SPOTLIGHT ON FAIRVIEW HEALTH SERVICES Part I
According to the latest guidelines for cystic fibrosis (CF) published in U.S. Pharmacist, pharmacists are an important part of counseling patients with CF.
Patient Care (PC) recently spoke with Sandy ILL, PharmD, CSP, a specialty pharmacist; Kim Ehlert, PharmD, a clinical pharmacist; and Tim Affeldt, PharmD, vice president of specialty pharmacy at Fairview Health Services, a nonprofit, integrated health system based in Minneapolis, Minn, to discuss how they address CF medication adherence in their health system.
PC: The Fairview CF medication adherence rate is 70% higher than among patients at the retail pharmacy. Why do you believe that is?
Sandy ILL, PharmD, CSP: I believe that with Fairview Specialty Pharmacy, we've done a really great job of educating our staff on cystic fibrosis and the complex regimen that these patients are on, so when a patient calls in, we recognize the intricacy of their disease and can offer a higher level of service. Education of the team is absolutely essential. We have a monthly meeting where both clinic and specialty pharmacy staff proactively discuss and collaborate on processes and procedures that span our health system. To continue our coordination of care, throughout the month we have open communication between the clinic and specialty pharmacy staff as to how we can work together in supporting our patients and addressing any specific problems or concerns a patient might be having at that time.
We also have a program that specifically trains patient liaisons in CF who check in with patients on a monthly basis and so really establish relationships with patients.
"We also have a program that specifically trains patient liaisons in CF who check in with patients
on a monthly basis and so really establish relationships with patients."
Dr ILL: Also, we utilize different types of technology to be able to reach a patient with the communication route that is best for them, whether that's a phone call or a text message or an email. For example, cystic fibrosis patients might prefer text messaging or emailing while they're doing their inhaled nebulization. They of course want to be available to do a phone call, to set up the next refill, but during a nebulization treatment, it’s more convenient to be able to send a text message or respond to an email. Again, it's really figuring out for each individual what works best for them, and how we can best help support them.
PC: Can you go into more detail about what the process is at Fairview? A patient comes into your health system, what is the first step? Who interacts with them? As they go through care, what different teams do they end up touching, and what are the roles of those folks in patient care?
Kim Ehlert, PharmD: I think we have an ideal setup in our health system. We have pharmacists in the care center and in the specialty pharmacy and they are partners so we can provide consistent care across all of those touchpoints within the system. When a CF patient comes to our clinic, they will meet with their providers and the care team, which includes the pharmacist in the clinic. Then, if they need a prescription or are starting on a new therapy, it is ideal if they can fill it in our health system.
When the prescription goes to the pharmacy, the staff has access to the patient's electronic medical records, so they can see the notes from the visit; they can see what the pharmacist specifically talked about with the patient and can reinforce that message when they have contact with the patient. We can also help communicate to the care team what we learn about patient preferences and any specific concerns that we have or the patient has.
Next: Pharmacy can bridge gaps