Take a look at this site for an overview of this concept, as well as links to other sites with more information. This article describes the role of the pharmacist within this system.
Can
you think of any additional roles that a pharmacist could play in a
system such as this? How pharmacist friendly does the concept appear to
be? Would you be interested in practicing in such a model?
50 comments:
I feel like medical homes are a great idea. It is available to provide primary care to patients. It would be great to provide more primary care to patients because now many medical students are wanting to become specialists because that is where the money is for them. We need more primary care physicians because they are less expensive for the patients receiving care. Also primary care physicians can focus more on preventative care which will allow them to catch diseases at an early state and will lower healthcare costs overall. Also feel like a lot of people like the sound of a medical home because it sounds as if they will get higher quality care just because when you hear the word "home" it makes it sound more appealing. It sounds a lot better to say I am going to my medical home rather than I am going to my doctors office. Overall they provide quality care and want to improve healthcare for patients.
I think a medical home would benefit immensely from a pharmacist's services. Pharmacists have more than enough training and education to have an important impact in moving the healthcare system forward.
This new idea of patient centered medical homes is a great idea in my opinion. If i was a patient looking for where to get treatment, I would much rather have whole team of medical professionals looking after me than just one practitioner. Aside from MTM, a pharmacist could provide other services to a medical home team. They could provide detailed information to the other members about certain drugs that the other members are unsure on or do not have a good knowledge base of, they could also provide valuable input about how a drug could affect (positively and negatively) a patient. This idea appears to be quite open and pharmacist friendly. It acknowledges that pharmacists are already familiar to MTM, which is a similar approach to the concept of patient centered medical homes and pharmacists are also very good at developing relationships with patients. I think that being a part of a medical home team would be a very interesting job. A pharmacists on a medical team can actually become a member of a team aimed at helping the patient and can do it effectively by working in coordination with other medical professionals that can consult between one another, thereby effectively meeting the patient's need and treating them with the best care possible.
iA medical home approach to patient care makes a lot of sense in my mind. This type of institution provides direct patient care and is also cost effective for many patients. This would provide patients the convenience of seeing a single team of health care providers rather than seeing multiple physicians and occasionally running into cases of poly-pharmacy and other drug related problems. I think that Niko’s point of preventive care should also be noted. A medical home could provide valuable education to patients about health and medications. This would increase the chance of prevention of further disease states and allows the ability to work towards curing any current health issues. I think as a pharmacist a medical home would be a great opportunity to work directly with physicians and could aid in solving many drug related problems such as non-adherence.
Nick Scaturo
Usually, the patient goes to the doctor’s office for a diagnosis, then goes to another office or offices if they need to see a specialist, and then go to their pharmacist to drop off and pick up their medication. With the medical home, the patient will be able to travel to one place and obtain all the medical care they need.
By having the physician, pharmacist, and other healthcare providers together in the same place, communication will improve which then improves patient care. All the healthcare providers can come together and work together to come up with the best drug therapy plan for the patient. Physicians provide information on the patient’s health conditions and history. The pharmacist will then be able to assist the physician in selecting the best medication for the patient.
The idea of a medical home is a wonderful idea because in my opinion, it puts health care personnel in a position where they can focus on the patients and provide them with the attention and care they need. Pharmacists can play an integral role in these medical homes as well. Especially for us, who are learning about Pharmaceutical care, we are developing skills to be able to work with patients and provide them with optimal care.
It's just wonderful to see a plan where all the health care professionals are working together in harmony with the mindset to help the patient get better and also provide them with preventative care, as well.
It is exciting to see pharmacists being incorporated into the medical home. I think the profession is a necessary addition to this patient-centered model. As pharmacists are already trained in the concepts of medication therapy management, it is only reasonable that they would be assigned the task of managing a patients medications and making sure they get the most benefit out of it.
One thing I noticed in the article was that this system targets "at risk populations." Therefore, I think this idea is great and can be very beneficial. This population may not have the means to have a primary physician and this system allows them to not only have a primary physician, but an entire medical team as well. They are able to get the spectrum of health services. As for the role of pharmacists, I don't think the system would function properly without one...just as the system would not function properly without a physician or any team member. Each member is crucial.
