Innovations in Hypertension Control pt. 1.mp4
Innovations in Hypertension Control pt. 1.mp4
Innovations in Hypertension Control Mini-Series Pt. 1- Team Based Care \u0026 the Role of Pharmacists in Hypertension Control featuring Dr. Annie Eisenbeis, PharmD, Missouri Pharmacy Association. This virtual workshop series was developed in collaboration with the American Heart Association, HQIN (Health Quality Innovation Network) and Missouri Dept. of Health \u0026 Senior Services.
Content
167.49 -> Rachelle Bartnick: Welcome everyone glad you are with us today, good afternoon, it is my pleasure to bring today's event as we celebrate hypertension education awareness month.
181.05 -> Rachelle Bartnick: And we're kicking off our innovations in the hypertension control mini series, my name is Rochelle Bart Nick and i'm the senior director of Community impact for the American heart association.
192.09 -> Rachelle Bartnick: serving the St Louis region and out state Missouri that over recent years, the American heart association and our partners in.
201.63 -> Rachelle Bartnick: The Missouri Department of Health and senior services or million hearts partners and others have put a spotlight.
207.69 -> Rachelle Bartnick: On the importance of managing hypertension, you through convenes workshops and symposia and we're excited to bring this workshop to you today i'd like to invite Chris Palmer field from the Missouri Department of Health and senior services to say a few words and welcome as well, Chris.
225.66 -> Kris Kummerfield: Thank you Rochelle.
227.76 -> Kris Kummerfield: few words about hypertension education month may is hypertension education month and is recognized by CDC and the national heart lung and blood institute the virtual workshop series is a collaboration of the American heart association.
246.6 -> Kris Kummerfield: Health quality innovators and the Missouri Department of Health and senior services three partners of the Missouri million hearts partnership, of course, there are many ways to lower blood pressure and we will highlight three promising innovations in hypertension control.
267.78 -> Kris Kummerfield: Each of the programs in the miniseries establishes an emphasis on improving the quality of hypertension for patients, thanks to all of our attendees for tuning in today Rochelle I turn this back to you.
287.04 -> Rachelle Bartnick: Great Thank you so much, and I do appreciate the collaboration in bringing this workshop together, we do have a couple of tips on ways to make your zoom experience positive on your screen now as a way to control your view.
308.37 -> Rachelle Bartnick: There are some tips on your viewing options, so at the top, are your viewing options, you can exit the full screen and then make sure your view is set to cal gallery view.
319.53 -> Rachelle Bartnick: And side by side mode, you can also control your speakers, as well as use the slide bar to determine the the viewing viewing scale and preference.
331.65 -> Rachelle Bartnick: And next we invite you to engage with us in throughout this conversation throughout this workshop, and please use the comment box or the chat box to to provide your comments.
343.38 -> Rachelle Bartnick: You can set it now for when we get to the Q amp a section to all panelists and attendees and if you'd like to go ahead and tell us where you're turning tuning in from you can make sure, then, then that that chat box is set up correctly.
364.23 -> Rachelle Bartnick: Alright, well, I am really excited to to introduce our featured presenter Dr any eyes advice.
372.72 -> Rachelle Bartnick: He has a practicing pharmacist their family owned pharmacy in rural sinful mystery, and as the director of product development was very pharmacy association.
381.36 -> Rachelle Bartnick: and her current role, she is involved in strategizing preparing and implementing successful and sustainable programs to enhance the quality of care and improve access for all patients through innovative grant projects.
394.14 -> Rachelle Bartnick: Currently she's working on pilot projects involving remote physiological monitoring of blood pressure.
400.38 -> Rachelle Bartnick: A pharmacist the pharmacist collaboration through shared ehr and education and training opportunities for pharmacists and billing is an sustainability of all programs.
410.1 -> Rachelle Bartnick: That are I sent by serves as the Vice President of the Missouri immunization coalition and was appointed to the substance abuse advisory Commission for the city of Columbia, I also love to be able to share unique.
422.88 -> Rachelle Bartnick: attributes of our presenters and she has a unique talent, she is a certified Irish dance instructor and owns the only Irish dance studio in central Missouri, thank you for being here today, Dr eyes and bias welcome.
436.59 -> Dr. Annie Eisenbeis: Thank you.
440.37 -> Dr. Annie Eisenbeis: All right, I am really excited to share with you all and kind of promote the role of the pharmacist, as I am still a practicing pharmacist and, in addition to my role as the director of practice development at MPA.
454.71 -> Dr. Annie Eisenbeis: The Missouri pharmacy association so just kind of a little bit more on my background and what will cover today.
461.52 -> Dr. Annie Eisenbeis: And i'm also like I said a practicing pharmacist at a family owned Community pharmacy and rural central Missouri and then I did start a consulting business enhanced care consulting specifically.
474.33 -> Dr. Annie Eisenbeis: Looking at and focusing on utilizing pharmacist and pharmacy teams in public health initiatives and increasing access to care for patients, so today we'll just cover some basic.
488.61 -> Dr. Annie Eisenbeis: and innovative things that involve pharmacist, so the surgeon general's call to action to control, hypertension.
495.3 -> Dr. Annie Eisenbeis: team based care approach and the pharmacist impact and then challenges and opportunities for involving pharmacists on your health care team.
502.68 -> Dr. Annie Eisenbeis: And for any pharmacist on today, I will be preaching to the choir a little bit for you guys, but hopefully I do I do a good job, promoting why pharmacists should be included.
514.74 -> Dr. Annie Eisenbeis: And the impact that we can have.
518.04 -> Dr. Annie Eisenbeis: All right, so diving in less about me and the US does spend as much money correcting the problems caused by medications as we do on the drugs themselves, and when I read this statement, and it really stood out to me.
533.82 -> Dr. Annie Eisenbeis: As just kind of looking at how much we spend on drugs, we all know, it's crazy, but then, looking at the problems related to those medications as well, so.
543.33 -> Dr. Annie Eisenbeis: The Congressional Budget Office actually estimates that spending on medicare part D, as in as in drug.
550.14 -> Dr. Annie Eisenbeis: benefits will total $96 billion in 2021 so this year alone, just on the medications not the medication related problems, but we'll be spending $96 billion and that's just with medicare so that doesn't involve medicaid and commercial insurance plans as well.
569.43 -> Dr. Annie Eisenbeis: All right, but in my opinion, money isn't really The biggest problem we have some real problems affecting patients and patient health in our communities that are bigger than money.
581.13 -> Dr. Annie Eisenbeis: So patient involvement and access to care, this is also incredibly important when you're looking at the role of the pharmacist, specifically in Community pharmacy.
591.33 -> Dr. Annie Eisenbeis: Because 90% of Americans live within only five miles of the Community pharmacy so when you're talking about increasing access to care, I think, top of mine should be that statistic that nine out of 10 Americans are within those five miles.
607.68 -> Dr. Annie Eisenbeis: And so, looking at as well in that increased access to care, you have provider time and reimbursement.
614.34 -> Dr. Annie Eisenbeis: Being an issue as far as your your reimbursement is drinking and your time is as well there aren't enough hours in the day to sit and speak with every patient and educate and counsel on everything that you could possibly think of to keep that patient healthier.
629.67 -> Dr. Annie Eisenbeis: So I want pharmacists to really be seen as.
634.32 -> Dr. Annie Eisenbeis: An extender of those those healthcare interactions.
639.75 -> Dr. Annie Eisenbeis: And then, education is not just for the patient so education is also an issue and just understanding when we talk about team based care what each member of the team can bring to the table so recently I helped with a.
656.52 -> Dr. Annie Eisenbeis: professional education Center at the College of pharmacy in St Louis and we involved several different specialties as far as nursing students md our.
667.29 -> Dr. Annie Eisenbeis: medical students ot PT PA students and pharmacy students as well, and we brought them all together, and when I mentioned.
676.53 -> Dr. Annie Eisenbeis: Certain elements or roles that the pharmacist can play it's always interesting to me that other healthcare professionals don't learn.
684.69 -> Dr. Annie Eisenbeis: about the teammates and TEAM members on their team, and so what we can bring to the table, not just as pharmacist, but also understanding what all of the elements and professionals bring to that team.
696.48 -> Dr. Annie Eisenbeis: And then navigating the system so here's where I think a real large problem exists is that our healthcare system is so complex that sometimes.
709.47 -> Dr. Annie Eisenbeis: pharmacists and other healthcare professionals even need help navigating it So how do we expect a patient who's not a healthcare professional to navigate that system.
719.31 -> Dr. Annie Eisenbeis: So just a patient understanding what's covered whether a deductible or a copay or a premium and what's the difference what's next for their care and what options are there for their care.
729.96 -> Dr. Annie Eisenbeis: So these are all areas that pharmacists, can play a role in but they're also issues that have kind of a bigger need, as far as needing to be addressed as a team based care approach.
743.85 -> Dr. Annie Eisenbeis: So now diving into the surgeon general's call to action to control, hypertension and this was especially near and dear to my heart, since it does call to action to utilize team based care approaches, including pharmacist.
758.7 -> Dr. Annie Eisenbeis: So i'm just going to kind of read my favorite blurb from it.
762.42 -> Dr. Annie Eisenbeis: That pharmacy should not simply be considered a way to distribute medication and pharmacists have known this for a long time our reimbursement on medications sometimes is less.
772.74 -> Dr. Annie Eisenbeis: than the patient, then we're purchasing the medication for so in some instances, with fees that come out of the back end from the pharmacy benefit managers, the pharmacy is losing money when they dispense medications.
787.05 -> Dr. Annie Eisenbeis: And so Community based pharmacist can support, hypertension management in meaningful ways, including being integral members of care teams through collaborative practice agreements which i'll talk about in a little bit.
798.48 -> Dr. Annie Eisenbeis: with local health care practices and health systems, they can provide medication therapy management services to reconcile medication regimens.
807.21 -> Dr. Annie Eisenbeis: Support adherence and recommend or make adjustments to medications to help patients lower their blood pressure and, ultimately, I don't think this is.
817.38 -> Dr. Annie Eisenbeis: necessarily specific to hypertension or blood pressure control, this is just an area where the surgeon general saw a big impact for pharmacy and pharmacists to be involved.
829.74 -> Dr. Annie Eisenbeis: So, looking at the comprehensive hypertension treatment protocol mentioned in the surgeon general's call to action I kind of question where could a pharmacist have an impact.
839.37 -> Dr. Annie Eisenbeis: And when I was looking at these elements I was going to put arrows on each one that a pharmacist could have an impact on but.
845.79 -> Dr. Annie Eisenbeis: It would have been covering the screen, because every element can involve a pharmacist so when you're looking at educating a patient on accurate VP measurements are optimal targets.
856.68 -> Dr. Annie Eisenbeis: That is self monitored blood pressure, which were already used utilizing pharmacist for in looking at the.
864.18 -> Dr. Annie Eisenbeis: cardiovascular disease risk calculation, we learned that in pharmacy school we're already doing that.
870.03 -> Dr. Annie Eisenbeis: The team based care approach is what we're here talking about today and on and on across the wheel of the treatment protocol are all medication and nonfarm therapies so.
881.88 -> Dr. Annie Eisenbeis: That was another element that we have extensive training in is non pharmacological therapies so even though i'm a pharmacist.
890.46 -> Dr. Annie Eisenbeis: And I actually personally don't enjoy taking medications and and I don't think i'm alone in that most of my patients don't enjoy taking medications as well.
899.88 -> Dr. Annie Eisenbeis: So I think that's also again where that education component and counseling component come into play.
905.85 -> Dr. Annie Eisenbeis: So I know most states have laws on the books that are similar to those in Missouri related to patient counseling.
912.03 -> Dr. Annie Eisenbeis: So in Missouri were required as pharmacist by law to offer counseling to every patient whether it's a new or refilled prescription.
919.8 -> Dr. Annie Eisenbeis: In other states like iowa they're actually required to counsel, not just offer counseling to patients on new and refill prescriptions.
927.42 -> Dr. Annie Eisenbeis: And so, this is an integral part of when you go to the pharmacy hopefully in Missouri every pharmacist or pharmacy technician who checks you out when you're picking up your medications asks do you have any questions for the pharmacist.
941.4 -> Dr. Annie Eisenbeis: And then my my quote here is that drugs don't work in patients who don't take them.
946.83 -> Dr. Annie Eisenbeis: So as a pharmacist again counseling just on the basics of why you're taking that medication.
952.38 -> Dr. Annie Eisenbeis: Because again we don't enjoy taking medication it's not something that you know i'd want to pick up as a hobby even as a pharmacist i'm not enjoying taking ibuprofen even when I have a headache so.
963.63 -> Dr. Annie Eisenbeis: understanding that patients are kind of in the same boat and are not excited about taking those medications and they obviously can't work and help control blood pressure or diabetes, etc, if they don't take them and take them as prescribed.
981.45 -> Dr. Annie Eisenbeis: So did you know i'm just kind of going to go through some basic facts about pharmacists.
987.03 -> Dr. Annie Eisenbeis: To date, and mainly because these are sometimes not well understood, so the education that a pharmacist gets now is a doctor to pharmacy so it's six to seven years to.
1000.62 -> Dr. Annie Eisenbeis: become a pharmacist and get that doctor to pharmacy with extensive training and medication therapy.
1007.04 -> Dr. Annie Eisenbeis: Even diagnosing to understand the appropriate medication that goes along with that disease and chronic disease state.
1013.13 -> Dr. Annie Eisenbeis: And, and then again non pharmacological therapy extensive knowledge of patient counseling and education so we're specifically trained in how to.
1022.22 -> Dr. Annie Eisenbeis: Talk to a lay person who doesn't maybe have a high high health literacy value to educate them on how to take medications and and kind of navigate that healthcare system that is so complex that I mentioned previously.
1036.41 -> Dr. Annie Eisenbeis: Another important aspect of pharmacy is that we're in all healthcare settings and not just healthcare settings so we're in the Community we're in the health systems, as far as Inpatient and outpatient.
1048.11 -> Dr. Annie Eisenbeis: So there are several pharmacies on teams or pharmacist on teams that are not based in the pharmacy they never actually pick up a prescription bottle unless it's counseling and medication to counseling on a medication to a patient.
1062.48 -> Dr. Annie Eisenbeis: There, a pharmacist involved in ambulatory care clinics and primary care offices there's long term care pharmacists and then, of course, industry and research is a big component, especially when you're talking about medications.
1074.99 -> Dr. Annie Eisenbeis: And then I mentioned previously, that there are collaborative practice agreements, but I think something that's somewhat overlooked is clinical service agreements.
1084.29 -> Dr. Annie Eisenbeis: And so kind of looking at what is the difference between a collaborative practice agreement and the clinical service agreement.
1091.04 -> Dr. Annie Eisenbeis: So, pharmacists right now federally do not have what's known as provider status so we're not able to bill medicare Part B, as in boy or any medical claims.
1102.86 -> Dr. Annie Eisenbeis: outside of the dispensing workflow for services that we may provide or interventions for patients.
1109.25 -> Dr. Annie Eisenbeis: However, under a collaborative practice agreement pharmacists can modify therapy have some additional.
1116.6 -> Dr. Annie Eisenbeis: services that they can provide as an extender of that primary care healthcare professional.
1122.3 -> Dr. Annie Eisenbeis: And then, with that is again that's if you're going to look at therapies and modify potentially discontinue change, etc, based on what's in that Protocol or practice agreement.
1134.21 -> Dr. Annie Eisenbeis: Then there's a clinical service agreement, and these are a little less extensive because pharmacists are strictly just monitoring the therapy and making recommendations versus modifying any therapy changes.
1146.54 -> Dr. Annie Eisenbeis: So, looking at medication optimization and what is best for which patients and collaborative practice agreements are kind of the way to go, if you're wanting a pharmacist have an impact on that medication therapy.
1161.27 -> Dr. Annie Eisenbeis: But clinical service agreements can allow pharmacist to still bill for services and be an extender without having to change anything in the patient's therapy without recommending and discussing it with their prescriber.
1174.2 -> Dr. Annie Eisenbeis: So I also recommend looking into clinical service agreements with a pharmacist if you're wanting to add them to your health care team and aren't quite ready to go that Protocol or practice agreement route.
1188.12 -> Dr. Annie Eisenbeis: and pharmacists did come together several years ago and created the pharmacist patient centered care process.
1195.29 -> Dr. Annie Eisenbeis: It was again somewhat of a misunderstanding that pharmacists are only involved in dispensing medications.
1201.59 -> Dr. Annie Eisenbeis: Really, when a pharmacist even is involved in the dispensing workflow at a pharmacy they're not the ones counting the pills and putting them in the bottles.
1209.78 -> Dr. Annie Eisenbeis: They are actually looking at you know, is it right dose right time right route right patient, etc.
1216.35 -> Dr. Annie Eisenbeis: and making sure there are no drug interactions no allergy interactions no disease drug interactions.
1222.17 -> Dr. Annie Eisenbeis: etc, and all of this within kind of a two to five minute span without needing additional follow up so if it is indeed the right and appropriate medication for that patient they kind of go through this list in their head.
1236.6 -> Dr. Annie Eisenbeis: of everything that is involved in making sure that that's the case.
1240.65 -> Dr. Annie Eisenbeis: So here is the patient centered care approach and this is where we really want to be involved in the services counseling and education of our patients.
1249.23 -> Dr. Annie Eisenbeis: And this is kind of what we follow as pharmacist it's taught in school and beyond, and continuously comes up but there's some things that I do want to point out and that's the collaborate and communicate in that Center.
1261.77 -> Dr. Annie Eisenbeis: So collaboration and communication are key, especially when you look at a pharmacist in relation to the team based care approach so as a pharmacy especially a Community pharmacy we are a hub for patient health information.
1277.79 -> Dr. Annie Eisenbeis: So when I say a hub for patient health information, I mean that everyone feeds into the pharmacy as long as the patient is utilizing one pharmacy which is highly recommended.
1287.81 -> Dr. Annie Eisenbeis: Because of this element, all of the prescriptions that are coming in, whether they're from the emergency room urgent care their primary care prescriber.
1299.63 -> Dr. Annie Eisenbeis: Any specialist they may see such as an endocrinologist or cardiologist are coming into the pharmacy now whether those have necessarily lab values associated with them or diagnosis codes.
1312.32 -> Dr. Annie Eisenbeis: That would be preferred but aren't always included in that script However, sometimes and often actually pharmacist will find potential drug interactions or a reason that a patient shouldn't be on a certain medication.
1326.75 -> Dr. Annie Eisenbeis: or potential for not needing that medication, for whatever reason, and.
1331.28 -> Dr. Annie Eisenbeis: Because they are that hub of health information they can see that you know the same medication was prescribed by the cardiologist as the primary care provider.
1339.02 -> Dr. Annie Eisenbeis: And having a note to say you know the patient's not going to know that they're taking lisinopril versus lisinopril with hydrochloric biocide and that those are two similar medications just kind of overlapping or duplicative therapy.
1352.97 -> Dr. Annie Eisenbeis: And they're going to see it as you know, this one effects this and this one effects something else versus both having an effect that wasn't necessarily intended.
1363.05 -> Dr. Annie Eisenbeis: And then we also have multiple touch points with our patients per year so i'll jump into that on the next slide which really hits home for that one.
1371.33 -> Dr. Annie Eisenbeis: And then again just tying in that collaboration with other healthcare professionals, because we see ourselves as the hub of patient health information.
1379.88 -> Dr. Annie Eisenbeis: And that final stop of safety and efficacy and education before the patient goes home and is then sent off to take care of their own health.
1390.59 -> Dr. Annie Eisenbeis: and medication use that is really, really important to pharmacy is that collaboration and communication.
1400.01 -> Dr. Annie Eisenbeis: And so, looking at the team based care of approach put into perspective so when I mentioned that you see your you have multiple patient touch points with the pharmacist.
1410.75 -> Dr. Annie Eisenbeis: I meant that, as almost 10 times more than you might have with your primary care providers so complex patients, those that utilize the most of our health care dollars and have the multiple comorbidities.
1422.66 -> Dr. Annie Eisenbeis: On several medications with chronic disease comorbidities as well see their Community pharmacists on average 35 times per year, and these same complex patients see their primary care provider and average of two to four times per year so again that's almost a 10 times difference.
1443.51 -> Dr. Annie Eisenbeis: In how often you see your pharmacist versus your primary care provider, and this is where again pharmacists can be primary care provider extenders so I recently graduated with my MBA and one of the.
1459.35 -> Dr. Annie Eisenbeis: classes entrepreneurship required or requested that we write a paper on a new idea and honestly when I was thinking of this new idea I was really surprised that it's not already in practice.
1474.23 -> Dr. Annie Eisenbeis: So my idea was you know we have primary care providers and because pharmacist don't have provider status we can't bill for that kind of service, but why is there not a primary care pharmacist, especially when you look at this statistic of seeing them 10 times more a year.
1490.64 -> Dr. Annie Eisenbeis: or sorry 25 to 30 times more per year 10 times more than your primary care provider there really should be a PCP and a PC farm on every patient steam.
1503.78 -> Dr. Annie Eisenbeis: And then, this is where I also want to dive into the Community preventive services Task Force recommendations that have recently.
1511.19 -> Dr. Annie Eisenbeis: In the last several years really involved patient care team based approaches and involving pharmacists so there's two specific ones that I wanted to point out.
1522.2 -> Dr. Annie Eisenbeis: One is on cardiovascular disease, specifically and it's pharmacy based medication adherence interventions.
1529.25 -> Dr. Annie Eisenbeis: And with that the summary of the recommendation was that tailored pharmacy based adherence interventions for cardiovascular disease prevention are recommended.
1540.38 -> Dr. Annie Eisenbeis: The CPS tf also finds these interventions are cost effective for cardiovascular disease prevention, and so it mentions this tailored pharmacy based interventions.
1551.6 -> Dr. Annie Eisenbeis: which aim to help patients who are at risk, take their medications as prescribed so we mentioned before, drugs don't work and people who don't take them.
1559.91 -> Dr. Annie Eisenbeis: But there's also opportunities here when you mentioned tailored pharmacy based interventions and i'll talk about that in some of the opportunities, as well as barriers to pharmacists services.
1571.85 -> Dr. Annie Eisenbeis: The second CPS tf recommendation is that team based care should be utilized to control type two diabetes as well, so team based care for diabetes management, which I thought was related.
1584.78 -> Dr. Annie Eisenbeis: To the hypertension, control and blood pressure, just because those two chronic diseases go hand in hand.
1591.71 -> Dr. Annie Eisenbeis: But one of the major findings of this recommendation was that adding either a nurse or pharmacist lead to improve diabetes related outcomes.
1600.38 -> Dr. Annie Eisenbeis: and pharmacists are generally less thought of as far as adding to the team based care of the nurses, but it also found that teams, with a pharmacist.
1608.84 -> Dr. Annie Eisenbeis: produced greater reductions in patient blood glucose levels and my mom's a nurse so nothing against nurses, I think you all are heroes and saints.
1617.72 -> Dr. Annie Eisenbeis: But when you add a pharmacist to the team, we can have an impact is all that i'm wanting to kind of hit home with that is improving diabetes related outcomes, as well as blood pressure related outcomes, or you can add a pharmacist to behavioral health teams asthma COPD etc.
1636.8 -> Dr. Annie Eisenbeis: So here i'm going to dive into the opportunities for involving a pharmacist on the team and there's a lot of words on the screen so i'm kind of going to go through each one just to explain what.
1647.09 -> Dr. Annie Eisenbeis: The opportunity is and why it should be included.
1650.51 -> Dr. Annie Eisenbeis: So I lumped together chronic care management remote physiological monitoring and transitions of care management, mainly because these are all opportunities for that clinical service agreement with a provider and a pharmacist.
1665.15 -> Dr. Annie Eisenbeis: To be able to bill for additional services under medicare Part B, as in boy so under the medical billing separate from the pharmacy drug benefits.
1674.78 -> Dr. Annie Eisenbeis: pharmacists can build for services outside of dispensing so all of these do not require any changes in therapy, so if a patient's on a blood pressure medication and they're getting chronic care management for their hypertension control.
1692.12 -> Dr. Annie Eisenbeis: Nothing needs to change in their therapy or the pharmacist doesn't need to have access or a collaborative practice agreement to be able to make those changes.
1699.98 -> Dr. Annie Eisenbeis: They just need to be working with a clinical service agreement with a provider who has an NPI that's able to bill medicare Part B.
1707.63 -> Dr. Annie Eisenbeis: And then remote physiological monitoring is very similar and transitions of care management as well, in that the pharmacist can't build for it themselves so they need to have an agreement to perform clinical services with another provider under their NPI for billing purposes, mainly.
1727.43 -> Dr. Annie Eisenbeis: And so, with remote physiological monitoring we actually.
1730.64 -> Dr. Annie Eisenbeis: have taken that as our next step from self monitored blood pressure so after we teach and educate the patients on self monitored blood pressure and all of the elements that go with that.
1740.96 -> Dr. Annie Eisenbeis: we're actually looking at programs and projects involving pharmacists, specifically in remote physiological monitoring and blood pressure.
1748.31 -> Dr. Annie Eisenbeis: So, this would be where a patient receives a blood pressure, monitor that bri ascends real time data to a platform that the pharmacist and.
1756.62 -> Dr. Annie Eisenbeis: The the primary care physician would have access to and the pharmacist is mainly looking at that for any changes in blood pressure, high or low and then following up with the patient to see if it's something that needs to be referred to the physician.
1774.29 -> Dr. Annie Eisenbeis: And this is really interesting when you're looking at continuous monitoring and looking at educating patients as needed threw out the the time span of in between their primary care visits.
1788.54 -> Dr. Annie Eisenbeis: So this is again, where the pharmacist really can have an impact, when you're seeing them so many more times, even in person, but this can be telephonically as well.
1798.08 -> Dr. Annie Eisenbeis: And then transitions of care management, I feel like transitions of care has been a hot topic that still is kind of not been addressed.
1806.09 -> Dr. Annie Eisenbeis: But it's an opportunity for pharmacists to be involved, and when you look at all of the healthcare settings that involve pharmacist from the er to the health system, the.
1815.87 -> Dr. Annie Eisenbeis: Inpatient versus outpatient and then the Community pharmacist as well, or the long term care or rehab facility.
1823.79 -> Dr. Annie Eisenbeis: that's where pharmacist really can have an impact, because you can not only have collaboration and communication between various health care professionals.
1832.28 -> Dr. Annie Eisenbeis: But we've looked at projects and programs involving clinic based pharmacy and pharmacists looking and connecting with Community based pharmacist as well.
1842.63 -> Dr. Annie Eisenbeis: So sometimes it's been difficult to connect a Community pharmacy with a health system, for example, just because of the IT and technology barriers associated with sharing ehr.
1854.93 -> Dr. Annie Eisenbeis: So instead we've kind of gone the route of well pharmacists already know what pharmacists, are doing in both settings so we'll connect there and have a bigger impact.
1864.71 -> Dr. Annie Eisenbeis: and better communication potentially just because we aren't necessarily having access to that ehr.
1871.49 -> Dr. Annie Eisenbeis: And so that's where the clinic based and community based pharmacy program kind of grew out of this transitions of care management approach.
1880.13 -> Dr. Annie Eisenbeis: And then, with diabetes education self monitor blood pressure and smoking cessation counseling I consider all of these kind of in that bucket of education and counseling that pharmacists are.
1891.17 -> Dr. Annie Eisenbeis: really well trained in bringing down to the patient level and then bringing it back up and having that communication and collaboration with the provider so with diabetes education.
1901.67 -> Dr. Annie Eisenbeis: This is an opportunity for pharmacies to become accredited through at CES or Ada.
1907.49 -> Dr. Annie Eisenbeis: To provide these education classes for patients again we've looked at self monitor blood pressure, education and taking that to the next level with remote physiological monitoring.
1917.99 -> Dr. Annie Eisenbeis: And then something unique to Missouri actually is that they're not unique to Missouri but that just passed in Missouri is that we can prescribe nrt therapy for or nicotine replacement therapy for patients.
1933.26 -> Dr. Annie Eisenbeis: outside of chantix and I ban for patients who, especially for patients, for example on medicaid were over the counters would be covered if they had a prescription.
1943.73 -> Dr. Annie Eisenbeis: And so we can write that prescription now for them to get it covered so that they're not having to pay out of pocket for somewhat expensive medications.
1951.92 -> Dr. Annie Eisenbeis: Even though they're over the counter and then we can provide that smoking cessation counseling so kind of going along with receiving an over the counter smoking cessation product or medication.
1964.16 -> Dr. Annie Eisenbeis: It really requires a village to quit smoking, so it also needs that counseling holding the patient accountable following up and monitoring them and their therapy.
1974.18 -> Dr. Annie Eisenbeis: And then medication optimization and comprehensive medication reviews, this is where, in my opinion, pharmacists really have an impact, and can shine unfortunately they kind of lumped comprehensive medication reviews under medicare part D, as in dog and recently.
1991.46 -> Dr. Annie Eisenbeis: Those are not recently started with those platforms that enable pharmacists to bill for medication therapy management, including the comprehensive medication reviews.
2001.09 -> Dr. Annie Eisenbeis: they're actually very retroactive so versus when a patient is non adherent to a medication for so many months, based on their film history.
2010.39 -> Dr. Annie Eisenbeis: So you know not picking up every 30 days for a 30 day medication, they may pick up a day 40 or 45.
2016.63 -> Dr. Annie Eisenbeis: consistently for three to six months, then they pop in for needing a comprehensive medication review or medication therapy management intervention.
2024.7 -> Dr. Annie Eisenbeis: To me that's a little too late, I think it should be a proactive approach to you know, a provider saying this patient is now on four or five medications let's have them sit down with a pharmacist for a see Mr.
2037.87 -> Dr. Annie Eisenbeis: and be able to address any issues, the patient may have with those medications in understanding how to take them not being willing to take them because they don't understand how it works or why they're taking it.
2048.4 -> Dr. Annie Eisenbeis: Understanding potential side effects, so they don't stop it early and then, when to what else to look out for and when to call their doctor as well.
2056.8 -> Dr. Annie Eisenbeis: So to me the proactive approach would be or would have a much bigger impact on saving healthcare dollars, improving patient outcomes and health benefits.
2067.51 -> Dr. Annie Eisenbeis: But unfortunately, where mtm has gone is under that retroactive approach now, I think, recently, a lot of providers and prescribers are looking at pharmacist to do these reviews.
2081.58 -> Dr. Annie Eisenbeis: For them outside of strictly pharmacist looking for them, but that's kind of where i'd like to see a pharmacist impact and utilizing that team based care approach is really thinking of the pharmacist first so if it's a medication related issue or they're on multiple medications etc.
2101.32 -> Dr. Annie Eisenbeis: Thinking of the pharmacist and how you know how do I send them how do I refer just like a pharmacist would refer to a physician, in certain instances.
2109.84 -> Dr. Annie Eisenbeis: or refer a patient to the er etc and i'd like other healthcare professionals to think of the pharmacist as a referral network as well, and then adherence counseling packaging and interventions so obviously patients are pharmacists are already doing a lot of adherence counseling.
2129.55 -> Dr. Annie Eisenbeis: But I wasn't aware of all of the opportunities and options for specific packaging and special interventions for patients who need additional adherence support.
2141.4 -> Dr. Annie Eisenbeis: So that packaging could include not only the bubble car the bubble cards that have like multiple medications per dose.
2148.63 -> Dr. Annie Eisenbeis: there's actually strips we we call them medication strips that have each dose.
2155.56 -> Dr. Annie Eisenbeis: per day in a package so, for example, if you were going out of town you don't need to take your 25 bubble cards or your one giant one with your medications in it.
2164.44 -> Dr. Annie Eisenbeis: You can actually just rip off the seven day doses, and then take that with you and still have the rest there, it also helps for caregivers.
2173.44 -> Dr. Annie Eisenbeis: to know if a patient took their dose that morning, they can see it because it's written right on the strip there.
2179.89 -> Dr. Annie Eisenbeis: So those are really unique packaging options for pharmacists and pharmacies, to have an impact on adherence and adherence counseling.
2188.05 -> Dr. Annie Eisenbeis: And I think along with those is if a patient is utilizing any specific adherence packaging referring them to that pharmacist for additional education and counseling.
2198.34 -> Dr. Annie Eisenbeis: I think it's it's an obvious thing to healthcare professionals, maybe to use a pharmacist on their team or to.
2205.57 -> Dr. Annie Eisenbeis: request or assume that the pharmacist is counseling it's not always as obvious to the public or patients.
2213.28 -> Dr. Annie Eisenbeis: So now patients who I mentioned previously, those complex co morbidity chronic disease patients who are on a lot of medications.
2220.51 -> Dr. Annie Eisenbeis: who attend and go to the pharmacy 35 times a year are more likely to ask their pharmacist for questions and know that the pharmacist can provide a lot of additional education and counseling for them, but you're.
2233.77 -> Dr. Annie Eisenbeis: you're kind of a typical less complex patient who may only go to the pharmacy you know 10 to 12 times a year for just that one you know monthly medication may not realize that their questions can be answered immediately and very accessible by a pharmacist.
2250.96 -> Dr. Annie Eisenbeis: And so, if a physician or another healthcare professional refers that patient to ask their pharmacist that really helps.
2260.77 -> Dr. Annie Eisenbeis: With navigating the health care team and promoting that team based care approach so i'm really big on developing referral networks.
2270.1 -> Dr. Annie Eisenbeis: Whether it's utilizing Community health workers to connect pharmacists pharmacy teams physicians nurses nurse practitioners anyone who's involved in that patients care.
2281.89 -> Dr. Annie Eisenbeis: really should be a part of a referral network and have kind of the go to people that they call or know who does what, on that team, I think it helps patients also navigate that healthcare system that's really complex in our in our society and in our country.
2299.83 -> Dr. Annie Eisenbeis: And so, letting a patient know exactly what to do and what to expect as far as you know, next steps, or what are their options for education and counseling and etc and services is really, really helpful and navigating that so kind of to go along with that.
2317.35 -> Dr. Annie Eisenbeis: That referral network and helping the patient navigate.
2321.01 -> Dr. Annie Eisenbeis: Even coming into a pharmacy for the first time I trained technicians, to let patients know that you know your medication won't be ready right away, it may take 10 to 15 minutes.
2331 -> Dr. Annie Eisenbeis: So, to have a seat, or else the patient ends up standing there and watching you the whole time and expecting it to be ready right away and that's mainly because.
2338.98 -> Dr. Annie Eisenbeis: it's not common sense the healthcare system is not common sense and patients don't understand how to navigate it even when going into a pharmacy where, as a pharmacist it's just second nature to me you drop your prescription off you sit down and you go pick it up after.
2354.49 -> Dr. Annie Eisenbeis: But it's not as common sense to somebody who's first time in a pharmacy it's their first time.
2362.89 -> Dr. Annie Eisenbeis: Alright, so jumping into barriers to pharmacy services these all have coins and money in the pictures because that's the biggest barrier, unfortunately, I mentioned that money isn't The biggest problem to our healthcare system, but it is a huge barrier to pharmacy services.
2381.88 -> Dr. Annie Eisenbeis: So when you're looking at barriers, especially with billing and reimbursement because we don't have provider status under the federal medicare and cms do not see us as providers.
2393.7 -> Dr. Annie Eisenbeis: We can't bill for services without a collaborative practice agreement or collect clinical service agreement so utilizing of providers NPI.
2403.33 -> Dr. Annie Eisenbeis: To me, I utilize the quotes over provider, because if you're providing services to me that makes you a provider, but just because the federal government doesn't see us that way.
2414.97 -> Dr. Annie Eisenbeis: we're not able to bill and so billing and reimbursement for pharmacy services, while we know that these services, according to CP St F and the.
2425.86 -> Dr. Annie Eisenbeis: surgeon general's call to action, we know that these services have an impact and save healthcare dollars, but we're not willing to spend them.
2433.69 -> Dr. Annie Eisenbeis: To prevent and promote utilizing a pharmacist on the team.
2438.16 -> Dr. Annie Eisenbeis: And then I included contracting and credentialing here, because our healthcare system separates out pharmacy benefits from medical benefits and services.
2446.89 -> Dr. Annie Eisenbeis: It makes it really difficult for pharmacists, who are able to provide services specifically based in their state scope of practice.
2455.2 -> Dr. Annie Eisenbeis: To get anywhere with commercial medicaid and medicare contracting.
2460.42 -> Dr. Annie Eisenbeis: So getting even your foot in the door to be able to bill for that service if you're allowed to in your state, for example, medicare allows pharmacies to.
2471.34 -> Dr. Annie Eisenbeis: bill for diabetes education as a site, because the site get can get accredited however pharmacies go through months worth of hoops and jumping through these hoops.
2484.3 -> Dr. Annie Eisenbeis: To just get a single contract to be able to build for these services if they get a contract at all, especially with commercial plans.
2493.48 -> Dr. Annie Eisenbeis: Because they get they get the run around, so what happens is a pharmacist will call them medical benefits for that patient want to get contracted to provide diabetes education with a referral from the physician.
2505.6 -> Dr. Annie Eisenbeis: or primary care provider and then they will get sent to the pharmacy benefits as their their next their next call so.
2514.42 -> Dr. Annie Eisenbeis: It kind of goes in this the circle of wanting to connect for medical benefits and getting sent to the pharmacy benefits.
2520.24 -> Dr. Annie Eisenbeis: pharmacy benefits that you can't send a diabetes education claim to us, you need to go to medical benefits and so just the lack of understanding and awareness of what pharmacist can build for in that healthcare insurance space so that's another barrier as well.
2538.3 -> Dr. Annie Eisenbeis: And then, my last slide is about how to make an impact so.
2543.82 -> Dr. Annie Eisenbeis: First and foremost, is a pharmacist on your healthcare team and, if not let's start there, or if it is.
2551.23 -> Dr. Annie Eisenbeis: If you can't add a pharmacist to your healthcare team, for whatever reason, I want you to think pharmacy.
2557.2 -> Dr. Annie Eisenbeis: So if it's a medication related problem or an education or counseling related problem, or you just need more time and extension of your services as a provider, I want you to think pharmacy.
2569.35 -> Dr. Annie Eisenbeis: If you need more patient care time again add a pharmacist, whether that's just referring the patient to their Community pharmacist.
2577.15 -> Dr. Annie Eisenbeis: It doesn't have to be within your clinic or within your building there's Community pharmacist within five miles of 90% of Americans, so you can refer their patient your patient to that pharmacist.
2589.36 -> Dr. Annie Eisenbeis: and the last thing is that we need advocates so pharmacy can shout from the top of the buildings and from the roof.
2597.58 -> Dr. Annie Eisenbeis: To promote pharmacist on the health care team and utilize us we're ready and accessible and we are the most underutilized accessible healthcare professionals, in my opinion.
2608.62 -> Dr. Annie Eisenbeis: But we need healthcare leadership champions, and so, whether that's to add a pharmacist on the team or to advocate to.
2617.89 -> Dr. Annie Eisenbeis: professionals and legislators as well, so non healthcare related advocacy as well and I don't mean necessarily politically I, although I do have somewhat of a political advocacy role at the pharmacy association it's more so about patient care.
2636.52 -> Dr. Annie Eisenbeis: Just to increase access and quality for patients, but again, pharmacists saying that you need to add pharmacist to this service or billing code or whatever it may be isn't as valuable as a healthcare team coming together and saying this is what we need for our patients.
2654.7 -> Dr. Annie Eisenbeis: In the best interest of our patients so again, if I can reiterate anything I want you to think of pharmacy have kind of this bidirectional referral process.
2665.29 -> Dr. Annie Eisenbeis: Allow pharmacy to have access to your ehr and have clinical start improving clinical service agreements or collaborative practice agreements.
2675.31 -> Dr. Annie Eisenbeis: I mentioned the ehr i'm going to jump on that just for for a quick second and pharmacy software and health system or health clinic ehr are a little bit different they don't necessarily interact very well.
2689.29 -> Dr. Annie Eisenbeis: pharmacists are actively trying to change that with e care planning or electronic care plans that they can send through their pharmacy software to an ehr that can be uploaded.
2701.05 -> Dr. Annie Eisenbeis: But I think the best avenue for again having that hub of patient health information is allowing access to an ehr it could be limited access, it can be even as simple if they can't have access to your ehr because they have to jump through the red tape of bureaucracy.
2719.77 -> Dr. Annie Eisenbeis: Look lab having sharing those lab values for a pharmacist, for your patience, so if it's on their hypertension sending the lab values of what were their last couple blood pressure readings.
2732.19 -> Dr. Annie Eisenbeis: or even if you have a question related to a medication as a healthcare professional think pharmacy call your Community pharmacists they're just as accessible to healthcare professionals, as they are to patients.
2744.07 -> Dr. Annie Eisenbeis: Because, as pharmacist we love sharing our knowledge, we went to school for a long time, too, so we are happy and willing to share it and I always tell patients if they're not then find a new pharmacy.
2756.04 -> Dr. Annie Eisenbeis: Because they may just you know nita a fresh fresh pharmacist ready to go and ready to educate and so with that and I will take any questions and open up to the chat.
2770.8 -> Dr. Annie Eisenbeis: And let's see I don't know if I should stop sharing my screen but i'll leave it on here, just in case anyone wants to connect and collaborate as well or ask any additional questions i'm always happy to chat.
2782.56 -> Dr. Annie Eisenbeis: You can reach me at Annie at enhanced care consulting COM, and I can.
2789.07 -> Dr. Annie Eisenbeis: Also, I went before I forget, I wanted to mention that i'm happy to work with state health departments as well if you're interested in utilizing pharmacist or pharmacy teams in your programs.
2799.78 -> Dr. Annie Eisenbeis: Missouri is amazing and and you know whoo hoo to Missouri for utilizing pharmacist and I feel that our Department of Health and senior services shout out to Chris comer feldon everyone there and thinking pharmacy in having an impact on patient care and patient access.
2819.13 -> Dr. Annie Eisenbeis: so happy to talk to any states that also want to involve pharmacy as well.
2827.38 -> Rachelle Bartnick: Thank you so much, any of this was was fantastic, and while we're waiting for some questions to come in, we did have we did want to have one come through the Q amp a feature in zoom and the question is how difficult, is it to get reimbursed for DS meds services through medicaid.
2851.56 -> Dr. Annie Eisenbeis: That is a great question um so it depends on the state some state medicaid programs and do not pay for DSM me services and that's mainly because the medicaid pharmacy benefits are outsourced to a.
2871.9 -> Dr. Annie Eisenbeis: managed care organization so.
2874.87 -> Dr. Annie Eisenbeis: When pharmacy as allowed to be be based under the medicaid like carved out of that managed care organization and just bill fee for service to medicate it's a little bit easier to advocate for payment for DSM new services.
2887.95 -> Dr. Annie Eisenbeis: So in Missouri we just recently added the SME to our state medicaid program we're still kind of working through some of the kinks.
2896.62 -> Dr. Annie Eisenbeis: Especially because one of our pharmacies who offers that service, for example in their Community tested.
2903.82 -> Dr. Annie Eisenbeis: About 50 patients on you know test claims calling medicaid and asking if this patient was eligible, and none of the patients were eligible.
2911.35 -> Dr. Annie Eisenbeis: For DS me services so we're just working really closely with our director of pharmacy here.
2917.35 -> Dr. Annie Eisenbeis: Advocating to him on any of the issues and we're again lucky in Missouri that our director of pharmacy for Missouri medicaid is very innovative and open to pushing the profession forward and doing anything he can to implement an impact patient care in Missouri.
2939.85 -> Rachelle Bartnick: Right, thank you, we have a couple.
2944.77 -> Rachelle Bartnick: Another question that has come in, so thank you everyone who's submitting questions you can use the chat or you the Q amp a section or raise your hand to request to ask your question live.
2956.62 -> Rachelle Bartnick: here's one I work at the local health department, we are tasked with trying to help pharmacy pharmacy and P PCP work together, like you're discussing do you think it's better to start by reaching out to the pharmacy side or the PCP side.
2974.62 -> Dr. Annie Eisenbeis: um I personally would start with both.
2979.09 -> Dr. Annie Eisenbeis: So I think it's actually really important to bring both sides together in that conversation whether, starting with the associations that oversee them so in Missouri that would be the Missouri pharmacy Association and the Missouri primary care association.
2993.13 -> Dr. Annie Eisenbeis: Sometimes in other states, they may have different acronyms or names for those associations, but looking at their organization that helps advocate for that profession and bringing those leaders to the table.
3007.14 -> Dr. Annie Eisenbeis: there's also.
3009.57 -> Dr. Annie Eisenbeis: A network of pharmacies across the nation so there's specific networks in each state and some states have multiple networks but there's also a.
3019.89 -> Dr. Annie Eisenbeis: nationwide network it's called the Community pharmacy enhanced services network or CPS in.
3025.83 -> Dr. Annie Eisenbeis: And these are Community pharmacies that are providing enhanced services or interested in adding enhanced services to their pharmacy so if you're interested in learning more about CPS in as well, I can connect you, with your state CPS and leadership.
3043.11 -> Dr. Annie Eisenbeis: I think that's a really not easy but low hanging fruit way to go, because those pharmacists and pharmacies are already reaching out have relationships with their PCP.
3054.39 -> Dr. Annie Eisenbeis: are providing these services as well, and so reaching out to them, in addition to the pharmacy association in primary care association and bringing those leaders to the table.
3065.19 -> Dr. Annie Eisenbeis: I don't think it's necessarily starting with one in each silo I really think it's bringing everyone into a conversation so we've had conversations just.
3076.26 -> Dr. Annie Eisenbeis: With within our organization and primary care association and just how we can collaborate better and that goes a lot further I think in that conversation in just that hour that we might talk or 30 minutes, because now we understand the pain points of both.
3094.56 -> Dr. Annie Eisenbeis: Both professions and both associations, even in reaching their professions, and so we can address those pain points before it comes up before we even implement a program.
3108.93 -> Rachelle Bartnick: Great Thank you.
3110.55 -> Dr. Annie Eisenbeis: I see in the chat Q amp a that it sounds like it's a case by case basis for DS me programs it it's not necessarily case by case, I think it's actually more of a.
3122.55 -> Dr. Annie Eisenbeis: of an advocacy route so.
3125.7 -> Dr. Annie Eisenbeis: I think in state medicaid programs paying for DS me first we need to make sure that they do, and if they don't, we need to advocate for that whether it's the pharmacist or the health department or both the more champions the better for promoting payment for services like the SME.
3145.8 -> Dr. Annie Eisenbeis: But then also not necessarily case by case as far as patients but also advocating for all eligible patients to be included, so I don't Yes it right now it's a case by case basis, probably, but I think it's also an advocacy route or opportunity.
3169.5 -> Rachelle Bartnick: Great and it looks like Liz we had Someone raised their hand.
3178.17 -> Rachelle Bartnick: Would you be able to unmute that person.
3190.44 -> Mohamed Jalloh: yeah can you hear me.
3192.72 -> Rachelle Bartnick: Yes, go ahead, thank you yeah.
3194.91 -> Mohamed Jalloh: I am a pharmacist as well, Dr Muhammad shallow i'm from North Carolina but my question is, are we just started the rpm program remote patient monitoring program and my biggest problem is getting the files from physicians How would you go about.
3214.62 -> Mohamed Jalloh: Trying to build that confidence in those providers being able to send you patients, so that you can get them into the patient into the lobby like mentioned mind.
3226.11 -> Dr. Annie Eisenbeis: That is a great question and so from the pharmacy side I think first having a conversation with other health care professionals, including physicians not just saying you know, we have the service, and we can provide this service.
3240.87 -> Dr. Annie Eisenbeis: But finding out what you can do for them first before they do something for you so, for example, just figuring out what are their pain points for their patients with diabetes, it may not be.
3253.74 -> Dr. Annie Eisenbeis: That they think they need a remote patient monitoring program, but when you look at those pain points and addressing.
3260.43 -> Dr. Annie Eisenbeis: Maybe it's just getting patients to come for their appointments or taking their medications as prescribed or.
3267.18 -> Dr. Annie Eisenbeis: utilizing their blood glucose monitor as often as they should or understanding how to utilize it or the education associated with it, whatever those pain points might be for their patients with diabetes.
3281.31 -> Dr. Annie Eisenbeis: First, addressing that and then showing how remote patient monitoring can have an impact, I think it's also really important to note that health system based physicians are harder to get referrals from, unfortunately, then you know private or independent physician groups or clinics.
3303.63 -> Dr. Annie Eisenbeis: I think it kind of is the same boat for pharmacists as well you know chain based pharmacist may be a little bit harder to get Ahold of than an independent, not in all instances, but just we've experienced that in misery that some health systems.
3317.73 -> Dr. Annie Eisenbeis: limit the referrals that their physicians can can send so they have to be internal which isn't really the best interest of the patient or helping access for the patient.
3329.64 -> Dr. Annie Eisenbeis: But I think sometimes it requires going up the ladder.
3333.9 -> Dr. Annie Eisenbeis: So, having those conversations, first with maybe the pharmacy team at that health system and then who are their diabetes specialist or endocrinologist that you can connect with.
3343.71 -> Dr. Annie Eisenbeis: And then, if their pain point is really that they're not allowed to refer outside of the health system just keep going up that ladder So who is it that is ultimately making that decision.
3353.55 -> Dr. Annie Eisenbeis: Because likely they don't know what a pharmacist can do, or the impact that a pharmacist can have so as the fellow pharmacist, I think.
3361.98 -> Dr. Annie Eisenbeis: we're in the we're in that stage of just educating everyone on what we can do as well, unfortunately.
3369.75 -> Dr. Annie Eisenbeis: So you're kind of battling two battles, at the same time.
3375 -> Rachelle Bartnick: Great Thank you and we've got john climber, with us who put a great comment in the chat but, as is live now and can expand on it go ahead john.
3388.44 -> John Clymer: Sure thanks for showing me, congratulations on the great presentation really well done and you packed a ton of useful information into it i'm.
3399.66 -> John Clymer: Executive Director of the national forum for heart disease and stroke, prevention and also a member of the Community preventive services task force so i'm really pleased to hear you refer to.
3411.09 -> John Clymer: The Community guide recommendations which strongly support the inclusion of pharmacists and team based care because after doing.
3422.28 -> John Clymer: Rigorous systematic reviews of evidence, it is crystal clear that, including pharmacists significantly improves hypertension control.
3432.36 -> John Clymer: It significantly improves cholesterol control it significantly improves diabetes control and, most importantly, it improves patient outcomes patient health and then, as you pointed out any.
3447.33 -> John Clymer: We also know from economic reviews that it's cost effective so now it's really important for all of us to advocate, as you said, as you suggested.
3459.03 -> John Clymer: With health systems for pharmacists to be included as part of the team, and I know that they're in some systems, they will look at financial pressures.
3472.47 -> John Clymer: against including pharmacists and it's certainly to the patients benefit and to the benefit of those who are primarily concerned about the quality.
3485.1 -> John Clymer: Of the care that they provide to include the pharmacist, so we need to be advocating and helping the decision makers understand that, and then we also ought to be looking at Jefferson city and advocating there for inclusion of pharmacists as providers, so that.
3504.09 -> John Clymer: pharmacists can provide the kind of care and make it more readily available to people that we know will help to improve their health and, to be honest, I think you're too diplomatic to to say this that's not a criticism.
3521.85 -> John Clymer: I will the resistance from this is the medical lobby they don't want competitors and they unfortunately view pharmacists, not as collaborators who you are.
3538.92 -> John Clymer: But unfortunately they in a very narrow view look at any other providers as competitors and that's led them to oppose provider status for nurses for PhDs for NPs and now pharmacists and that's, to the detriment of the public and patients and we need to solve that.
3564.18 -> Dr. Annie Eisenbeis: I just want to reiterate what you said about being an advocate so if you're not at the table you're on the menu, and that goes for health care in general, not just pharmacy.
3574.17 -> Dr. Annie Eisenbeis: So it's yeah everyone needs to be an advocate, even if you say you don't like politics and the people making the decisions on what we can and can't do in the healthcare system or the politicians.
3588.33 -> John Clymer: Absolutely.
3590.55 -> Rachelle Bartnick: Right and thank you.
3592.92 -> Rachelle Bartnick: Andy will, at this time, thank you for your participation today for a fantastic.
3600.45 -> Rachelle Bartnick: content, and you know thought provoking discussion there are additional couple additional questions in the Q amp a box, if you have a chance to.
3609.63 -> Rachelle Bartnick: respond to those great if not we can certainly get those back out to the group, but in the interest of time, I would like to go ahead and get to our conclusion.
3620.61 -> Rachelle Bartnick: quickly this one, to point out the American heart association program in conjunction with the American Medical Association target blood pressure or target VP.
3633.36 -> Rachelle Bartnick: This is an initiative aimed to add in improving health outcomes by evidence evidence approaches to hypertension, control and.
3644.76 -> Rachelle Bartnick: blizzard you want to just go ahead and switch through the slides Yes, our framework is based on map which.
3651.33 -> Rachelle Bartnick: listed here is around measuring accurately, but every patient every time acting rapidly partnering with patients, and I think today our presentation highlighted that.
3662.67 -> Rachelle Bartnick: That sector of the map framework so really does bring it full circle it's forget blood pressure has some great resources some online resources.
3673.17 -> Rachelle Bartnick: But for our health care practices, you are diagnosing and treating hypertension anything from webinars and CME credits to tools for patients and providers, as well as.
3685.35 -> Rachelle Bartnick: Quick assessment tool on where, as a practice, you could start with looking at some evidence based techniques to improve central control.
3693.96 -> Rachelle Bartnick: For recognition, this year the data submission deadline is may 28 at 11:59pm Eastern standard time so just.
3703.77 -> Rachelle Bartnick: A few short days away who encouraged healthcare organizations who are one are participating in target blood pressure to be mindful of that deadline.
3713.01 -> Rachelle Bartnick: i'd like to take this opportunity to again thank our our co present or co collaborators today and making this.
3721.47 -> Rachelle Bartnick: Innovation in hypertension control series possible and put a plug in for two additional workshops that are coming up.
3727.95 -> Rachelle Bartnick: The first workshop or the next workshop is next week at noon and then following on June 9 at noon more information he found your email.
3736.89 -> Rachelle Bartnick: So with that I thank you all again for being a part of today's webinar and wish you well we'll close today with an important message from the American heart association again.
3752.64 -> Getting back to this.
3755.31 -> to her family to friends to hawks.
3761.55 -> For people and higher risk of colon 19 complications because of diabetes, high blood pressure and heart conditions, the covert 19 vaccine is an important choice consider it's the first step towards getting back to what you missed so much safely.
3776.4 -> Getting back to life set your heart on it it's up to you a message from the American heart association.
Source: https://www.youtube.com/watch?v=3fjys1Ban2c