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Bringing Patient-Centered
    Health Care to the Patient by
    Integrating Retail Pharmacy
    Wayne Pan, MD, MBA, Chief Medical Officer
    The Individual Practice Association Medical Group of Santa
    Clara County Inc. (SCCIPA)


The National Medical Home Summit West • September 20-22, 2011 • San Francisco
ourjourney
MIND THE GAP
because of these
too many of these
carecoordination
 andtransitions
direction
• focus on the patient
• fix processes first
• empower providers and
      the care team
• clinical must lead
      technology initiatives
• focus on the patient
source: SF Jencks et al., Rehospitalizations among Patients in the Medicare Fee-for-Service Program, New England
             Journal of Medicine, 2009;360:1418-28.
$17B
source: SF Jencks et al., Rehospitalizations among Patients in the Medicare Fee-for-Service Program, New England
             Journal of Medicine, 2009;360:1418-28.
from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)
from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)
?
from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)
peopleprocessesplatform
3P’s
peopleprocessesplatform
big      C
peopleprocessesplatform
culture
peopleprocessesplatform
changingthewaywedothings
n ew
 V
a waywedothings
why?
what got you here


         marshall goldsmith
won't get you there




           marshall goldsmith
how?
insanity:
 doing the
      same
thing over
  and over
        and
expecting
   different
    results
get out of the rut?
patientcentereddesign
from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
behaviordesign
put hot triggers
 in the path of
motivated people
                             BJ Fogg, PhD
      Director, Persuasive Technology Lab
                        Stanford University
work with
humannature
                           BJ Fogg, PhD
    Director, Persuasive Technology Lab
                      Stanford University
lazysocialhabits
                             BJ Fogg, PhD
      Director, Persuasive Technology Lab
                        Stanford University
theproblem:
readmissions
physicianfollow-up
medicationreconciliation
Santa Clara County
 1,304.01 sq. miles
  1,781,642 (2010)
           $74,335
5 PCP
 80 Specialists
                                           173 PCP
                                           343 Specialists




               57 PCP
        104 Specialists

                                                         11 PCP
                                                         30 Specialists

SCCIPA
 founded in 1986
 physician-owned, physician-governed
 800+ physicians - 240+ PCPs, 550+ specialists
 all 9 hospitals - including a tertiary care center
 9 health plans (Commercial and Medicare Advantage)
from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
hosspital
discharge
                 IPA
               onsite
                           hospitalist    hospitalist     Rx     discharge
                                                                instructions

                case
 planner      manager



      hospitalist
                             Rx
                                            discharge
                                           instructions     family




      patient              patient        patient           patient




                                         outpatient
 discharge              medication       physician        discharge
 planning               reconciliation   follow-up




            thepatientjourney
hosspital
discharge
                 IPA
               onsite
                           hospitalist    hospitalist     Rx     discharge
                                                                instructions

                case
 planner      manager



      hospitalist
                             Rx
                                            discharge
                                           instructions     family




      patient              patient        patient           patient




                                         outpatient
 discharge              medication       physician        discharge
 planning               reconciliation   follow-up




            thepatientjourney
hosspital
discharge
                 IPA
               onsite
                           hospitalist    hospitalist     Rx     discharge
                                                                instructions

                case
 planner      manager



      hospitalist
                             Rx
                                            discharge
                                           instructions     family




      patient              patient        patient           patient




                                         outpatient
 discharge              medication       physician        discharge
 planning               reconciliation   follow-up




            thepatientjourney
from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
brainstorm
hosspital
discharge
                 IPA
               onsite
                           hospitalist    hospitalist     Rx     discharge
                                                                instructions

                case
 planner      manager



      hospitalist
                             Rx
                                            discharge
                                           instructions     family




      patient              patient        patient           patient




                                         outpatient
 discharge              medication       physician        discharge
 planning               reconciliation   follow-up




            thepatientjourney
hosspital
discharge
                 IPA
               onsite
                           pharmacist     hospitalist     Rx     discharge
                                                                instructions

                case
 planner      manager



      hospitalist
                             Rx
                                            discharge
                                           instructions     family




      patient              patient        patient           patient




                                         outpatient
 discharge              medication       physician        discharge
 planning               reconciliation   follow-up




            thepatientjourney
put hot triggers
 in the path of
motivated people
                             BJ Fogg, PhD
      Director, Persuasive Technology Lab
                        Stanford University
Santa Clara County IPA (SCCIPA)
Medication Reconciliation Pilot Project
     How to find the medication list for patients using AccessExpress