Katie Easterling
I think this concept is a great one. The idea of having multiple healthcare professionals communicating together on a patients health is great. Like it was previously mentioned this is a huge benefit to "high risk" patients to make sure they are not only compliant but really understand why they need to be compliant.
The biggest challenge that I see is figuring out how patients are going to be able to afford this type of care? Are insurance companies going to compensate these services? Also, the current changes in healthcare and number of physicians, pharmacists, etc. going to make this possible. I love just knowing that this idea is out there because I think this would be a huge benefit to any patient involved in this type of care. It is a great look into the future of healthcare!
I Believe that the medical home will be effective in providing quality primary care to the patient. This will create a more active communication between the physician and the patient, as well as the physicians with other professionals. I believe that pharmacist are more than qualified to participate in this, and it may clarify indication, and other issues that are present now in pharmacy.
This is great concept. I feel like this is definitely the direction that pharmacy is headed, working together as part of a team of healthcare professionals in the best interest of the patients. I think that it was very interesting in the article where it stated, “The pharmacists document and communicate with the primary care provider in the same way that a specialist would,” Giuliano says. I think that pharmacists are not “like” a specialist but we are a specialist. If the pharmacy industry could reach a level of acceptance by other healthcare providers as medication specialists it would change their views on the role of pharmacists.
This is great concept. I feel like this is definitely the direction that pharmacy is headed, working together as part of a team of healthcare professionals in the best interest of the patients. I think that it was very interesting in the article where it stated, “The pharmacists document and communicate with the primary care provider in the same way that a specialist would,” Giuliano says. I think that pharmacists are not “like” a specialist but we are a specialist. If the pharmacy industry could reach a level of acceptance by other healthcare providers as medication specialists it would change their views on the role of pharmacists.
With the oversaturation of pharmacists in the community pharmacy setting and many of them being laid off in chain stores, the medical home business is a badly needed opportunity for us to consider. Also, for those of us who highly value close interaction with patients, this would create a great fit!
Students can also benefit because they can do residency in the medical homes.
I think that patient centered medical home is a great idea. I particularly think it is great to see the involvement of the pharmacist with this idea. With the emphasis of more patient focused care, this is a great opportunity for all healthcare professionals to get involved and build personal relationships with their patients. The idea of having all the providers together in one, makes patients more likely to keep up with their healthcare. Going from one physician, to another specialist, to the pharmacy can turn away patients. This way, it is easier for the patient. Medical home can also be beneficial to the healthcare providers. The inclusion of everyone together keeps a clear line of communication and keeps everyone on the same page in relation to their patient. Working in a pharmacy, I see patients come in all the time having no clue about their medications, what doctor prescribed them, etc. I think with patient centered medical home, patients will be less confused and everyone involved in their care will know exactly the same thing. Lastly, I think that with the members of this team, including a pharmacist is necessary. I think to be successful with this idea, the role of a pharmacist is crucial and just as essential as the physician. This a wonderful opportunity for the profession of pharmacy to be recognized and gain the acceptance from other healthcare providers.
The roles of a pharmacist would fit in well with the concept of a medical home. There are many barriers that exist for medical homes, but they provide great results for patients. The article stated that a medical home in Raleigh, NC “saw a 40% decrease in hospitalizations for asthma and 16% fewer ED visits.”
I like the idea of holding daily “huddles” to discuss patient problems. We have daily huddles at the hospital pharmacy I work for in Concord. It creates transparency, and it allows employees to voice their concerns.
In this new role, pharmacists could transition their current skills to add value. Pharmacists would be able to immunize patients, counsel them on their medication list, provide advice on stress management, help the patient manage chronic diseases and recommend DME.
I think that the medical home model is pharmacy friendly. It emphasizes teamwork between members of the healthcare community in order to provide more efficient care. The numbers from the article show that the model has proven itself to be successful. Several statistics show that the model has decreased hospitalizations and readmissions.
Obviously, the decrease in hospital readmissions is a perk to patients, but doctors may see this differently. While I agree that the model will actually free up doctors for more serious clinical matters, they may not see it the same way. This goes back to our discussion about how doctors view themselves, and how they view pharmacists. Doctors may see pharmacists, in a medical home model, as imposters who are encroaching on their territory of clinical care.
