Our independent pharmacies in West Virginia have had a long, arduous journey since our world was turned upside down in March of 2020. Independent pharmacies far and wide have made heroic efforts, turning their workflows upside down to sustain high-level patient care during the initial phases of lockdown, not to mention stepping up to the plate to vaccinate our communities when their number was called. We owe our independents in WV big time for leading the charge in getting the majority of our LTC residents vaccinated across the state. While we’re not out of the woods yet, I’d like to take this opportunity to give our awesome pharmacies across the state praise for their efforts.
That being said, given how busy our community pharmacies have been, I can’t begin to tell you how excited I was when one of our CPESN pharmacies reached out to me this past month eager to start submitting eCare plans. After my initial call with the owner, I got to thinking, there’s surely other pharmacies across the country, let alone our own network, that are bound to be working through similar growing pains as they begin to experiment with the various vendor planforms available and submit their first eCare plans. So what’s the secret sauce? Well, you guessed it, there’s a slightly different recipe for everyone, but some common principles can help guide the process for all.
Here’s my take: Getting started with eCare plans, or any workflow innovation for that matter, can be similar to incorporating a new habit into your daily routine. The book Atomic Habits, by James Clear, suggests it’s important to make the new habit attractive, simple, and or obvious. There are other strategies of course, but I think these three in particular can be applicable to getting started with submitting eCare plans at your pharmacy!
Q: How can I make the action attractive?
A: This one might be the most difficult, but I think it comes down to perspective. What are some activities you enjoy with regard to your day to day tasks at the pharmacy, and how can you stack the new habit of documenting an eCare plan on top of those activities?
Examples:
Every pharmacy enjoys taking on new patients. Perhaps you tie eCare plans to
documenting new patient enrollments to pharmacy programs like medication
synchronization or adherence packaging.
Tie eCare plans to clinical activities that impact the business’ bottom line. This can
include maximizing your participation in payor partnerships opportunities available to
your pharmacy, if your network is established with a local Payor. If your network does
not yet have a payor partnership, an example of this can be documentation of clinical
interventions focused on outlier patients in EQuIPP. These interventions, if successful,
can have the potential to significantly impact your business’ DIR withholding for
certain plans.
Q: How do I make it simple?
A: CPESN has you covered. Utilization of the “Common Medication Related Problems & Interventions: Patient Encounter Documentation Form,” can simplify the task of getting multiple staff involved in documenting eCare plans in real time. Especially if your pharmacy if still getting used to your vendor’s software, and or in the process of training additional staff how to use the software.
A: Build a template! Many eCare plan vendors give you the ability to build custom intervention templates. This can help you drill into specific patient populations, while also making the documentation process more efficient and consistent.
A: Write a policy! Keep it simple for all of your staff by maintaining a central policy that walks through the documentation process start to finish. Make it accessible to all staff involved in documenting eCare plans. Similar to building templates, this can also help make the documentation process more efficient and consistent.
Q: How do I make it obvious?
A: Place a reminder in a physical location within the pharmacy, electronic location within the patient profile, or other location within your dispensing software (i.e. drug memo, insurance memo, etc.) that will be associated with the specific intervention you want to document.
Example:
Make it obvious that documentation is needed following an immunization by placing
blank Patient Encounter Documentation Forms with the vaccine screening
questionnaires in your pharmacy.
If your pharmacy has private patient rooms, you may also consider placing blank
Patient Encounter Documentation Forms for various interventions in these rooms for
real time documentation of BP monitoring, CMR’s, Targeted Medication Reviews,
immunizations, etc.
Drill into a specific patient population using your vendor or dispensing software and
place a reminder note or other place holder in the profile. This will remind the staff
member viewing a particular patient’s profile of the clinical intervention opportunity.
For those of you just getting started, I hope you’ll find some of these examples helpful. For the seasoned eCare plan veterans out there, I encourage you to share your success! We want to know what’s working and how to scale those innovations. Be sure to reach out to your coach if you’re having trouble as we are all here to help. At the end of the day, it’s all about finding what works best for you that will create those WIN-WIN situations, for both your patients and your pharmacy.
Written on behalf of CPESN West Virginia by FtP coach, Evan Turco, PharmD