Slater - CCO Oregon

Health Share
Pharmacy Workgroup Experience
Jim Slater
Workgroup Pharmacist Participants
Adventist Health
Central City Concern
Clackamas County (Mental Health Services)
Kaiser Foundation Health Plan of the Northwest
Legacy Health System
Multnomah County
Oregon Health & Science University
Providence Health & Services
Health Plan
Medical Group
Specialty Pharmacy
Tuality Healthcare
Washington County (Mental Health Services)
• Janice Hogue…
• Jim Slater, Dean Haxby…
• Sandy Anderson
• Steve Logan, Nancy Louie Lee…
• Kathy Stoner, Cory Huot…
• Carol Richmond, Michele Koder…
• Yen Pham, Amy Szczukowski…
Priyesh Patel…
Steve Stoner…
Helen Noonan-Harnsberger/Greg Dietzman…
Terri Bianco…
• Brian Dotter…
Shared Expectations & Questions
• What are you hoping to accomplish with
• What questions do you have about the HSO?
• What questions do you have about working
together as a workgroup?
• What do you think would make a great
collaborative relationship?
• Collaborative workgroup of pharmacy staff
from each HSO partner
• Goal is to demonstrate the power of
collaboration using collective resources of the
collaborative participants
• Indentify 3-5 cost-saving drug-therapy
initiatives with savings measurable in 6-12
Possible Traits of a Successful Initiative
• Clear evidence or experience suggesting good chance of
cost-savings (direct/indirect [high correlation])
• “Shovel Ready” – Can be implemented in 3 months
• Collaborative partners can provide sufficient staff
resource allocation to be successful
• Members and/or Providers likely are positively impacted
(Triple Aim) – Tangible experience for the better
• Project can work in more than one setting/facility
• More than one HSO partner participates together
– Even better to work across the system (Plan + Hospital +
Clinic/Medical Group)
Some Cost-Saving Drug Utilization Levers
That Can Be Pulled – Others?
• Improving PCP and office staff productivity
– Formulary & prior-authorization standardization & unification
– EMR best practice – formulary communication & individualized drug therapy plan
documentation and updating (EPIC and other platforms)
• Ensuring success of drug treatment care plans for high-acuity individuals
– Concurrent review/collaboration – hospitalization
– Medication reconciliation/transition-of-care post-discharge drug treatment plan F/U
(Handovers) Clinic ↔ Hospital ↔ Clinic
– Monthly coordinated fills (Adherence packing, dispensing appointments, clinical
pharmacist monitoring/updates of drug therapy care plan)
• Pro-active steps to protect at-risk members
– Hepatitis C (readiness –to – treat, progress/refill monitoring)
– Safe Opiate Use (standardizaton: dose ceilings & quantity limits, tapering protocols,
instruments: D.I.R.E Score, applying prioritized list coverage/PA criteria)
– Guideline Note 1 & 12 – best practice oncology & palliative care
– Mental heath access issues ( PCP education on appropriate antipsychotic drug therapy &
pearls, limiting off label/poor evidence use)
Project Idea Brainstorming
• Open Discussion
– What projects would lend themselves towards a
6-12 month cost-saving (Triple Aim) objective?
Internal & External Communication
• Goal: Inspire/achieve orderly & effective team
collaboration within the CCO and within the
– How should we proceed with inside and outside
interest to join the work?
– What are key opportunities to consider in how we
communicate our work?
– What other groups of pharmacist should we
consider to keep in the loop and what is the right
Project Implementation Ideas
• One page sponsor report created for each
project to report up to HSO
• At least co-leads for each project (creates
continuity and back-up to keep it moving)
• Roll-up dashboard to track progress for each
project – regular reporting (monthly)
• LEAN/A3 API methodology encouraged to
refine work on each project towards success
(2012 – 2013)
• 3Q2012
– Form pharmacy workgroup and identify projects,
• 4Q2012
– Form sub-workgroups, interpret scope into actionable steps
• 1Q2013
– Monitor projects, CQI/Lean along the way, monthly progress reports
• 2Q2013
– Presentations to collaborative of success/learning’s
– Start working on next year objectives
TCMC Pharmacy Work Group
Draft Sponsor Report
Project Title:
Date Updated:
Oversight Owner(s):
Implementation Owner(s):
Key Stakeholders (KS),:
Next Steps/Timeline:
Key Learning's:
Success Defined:
*Report Change **Process Change
VSMs and A3s for Project Management
Current State VSM
Future State VSM
New Current State VSM
Future State Plan
Project Implementation Brainstorming
• Open Discussion
– What project resources can we collectively
– What training would help project teams be
– What infrastructure do we need to secure
pathway towards project success?
Pharmacy Workgroup Steps
Establish Pharmacy
Director Workgroup
with representation
form each CCO
Board Partner 1
Orient workgroup
to known CCO facts
and workgroup goal
Gather key
questions and
expectations from
participants 3
Conduct Ease &
Impact exercise to
help identify project
Agree on initial
projects for first
year. Define initial
Create sub
workgroups with
CCO partner staff
for each project 6
Report to HSO CMO
workgroup progress
Report out progress
or clarification
needs to pharmacy
director workgroup8
Subgroups meet
monthly and
interpret scope to
create actionable
Medication Reconciliation Process
Mapping Workshop 12-17-2012
Thank You!

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