I think that if doctors are presented with positive figures such as those in the article, they may be more inclined to progress towards a medical home model. Happy patients and successful treatment SHOULD (and I emphasize should) be the primary concern for doctors. However, as we said in the “conflict of interest” discussion, doctors may be more worried about their own pockets rather than their patient’s health.
For me, this type of model would be ideal. I would love to work on a team to provide quality health care to people. I can only see positive effects coming from the utilization of strengths from various health care members. I personally would also like to utilize the clinical knowledge I ascertain in pharmacy school, rather than letting it go to waste.
I think the putting a pharmacist into a medical home is a great idea. From the article, it shows that having that personal care for your patients can offer better monitoring of your patient, personally knowing your patient and their goals, and being able to follow up with your patients. Granted, those were just a few of the benefits. I think by having a pharmacist around it can prevent drug related problems from occurring, like poly-pharmacy. I think that having the pharmacist readily available and there to check up on patients, you can get better compliance from the patients, especially because when a doctor sends an electronic prescription in for a patient, more than half the time they are never even picked up. I really like that implementing a pharmacist or even having medical homes has reduced re-admission, hospitalizations and has even ended up saving money for insurances. I really think building relationships is key to providing the best care for patients.
Lora Steffner
I firmly believe that medical homes can be beneficial to the patient as well as the physician and pharmacist. Not only does it save the patient money and reduce risk for polypharmacy, it saves them time. Time is very valuable to people and I think patients will be really appreciative of the convenience of a medical home. In addition it saves the risk for drug interactions, allergies and the inability for a pharmacist to get in touch with a patient's doctor. It makes it easier for doctors and pharmacists to monitor their therapy and compliance and follow up with them. Patient-centered medical homes also reduce drug-related problems and reduce hospitalizations and readmissions. Overall it is a great thing and would love to see more of them.
I think placing a pharmacist role into a medical home are essential and a win-win situation to all including physicians to patients. To have pharmacists working and collaborating with other healthcare professionals are exciting as it takes the pharmacy profession to another whole level. As the article stated, medical management is very important in delivering effective health care to patients, pharmacists working in medical home can have a huge impact on this such as lower hospitalization and readmission rates. This practice is similar to clinical pharmacists working in a hospital setting, where they collaborate with physicians in delivering effective health care to patients. I would be really interested to practice in a medical home setting.
- Tam Pham
I think implementing pharmacists into the medical home is a great and exciting way to the expand patient-centered care model. As the article points out, pharmacists can implement MTM's on a more personal level evaluating all of the medications their patient is on. This not only significantly improves patient outcomes, but it saves money (as the article points out) as it would substantially decrease hospitalizations and readmissions. Many of the problems with managing disease states are due to drug related problems, adding a pharmacist to the home program would improve patient outcomes by decreasing or eliminating drug related problems. Personally I am excited about our potential involvement in the home care system!
Incorporating pharmacists into the medical home is practical and a great idea. There has been lots of talk about pharmacists professional future and what that will look like, I think that this concept is a great start for working towards the future plan of pharmacy incorporated patient care. The article stated it well; that many what many pharmacists know well is how to manage patient’s health by MTM. The medical home would be a great position for pharmacists who show interest in the therapy programs that many pharmacies have implemented. What pharmacist would be able to provide is a complete medication profile that currently many of the medical homes are lacking.
The medical home is a very intriguing idea, as it could be very beneficial for patients, as well as encouraging cooperation and mutual respect between members of the patient care team. The article outlined the pharmacist's responsibilities as those of a specialist involved in MTM and consulting with the physician about other aspects of the patient's care. I don't yet know what other functions we, as pharmacists could serve, but it is nice to be recognized as valuable members of a healthcare team. The medical home model seems fairly pharmacist friendly for the reasons discussed above and it reviewed how having a pharmacist on the team would help to make the patient's care more comprehensive. However, the last sentence of the article explains how pharmacists would have to prove their worth to be viewed as necessary parts of this healthcare solution. I would like to see other disciplines recognize the importance of a good pharmacist on any healthcare team, especially on one that puts such an emphasis on the total well-being of the patient. I would consider being part of a medical home team, as I see it as a practical extension of what already is going on in many hospital settings and a very beneficial system for the patient. It would depend on the system I was to be placed in and the team i would be working with, but that pretty much extends to most every job. Working in a medical home scenario would be a great way to associate with other professions, promote a high standard of patient care, and keep my professional skills sharp. Also, I would be very interested in being compensated for my work at a rate of three dollars per minute. Just saying.
- Jesse R Alvarado
I think that the idea of a medical home is sound, but I'm not sure that it will truly be effective. Just because you bring a lot of people together does not mean that communication between the groups will be better than before. It doesn't mean that the patient will be better informed, or that they are receiving better care from their doctors. What we read about was simply the model of the medical homes, and we all know there is a difference between models and practice.
As a side thought, how will these medical homes be funded? Patients already pay a copay for seeing their doctors, how much extra will this cost them? With all of the integration and technology used, there must be some kind of start-up cost or investment and I can only imagine that it won't be cheap.
I like the idea of the medical home. I think it would be safer for patients to have everyhting all in one place in a way. If the health care profession really is moving in this direction then pharmacists need to be proactive about the part that they can play in it and the services that we can provide. I think this idea would allow us to do even more when it comes to checking medication therapy to make sure that it is the best therapy for that patient. Also, we could help the doctor monitor the patient. The health care profession would seem more like a team, and I think it would cause people to understand the integral part that pharmacists play.
This concept is very pharmacist friendly, as pharmacists play a key role in MTM. The best way to help patients is to make ourselves completely familiar with their history, current conditions, etc and this would come naturally in a medical home setting.
The idea of a medical home practice is still somewhat vague to me even though it seems like a very positive idea for patient-centered care. In the model, patients have an increased access to their primary care provider (PCP) in addition to other medical personnel on the PCP's team. Ideally, all medical professional members work together as a team to come up with a care plan to treat or prevent patient disease.
The question remains, will each medical home professional be required to situate in one physical location for this model to be effective? A centralized database for patient information was mentioned in the article and this will help keep everyone on the team up to pace, but in the end, will this improve patient health outcomes? Having a common database is one thing, but having all medical professionals present and working together is a different story.
Then there are the costs incurred in operating such a model. It is not uncommon for pharmacists to fill 300-400 prescriptions a day in the retail setting, and while placing pharmacists in the medical home setting is beneficial for the patient, how will pharmacists get compensated for interacting with less patients?
These are just some of the questions that came to mind as I was reading the article. Perhaps someone can enlighten me.
Patient-centered medical homes seem to be a great idea that will help in the pharmacists role in patients' lives. In this type of environment I feel like the pharmacist will be able to help in medication therapy management, as well as uphold their dispensing and counseling roles.
Although I'm still not entirely sure about the specifics of exactly how this practice type operates, it is definetly something I would be interested in learning more about and getting involved in. The key principle of it, the patient/professional relationship, is something that we as a profession need to continue to strive for and this seems like it could be an ideal situation.
~Chris Pavero
I definitely like the idea of incorporating a pharmacist's expertise into the medical home model. It looks like the pharmacist will be practicing basic medication therapy management skills as they apply to the medical home model. MTM encompasses a large amount of roles that a pharmacist can potentially fill, so I don't think there are any other roles that the pharmacist needs to take on. As stated in the "Medical Home 101" article, pharmacists will not only be providing MTM for patients, but they will be a part of the medical home team - this means that the pharmacist will give information to the physicians about the drugs the patient is on. I had no idea that there was such a gap in medication documentation for patients. I think the articles stated that upwards of 40-50% of medications go undocumented for a given patient. The pharmacist's job will be to narrow that gap by making sure to document all prescribed, OTC, and herbal medications for future reference by the entire medical team. It seems like the pharmacist fits well in the medical home model, making the model very pharmacist friendly.
I Think that the idea of a patient centered medical home is a great idea. The medical professionals will be able to work with each other to determine the best method of treatment for patients. This will lower costs from unnecessary treatment as well as fewer cases of drug related problems. The pharmacist has the most knowledge about drugs and will be a vital piece of the medical team involved in the medical home. This idea would also be helpful in increasing preventative care in the patients because of the routine checkups from the physician. This allows for their medical plan to involve preventing a disease instead of always treating or coping with the disease.