1.   Go to the PPMSI AccessExpress provider portal
     (http://ppmsi.com/accessexpress.html):




2.   Select Santa Clara County IPA:




3.   Enter USER NAME and PASSWORD, click on “SUBMIT”:
Your   SCCIPA doctor wants to help you with
your medications, after you leave the hospital.
                                      Michael Lam, RPh
                                      pharmacist

                                      Samaritan Medical
                                      Center Pharmacy
                                      2505 Samaritan Drive
                                      San Jose, CA
                                      (408) 356-7111

Please visit the Samaritan Medical Center Pharmacy to pick up
your new prescriptions and have a pharmacist review your
medications with you.
                                                          SCCIPA
                                            A Pacific Partners Medical Group
from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
it’saboutthepatient
thankyou
wpan@ppmsi.com
Bringing patient centered health care to the patient by integrating retail pharmacy v2

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Bringing patient centered health care to the patient by integrating retail pharmacy v2

  • 1. Bringing Patient-Centered Health Care to the Patient by Integrating Retail Pharmacy Wayne Pan, MD, MBA, Chief Medical Officer The Individual Practice Association Medical Group of Santa Clara County Inc. (SCCIPA) The National Medical Home Summit West • September 20-22, 2011 • San Francisco
  • 3.
  • 6. too many of these
  • 8.
  • 9.
  • 10. direction • focus on the patient • fix processes first • empower providers and the care team • clinical must lead technology initiatives • focus on the patient
  • 11.
  • 12. source: SF Jencks et al., Rehospitalizations among Patients in the Medicare Fee-for-Service Program, New England Journal of Medicine, 2009;360:1418-28.
  • 13. $17B source: SF Jencks et al., Rehospitalizations among Patients in the Medicare Fee-for-Service Program, New England Journal of Medicine, 2009;360:1418-28.
  • 14. from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)
  • 15. from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)
  • 16. ? from: Dan Roam, American Healthcare - a 4 napkin explanation (2009)
  • 17.
  • 20. big C peopleprocessesplatform
  • 23. n ew V a waywedothings
  • 24. why?
  • 25. what got you here marshall goldsmith
  • 26. won't get you there marshall goldsmith
  • 27. how?
  • 28. insanity: doing the same thing over and over and expecting different results
  • 29. get out of the rut?
  • 31. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 33. put hot triggers in the path of motivated people BJ Fogg, PhD Director, Persuasive Technology Lab Stanford University
  • 34. work with humannature BJ Fogg, PhD Director, Persuasive Technology Lab Stanford University
  • 35. lazysocialhabits BJ Fogg, PhD Director, Persuasive Technology Lab Stanford University
  • 39. Santa Clara County 1,304.01 sq. miles 1,781,642 (2010) $74,335
  • 40. 5 PCP 80 Specialists 173 PCP 343 Specialists 57 PCP 104 Specialists 11 PCP 30 Specialists SCCIPA founded in 1986 physician-owned, physician-governed 800+ physicians - 240+ PCPs, 550+ specialists all 9 hospitals - including a tertiary care center 9 health plans (Commercial and Medicare Advantage)
  • 41. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 42. hosspital discharge IPA onsite hospitalist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 43. hosspital discharge IPA onsite hospitalist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 44. hosspital discharge IPA onsite hospitalist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 45. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 47.
  • 48. hosspital discharge IPA onsite hospitalist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 49. hosspital discharge IPA onsite pharmacist hospitalist Rx discharge instructions case planner manager hospitalist Rx discharge instructions family patient patient patient patient outpatient discharge medication physician discharge planning reconciliation follow-up thepatientjourney
  • 50. put hot triggers in the path of motivated people BJ Fogg, PhD Director, Persuasive Technology Lab Stanford University
  • 51.
  • 52.
  • 53.
  • 54. Santa Clara County IPA (SCCIPA) Medication Reconciliation Pilot Project How to find the medication list for patients using AccessExpress 1. Go to the PPMSI AccessExpress provider portal (http://ppmsi.com/accessexpress.html): 2. Select Santa Clara County IPA: 3. Enter USER NAME and PASSWORD, click on “SUBMIT”:
  • 55.
  • 56. Your SCCIPA doctor wants to help you with your medications, after you leave the hospital. Michael Lam, RPh pharmacist Samaritan Medical Center Pharmacy 2505 Samaritan Drive San Jose, CA (408) 356-7111 Please visit the Samaritan Medical Center Pharmacy to pick up your new prescriptions and have a pharmacist review your medications with you. SCCIPA A Pacific Partners Medical Group
  • 57. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)