Collaborative care alchemy: Pharmacists + nurses = gold
Last month, the American Journal of Managed Care published a review of more than 40 years worth of studies from various medical journals that demonstrated that the best way to improve adherence is to get patients to talk to the store pharmacist; the second-best way is to get them to talk to a nurse before they leave the hospital.
“There have been many studies on the subject of boosting adherence,” said William Shrank of Brigham and Women’s Hospital and Harvard University, who led the team of researchers that carried out the study, sponsored by CVS Caremark. “We decided it was important to review the total body of work to determine which communication channel had the greatest impact.”
In all, the study covered more than 6,500 journal articles published between 1966 and 2008. “These findings offer payers, healthcare providers and policy-makers guidance about how to develop programs that improve patient adherence,” CVS Caremark chief medical officer Troyen Brennan said.
As the clock ticks away toward full implementation of the Affordable Care Act in 2014, and with Republicans in the new Congress hell-bent on repealing or at least replacing the parts of it they don’t like — even if they can’t — there is going to be more attention paid to how all this extra health care is going to get paid for and what America is getting for its money. Fixing adherence is worth about one-third of the total cost of health reform.
Drug Store News has believed in the power of pharmacists and nurses to improve health care for several years. It was a key reason we added Retail Clinician magazine to The Drug Store News Group in 2006 — you didn’t have to be a fancy Harvard doctor to see that pharmacists and nurse practitioners working together in a collaborative care setting was going to be a big part of the future of health care in America. We wanted to help connect the dots between these two incredibly important groups of practitioners to help close the gaps in access and affordability in the U.S. healthcare system.
This year, we are taking that commitment to a new level. A new addition to the program at the fourth annual Retail Clinician Education Congress this August will feature a special day of Collaborative Care Track education, including six dually accredited continuing education sessions for pharmacists and nurse practitioners. The topics are targeted specifically to pharmacists and NPs practicing in a pharmacy/retail clinic environment. We want to help get these two critically important healthcare professionals closer together in the interest of driving better patient outcomes.
If you have retail clinics in any of your pharmacies, I strongly encourage you to send some of your key pharmacy managers to RCEC this year. Contact me at [email protected] if you need more information.
‘Interactive conversation co.’ puts fun in patient education
CHICAGO — At first glance, there doesn’t seem a natural connection between the CD-ROM version of “Who Wants To Be A Millionaire?” and health education. But one company’s smashing success with interactive games led to its venture into prevention and disease management.
The company is Jellyvision, founded in 1989 as Learn Television to create children’s films. After producing “The Mind’s Treasure Chest,” an award-winning educational film, Learn developed the interactive, best-selling trivia game “You Don’t Know Jack,” released in 1995. The following year, the company changed its name to Jellyvision to reflect its broader focus beyond education, and launched a spinoff, Jellyvision Labs. Its mission: to create interactive programs online “to communicate complex subjects.”
The result is a growing series of Web-based, interactive programs about a variety of topics, including such products and services as pharmaceuticals and health coverage options. What sets the interactive dialogues apart is that they’re conversational, funny and entertaining, as patients and virtual hosts walk them through a question-and-response process.
Dialogue is crafted by writers, including screenplay writers and even comedians, who are “well versed at communicating” and “subject-matter agnostic,” explained Josh Braun, Jellyvision’s VP business development.
Those writers, he said, are paired with subject matter experts, “but the experts don’t do the writing, which is why the conversations don’t sound like a marketing brochure; they sound like a human.”
Such drug companies as Bayer and such insurers as Aetna “have experienced much success from implementing interactive conversations via Jellyvision,” noted a representative. For instance, she explained, for a patient who finds out she has multiple sclerosis, “the interactive conversation walks [her] through the differences between treatment, breaking down … complicated information into a short conversation that’s easy to understand and reassuring. [The patient] now feels relieved because she has a grasp on her diagnosis and how to handle it.”
Pharma companies, Braun said, “drive brand conversations” via Jellyvision. “Educating people about diseases and possible treatment options hopefully drives them to visit their doctors and mention the medication,” he said.
Drug manufacturers also can apply Jellyvision’s interactive approach to doctors. “It’s difficult for sales reps to see physicians nowadays,” Braun told Drug Store News. “So interactive conversations can be used as a learning device for physicians. Then, when the sales reps go in and visit, the physician is a little more ‘warmed up’ and better educated.”
With a company like Aetna, he added, it’s about educating plan members about their benefits and providing decision support.
There’s no reason a pharmacy chain couldn’t use the same approach, Braun said, by participating in patient education activities or other brand-building actions.
Congress exempts pharmacies from ‘red flags’ rule
ALEXANDRIA, Va. — Congress handed community pharmacies a Christmas present in December, voting to exempt them from burdensome accounting requirements imposed by the Federal Trade Commission.
Both the House and Senate approved bipartisan legislation that removes community pharmacies and other small businesses from new requirements by the FTC and six other federal agencies regarding credit and debit card use. The so-called “red flags” rule, geared toward financial institutions and other creditors, requires such entities to develop and implement identity theft prevention and detection programs.
Independent pharmacies, in particular, have long sought legislative relief from the new rule, saying it would impose huge financial burdens on small-scale drug store operators by forcing them to scale up their automation and electronic reporting capabilities with expensive new systems.
The National Community Pharmacists Association hailed the votes in the House and Senate. “Community pharmacists appreciate passage of this bipartisan, bicameral legislative solution exempting pharmacies and other small businesses from the onerous FTC red flags rule, which is intended for financial institutions,” said NCPA EVP and CEO Kathleen Jaeger. “Thanks to the House … and the Senate vote, … community pharmacists can continue providing expert medication counseling and other services without an additional regulatory burden.”
Jaeger singled out several lawmakers in both houses for their efforts on behalf of pharmacy owner-operators. Among them: Reps. John Adler, D-N.J., Barney Frank, D-Mass., and Spencer Bachus, R-Ala., in the House; and Sens. Mark Begich, D-Alaska, and John Thune, R-S.D., who authored bipartisan legislation earlier this year to exempt many small businesses from the new rule. Key to passage in the Senate, Jaeger said, was additional support from Sens. Chris Dodd, D-Mass., and Richard Shelby, R-Ala.
“We commend Sens. Begich, Dodd, Shelby and Thune for their hard work to ensure that reasonable consumer protections can go forward without unduly burdening pharmacists and other providers with unnecessary, time-consuming requirements,” Jaeger said.
Dodd was quoted by the Congressional Record as saying that the legislation “makes clear” that pharmacists and “other types of healthcare providers and other service providers will no longer be classified as ‘creditors’ for the purposes of the red flags rule just because they do not receive payment in full from their clients at the time they provide their services, when they don’t offer or maintain accounts that pose a reasonably foreseeable risk of identity theft.”