Jeff Auten
I would be very willing to practice pharmacy in a medical home atmosphere; I am all for expanding the field of pharmacy and working in a medical home is an open door. Medical homes are a great way to help patients as well as doctors and pharmacists. The patient will have easy access to physicians and pharmacists and the healthcare providers will have access to all of the patient’s medical records. A major issue that pharmacists encounter is not having access to a patient’s medical history. A medical home would allow all of the patient’s information to be in one place. This could allow healthcare providers to catch diseases early on and treat them. Also, by having everyone you need in one place it will be easier to communicate and work together. I was really impressed with the statistics the article provided that demonstrated how medical homes benefit patients. I feel that more places should have medical homes when there is proof that is it having such a positive impact on patients. I hope to see medical homes expand and succeed.
BY Amanda Elliott
Medical homes are a fantastic idea. The patient and the patient's well-being are definitely at the center of this model. No medical professionals are jacks of all trades, each have their special niche and in this model it allows each of these niches to be fully utilized. Teamwork despite the arguments that might shortly ensue is always a positive thing because it encourages people from all backgrounds to work together. As long all the members of this medical home team act alongside one another as professionals and not selfishly to advance themselves I believe this can work without a fault and drastically improve the quality of the patient's care and decrease the amount of time they are sick. If this becomes the medical model of the future, pharmacist as drug experts need to be an indispensable and contributing part of the team.
I think medical homes would be very beneficial for patients. This would allow patients to be better monitored, and it would allow patients to receive primary care. I think pharmacists would greatly help in the medical home model. Pharmacists are educated to know all about different medications and interactions. Pharmacists in different areas of pharmacy are beginning to do more and more MTMs. This is great experience that would help in the medical home. Overall, I think medical homes are a great idea.
-Curtis Austin
Like most people, I believe that a patient-centered medical home is a great idea. This type of direct patient care is something that does not currently exist in our medical systems. As long as these are cost effective, then I believe they are very feasible. A pharmacist would play a major role in the daily interactions with patients and ensuring that their medication regimen is beneficial. This type of primary care is tremendously advantageous to the patients because this level of attention is not usually received at your every day pharmacy.
I think the medical home idea is a great idea. It would be very beneficial to patients and pharmacists could really help out in this new system. Our counseling skills would be beneficial to the patients and also help the physicians in this new system. I think this is a good idea to go forward with.
I think that this is a great idea to expand the role of pharmacists in various areas of healthcare. This would be a great way to get a new type of interaction with physicians that could benefit pharmacy as a profession and perhaps make the physicians see us in a new light.
I think that having pharmacists in medical homes would be great. I think that doctors have so many patients to see within a home that they just typically diagnose, give meds, and rarely follow up. However, I think a pharmacist would have a very important role within a home like this. For example, before administering meds, a pharmacist could make sure the drug is appropriate and necessary. A pharmacist's job could be very helpful in this setting. A personal story is when my grandmother was in a home to recover from a surgery. She never seemed to be getting better because all she would do is sleep and be "out of it." A pharmacist overlooked her medications and realized she shouldn't be on a certain med because it was causing this inhibition. She was taken off the drug and got well very quickly. A pharmacist could be a great advantage to this type of "home" setting. Something else mentioned by peers it that it could increase communication between all health care professionals, which is a big deal!
-Aaron Shaver
I feel this is a positive opportunity for pharmacists to further become involved in the management of patient care. I fully support any view of patient care that is more comprehensive to incorporate everything about the patient's life, rather than just focusing on a localized problem, because this allows for more appropriate treatments that are less likely to conflict with each other.
This is a great idea. A lot of DRPs would be eliminated. I think the implementation of this idea would be a challenge and I am interested to see how such a system would work.
-Yelena Panko
According to some of the pharmacists I have spoken with, medication therapy management is a growing area of pharmacy. Besides the important factor of cost, the patient-centered medical home is a great idea because the patient is the main focus of the group. The doctors and pharmacists work around the patients schedule to determine the best treatment plans and options. This is also a more attractive option since retail pharmacy is becoming saturated.
-Jessica Osteen
I think the skills that pharmacists have to offer would be very relevant and beneficial in a home care setting. They could pretty easily coordinate with the patient's primary care physician to ensure that prescribed drugs are taken correctly and to warn the prescribing physician of any possible drug interactions/contraindications beforehand. They could also possibly keep the doctor informed of any new problems the patient may develop and can make sure the patient understands how to correctly take their medications adn what they are supposed to treat.
