long time, we relegated pharmacists to be more of a dispensing professional than an educational professional. What we found is that allowing physician access to pharmacists drives a different level of care and a different type of clinical outcome,” he said. Through a collaborative practice agreement, caregivers have easy access to consults for generic-medication substitutions, for instance, and faster processing of pre-authorization forms.

That model is further ameliorated thanks to athenahealth’s cloud-based EHR, which provides transparency between different care settings, providers, and pharmacists. Multiple providers can review medications a patient is already taking to see if there will be an adverse reaction to another new prescription, or whether dosages need to readjusted, for instance. “Our EHR allows us to deliver a 360-degree view of the patient, not just at the point that a patient is seen by a physician, but to all other members of the care team,” said Dr. Fields.

The outcome 

VillageMD averages more than 85% adherence to chronic medications, which is a 5-star performance level. “We know clinically that the model works, and so building on that experience of having a co-located practice in your neighborhood, it’s some of the most convenient real estate around that is integrated with our clinical platform,” Dr. Asplin said.

Thanks to better care coordination and communication, athenahealth is a solution of choice when it comes to growing the adjacent-pharmacy model to scale. “It’s easy for me to see what a physical therapist may have done or what a care coordinator may have spoken to a patient about…The ability to message physicians within athena outside of the medical record, or the ability to communicate with a nurse inside of a medical record” even at a different site, Dr. Fields says “is something I literally could not live without.”