Incorporating pharmacy care plans into your dispensing program

In recent years, the delivery of cancer treatment has shifted dramatically from intravenous medications to a surge of oral oncolytics. In 2017, more than half of all novel cancer drugs approved by the FDA were oral oncolytics, and nine additional oral oncolytics were approved in 2018. In response, oncology practices have begun dispensing drugs in-house in large numbers, with an estimated 50 percent of US community oncology practices establishing in-house pharmacies as of 2016. Over the same period, the practice of pharmacy has seen a shift as well from a focus on medication distribution to offering expanded, clinically-oriented patient care services.

As growing numbers of pharmacists join coordinated healthcare providers within community oncology practices, documenting patient interactions and ensuring that pharmacy records can be accessed and shared via EMR is vital to patient-centricity.

Pharmacy care plans can serve as a standard framework for maintaining centralized documentation of patient interactions and help foster a patient-centric approach to care. Serving as a step-by-step plan of action, a pharmacy care plan can help to ensure that medication monitoring and patient follow-up are taking place.

Stacy McDaniel, PharmD, is a clinical consultant for VitalSource GPO with more than 10 years of expertise in developing both oral and IV chemotherapy treatment plans. At Northwest Georgia Oncology Centers, she led oral dispensing programs and the creation of pharmacy care plans for patient management. We spoke with Stacy about the value pharmacy care plans offer, how they can help contribute to improved adherence and how to implement an automated care plan through prescription software platforms.

SM: A pharmacy care plan serves as a script and a roadmap for documenting all patient interactions in a centralized location. It outlines what follow-up actions need to be taken for each patient, beginning at the point of dispensation, and provides suggested questions and guidance on how to assist patients with any adherence challenges they have or side effects they experience. It also serves as a scheduling tool to help pharmacists keep track of when to reach out for additional follow-up.

A pharmacy care plan should include all relevant information about the medication itself, such as the indications, recommended dosage, interactions and common effects, and any storage or handling requirements. In addition, it should note necessary patient education and counseling. In addition to listing all relevant clinical information, it should also be a living document of patient responses and any notes from patient calls.

SM: Working as part of a coordinated care team within an oncology practice, pharmacists’ encounters with patients will often result in clinical insights that can assist physicians in delivering improved outcomes. Patients may share information about side effects, new interactions or disease states. Additionally, regularly scheduled calls can provide updates on when patients stop or start medication, which can aid in medication reconciliation and adherence. The ability to store this information and securely transmit it to an EMR may lead to improved communication and more patient-focused care.

SM: Oncology practices are busier than ever before as patient volume continues to grow. Scheduling patient follow-up calls manually and ensuring that all information relevant to each medication is included can be a daunting task.

VitalSource™ GPO worked with PioneerRx to integrate pharmacy care plans into their pharmacy management software so that care plans can be generated at the point of dispensing. Whenever a medication is dispensed, the pharmacy care plan will be automatically populated with the correct drug information. It also automatically generates relevant discussion questions based on the patient’s medication regimen and disease state. The plan also schedules follow up calls and creates a work queue for documenting actions.

Additionally, storing all patient interaction documentation within a pharmacy management software program like PioneerRx allows the practice to generate metrics for increased visibility.

SM: Both URAC and ACHC require comprehensive documentation of patient interactions. While the specific data points are not specified, practices must be able to compile all clinical information into reporting and ensure that this information can be transmitted to an EMR. Practices must also demonstrate that they are monitoring side effects and providing outstanding patient care. Implementing centralized reporting through a pharmacy care plan allows the practice to provide a complete picture of their patient interactions to accreditation boards.

VitalSource™ GPO has collaborated with our network of community oncologists and PioneerRx to develop automated oncology drug-specific pharmacy care plans developed by pharmacists, for pharmacists. Our practice consultant team can work directly with your practice to design a customized workflow.

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