The article stated that pharmacists need to be involved in medical homes in performing medication management. The management needs to be comprehensive, taking into account all medications, supplements, etc being taken in order to cut down on drug interactions and adverse effects. I believe that having at least one pharmacist on a medical home team could drastically expedite this process while also cutting down on patient readmissions to hospitals and other care centers due to ill health. On top of these aspects, medical home involvement could change the view of pharmacists in the public scope, giving more credit to pharmacists as professional providers with hands on contribution to patient health.
I believe that the medical home will benefit the pharmaceutical industry. With the new aspects of this, including medication therapy management and centralizing the records, the pharmacists roles and the utilizing their abilities. This could change the patients view of pharmacists that would benefit the profession on a universal level. Also, this would benefit the patients because there would be a centralized information database so no needed information would be left out. If a patient is getting drugs from multiple places, which the article says is rather common, a drug interaction could be missed and would cause many problems for the patient. I feel as if this is a promising idea if the payment for the pharmacist time and work is compensated correctly.
I think there are many other roles that a pharmacist can play in this type of system. One of the roles pharmacist can participate it in is counseling in doctors offices. For example, if a doctor is willing to have a pharmacist available at their practice for medication therapy management (MTM’s), to help the patient understand why they are taking the medications they are prescribed. This will also allow the pharmacist to catch any possible drug interactions and possibly alter dosing or medications for more effective treatment. Another role a pharmacist can play would be in a hospital setting. Having a pharmacist working side by side with the physicians to effectively treat patients by recommending more effective drugs and dosing as well as be available to recognize any drug interactions. Another interesting role that I really like is, pharmacist at nursing home or senior citizen homes. For example, my home store in Michigan, we delivered to a senior citizen complex. If we can have pharmacist come to these senior citizen homes for a few hours a day would be very beneficial. Since they don’t have direct interaction with the pharmacist, I think it’s a great way for the pharmacist to spend one-on-one time with the patients going over all their medications, answering any questions they might have, as well as making sure they are compliant. Overall, I believe that are many roles that pharmacists can play in this type of system to essentially better patients lives.
The medical home will be helpful in reducing overall healthcare cost to patients in the sense that doctor's visit could be reduced because of the effective management of their diseases. The goal of the healthcare team is to reduce sick time of patient and also ensure the holistic care of the patient and I believe as more patients buy into it, there will be a boom for this industry and demand for all the medical team involved which of course will include Pharmacists.
.... Vida Ohene Agyeman.
Having a patient centered medical home is a great idea. It would decrease problems like Polypharmacy, patients unsure why they are receiving a specific medication, correct dosing, contraindications and other inconveniences. Patients will be fully taken care of. I do think that a patient centered medical home should be mainly provided for those who have more healthcare problems (or prescriptions) as opposed to just one situation (or prescription). More time is devoted to each patient, which means fewer patients throughout the day, so it seems unnecessary for someone to come in for just high blood pressure as opposed to a patient who has high blood pressure, high cholesterol, diabetes, injuries problems, etc.
I personally think the concept ‘medical home’ is very effective to both healthcare system and patients. To be focusing on healthcare system, healthcare professionals are to create a synergy effect by communicating to each other and working together. Physicians and pharmacists can be monitoring each other sharing positive and negative feedbacks to each other to amplify the synergy.
I am all for this system and believe that it would produce optimal health outcomes for the patients due to the increased collaboration between physicians and pharmacists. This system allows for group think and a better system of checks and balances to determine if the best course of therapy is being followed.
-Amy Miller
The patient-centered medical home may be seen as an overdue item of interest in the pharmacy industry, and with good reason. Especially in a society where financial savings are highly valued, this system would not only reduce problems including [but certainly not limited to] polypharmacy, but—more importantly—the overall healthcare cost to patients. Just one of the many potential benefits of utilizing the medical home would be reduced visits to doctors' offices, seeing as it would offer very effective management of patients’ disease states. Only a matter of time until this system or one of similar concept are bought into by patients. And as demand for said system(s) increases, we can only expect the role of the Pharmacist to play an active role...
-James Agtuca
This sounds like a great ideas. I would like to work in such an environment. I do not understand how the load would be lifted off the primary care physician since the patients would still have to filter through him/her to get anywhere eles right? I would love to see this in action to better understand it.
-Yelena Panko
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