Pharmacy and COVID-19: Time to Deploy The Most Accessible and - - PowerPoint PPT Presentation

Steven Chen, Pharm.D., FASHP, FCSHP, FNAP Associate Dean for Clinical Affairs William A. Heeres and Josephine A. Heeres Chair in Community Pharmacy University of Southern California School of Pharmacy, chens@usc.edu

Pharmacy and COVID-19: Time to Deploy The Most Accessible and Overtrained Healthcare Profession

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Vital Roles for Pharmacy:

• Community containment
• Improve chronic disease control

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“The size of an outbreak can be substantially reduced by quick identification of cases using rapid diagnostic tests.”

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https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56

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8 Pharmacies per 10,000 People by County in the U.S., 2015

https://doi.org/10.1371/journal.pone.0183172

In the US:

• 67,000 pharmacies, 90%+ of US

population lives within 5 miles

• 5,500 hospitals
• 5,400 emergency rooms
• 1,400 community health centers

15,149

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Education, quarantine, self-care, referral Immunizations (eventually) Urgent research

• Treatment
• Immunity

Data tracking Ongoing testing-tracing-quarantine

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https://www.hhs.gov/sites/default/files/authorizing-licensed-pharmacists-to-order-and-administer-covid-19-tests.pdf?language=es

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https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56

11 https://ethics.harvard.edu/covid-19-response

“Achieving common acceptance of the need for tens of millions of tests a day and coordinating efforts to hit this target is therefore critical to our ability to go outside again.” “For somewhere in the ballpark of tens to hundreds of billions of dollars, combined with an intelligent use of tracing, we can end a lockdown that is costing the US economy tens of billions of dollars every day.”

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https://www.tracetogether.gov.sg/ https://www.apple.com/newsroom/2020/04/apple-and-google-partner-on-covid-19-contact-tracing-technology/ https://www.theatlantic.com/ideas/archive/2020/04/contact-tracing-could-free-america-from-its-quarantine- nightmare/609577/

• Bluetooth-based
• Interoperable between Android and iOS
• Preserve privacy

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Vital Roles for Pharmacy:

• Community containment
• Improve chronic disease control

http://dx.doi.org/10.15585/mmwr.mm6915e3

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PCPCC Resource Guide- Integrating Comprehensive Medication Management to Optimize Patient Outcomes https://www.pcpcc.org/sites/default/files/media/medmanagement.pdf https://innovations.ahrq.gov/qualitytools/patient-centered-medical-home-resource-guide-integrating-comprehensive-medication

Comprehensive Medication Management: Standard of Care for Optimizing Medication Therapy

Right choice Comorbidities and other medications

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• Quadruple Aim aligned
• Greater access
• Sustainable (value-based payment)

https://rightcare.berkeley.edu/wp-content/uploads/2018/05/RCI-Pharmacist-on-Care-Team-Brief- 5.25.18-1PM-FINAL.pdf

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Pharmacist on the Care Team: Modes of Delivery

http://www.pcpcc.net/files/medmanagepub.pdf http://www.cdc.gov/dhdsp/programs/nhdsp_program/docs/pharmacist_guide.pdf

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www.calrightmeds.org Mission: To provide optimal medication therapy for high-risk patients in their communities

IHI Breakthrough Series Collaborative Process

Ongoing Support:

• Additional live trainings, including standardized patients
• Virtual care training (phone and video telehealth)
• Biweekly webinars
• Local coaching
• Data sharing for quality improvement and aggregation of

impact measures Participants: 10-300 teams- Vetted through surveys, plan data, location, site visits

Mission: Provide

• ptimal medication

therapy for high-risk patients in their communities Expert Leadership Committee(s) LS1

LS: Learning Session AP: Action Period

Prework

LS2 LS3 Dissemination of Results (publication, Congress, etc.) Holding the Gains

AP1 AP2 AP3 Nov ‘18 Sep ‘19 19 19

USC Clinical Pharmacy Video Telehealth Services

• USC Health Sciences Campus
• Direct to patient’s home / office
• Commercially insured
• High-risk heart failure
• AltaMed Health Services
• To clinic
• Medi-Cal population
• Common chronic diseases
• Several platforms used / available (BlueJeans, WebEx,

Zoom, Doxy.me, etc.)

Calrightmeds.org

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Mariel Romero QI Coordinator

• Dr. Connie Kang

CRMC LA Lead

• Dr. Jessica Abraham
• Dir. Population Health
• Dr. Jennifer Kwon

Jeff Shapiro COO Vassilios Papadopoulos Dean

• Dr. Kathy Johnson Dr. Pete Vanderveen
• Dr. Rita Shane

Chief Pharmacist Sang-Mi Oh VP / Sr. Director

• Dr. Mike Hochman

Director

• Dr. Jessica Nunez

Chief, Chronic Disease Control Branch

• Dr. Paul Gregerson

CMO Hattie Hanley Founder Dennis Wagner

• Dir. iQI and

Innovation

• Dr. Tony Kuo
• Dir. Chronic Disease

& Injury Prevention Noel Barragan Program Manager

• Dr. Hanna Sung

Amb Care Pharmacy Director

• Dr. Alex Kang
• Dir. Clinical Pharmacy

Dr Edward Jai

• Sr. Director
• Dr. Mike Blatt
• Dir. Clinical Pharmacy

California Right Meds Collaborative: What Makes it Work?

• Dr. Dri Wang

Psych Sr. MSL

• Dr. Ron Victor
• Dr. Florian Rader
• Dr. William &

Josephine Heeres

22 Stringent pharmacy vetting process Clinical documentation platform, CQI

200 400 600 800 1000 Pre Post

USC / Blue Cross / Schering Community Pharmacy Asthma Program (N=434)

California Right Meds Collaborative: What Makes it Work? Calrightmeds.org

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High Risk Low Risk

Patients

HEALTH PLANS

Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx Rx

• Community containment

– “Hammer”: Widespread testing and tracing, reduce pressure on hospitals and ERs, buy time – Facilitate / conduct needed research (eg, treatments, immunity) – “Dance”: Ongoing testing, tracing, quarantine as restrictions lifted

• Improved chronic disease control

– System struggling to care for patients with other illnesses – Lower risk of severe infection / death – Facilitated by remote care supported by health plans

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Pharmacy and COVID-19

…but only 2,497 locations in the US