Article

3-minute case study: PCP with on-site pharmacy drives better outcomes, with less driving

By Carley Thornell | May 27, 2020

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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 another. 

The challenge

Patients being prescribed several medications by multiple providers is common, but that increases the odds for complications with interactions and incorrect dosages. VillageMD Chief Medical Officer Clive Fields and President Brent Asplin repeatedly noticed that multiple providers across the patients’ care continuum were not on the same electronic medical 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 Clive’s father founded as a family practitioner in Houston more than 50 years ago.  

The solution

VillageMD was able to find a physical and cloud-based solutions. The introduction of Village Medical at Walgreens, which offers primary care services adjacent 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.  

The model means patients can be diagnosed and not have to drive to another location to wait at a pharmacy counter or go online to sign up for traditional mail prescriptions. This is especially important for Houston’s senior and immobile populations, as urban sprawl often means public transit is not only lengthy but difficult in warm Texas weather. Ordering prescriptions online involves a waiting period and is difficult for those with limited internet access.  

For Fields, the on-site pharmacy partnership fosters better relationships and communication within the health-care 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, clinicians, and pharmacists. Multiple providers can review medications a patient is already taking to see if there will be an adverse reactions 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 Fields.   

The outcome 

Asplin reports five-star medication adherence for patients who use the integrated pharmacy at Village Medical at Walgreens. “We know clinically the model works, and so building on that experience of having a co-located clinic in your neighborhood, it’s some of the most convenient real estate around that is working off of and integrated with our clinical platform,” he said.  

Thanks to better care coordination and communication, athenahealth is their 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, Fields says “is something I literally could not live without.” 

Village Medical at Walgreens has opened several locations in the Houston area, with plans to add more in 2020. In 2020 and beyond, plans also include expansion in other key U.S. markets including Illinois, Florida, and Arizona.