True Community-Based Care Centers on Collaboration

Team-based care and the importance of relationships between pharmacists and physicians were the emphasis of the keynote address at the American Pharmacists Association (APhA) 2015 annual meeting.

L. Brian Cross, PharmD, BCACP, CDE, and Reid Blackwelder, MD, FAAFP, of the East Tennessee State University Family Physicians clinic, co-delivered a keynote that focused on how collaboration between pharmacists and physicians and integrated care teams are the way forward in the path toward value-based care.

Dr. