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门诊老年护理诊所中药剂师提供的慢性护理管理服务的开发与经济评估

Development and economic evaluation of a pharmacist-provided chronic care management service in an ambulatory care geriatrics clinic.

作者信息

Fixen Danielle R, Linnebur Sunny A, Parnes Bennett L, Vejar Maria V, Vande Griend Joseph P

机构信息

Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO

Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO.

出版信息

Am J Health Syst Pharm. 2018 Nov 15;75(22):1805-1811. doi: 10.2146/ajhp170723. Epub 2018 Aug 13.

Abstract

PURPOSE

The implementation and delivery of a pharmacist-led chronic care management (CCM) service in a geriatric primary care clinic are described.

METHODS

A CCM service was provided March 1 through December 31, 2016, at the University of Colorado Hospital Seniors Clinic ("Seniors Clinic"). The electronic health record (EHR) team for the University of Colorado Health system developed a patient registry through EPIC Healthy Planet (Epic Systems Corp., Verona, WI) to identify patients at the Seniors Clinic eligible for CCM services. The EHR team constructed a note type and documentation template within the EHR to ensure documentation of all necessary components for billing and to allow individual clinical staff to document the time spent providing CCM care.

RESULTS

Overall, 36 elderly patients enrolled in the pharmacist-provided CCM service over the 10 months. Clinical pharmacists spent a total of 156-849 minutes per month providing CCM services, with a mean outreach time of 45.4 minutes per patient. The clinical pharmacists submitted 95 claims, and all but 5 were paid. The total amount reimbursed from the health plans during the 10 months was $2,775.02.

CONCLUSION

Medicare patients were successfully enrolled in a CCM service in a geriatrics primary care clinic led by clinical pharmacists and medical providers. The CCM services were more time-consuming than the allotted 20 minutes per patient per month with the CCM Current Procedural Terminology code used during this study.

摘要

目的

描述在老年初级保健诊所实施并提供由药剂师主导的慢性疾病管理(CCM)服务。

方法

2016年3月1日至12月31日期间,在科罗拉多大学医院老年诊所(“老年诊所”)提供了CCM服务。科罗拉多大学健康系统的电子健康记录(EHR)团队通过EPIC Healthy Planet(Epic Systems Corp.,威斯康星州维罗纳)开发了一个患者登记系统,以识别老年诊所中符合CCM服务条件的患者。EHR团队在EHR中构建了一种记录类型和文档模板,以确保记录计费所需的所有必要组件,并允许各临床工作人员记录提供CCM护理所花费的时间。

结果

总体而言,在这10个月中,有36名老年患者参加了由药剂师提供的CCM服务。临床药剂师每月提供CCM服务总共花费156 - 849分钟,每位患者的平均外联时间为45.4分钟。临床药剂师提交了95份索赔申请,除5份外其余均获支付。在这10个月期间,健康计划报销的总金额为2,775.02美元。

结论

医疗保险患者成功参加了由临床药剂师和医疗服务提供者主导的老年初级保健诊所的CCM服务。使用本研究期间的CCM现行程序术语代码,CCM服务比每月每位患者分配的20分钟更耗时。

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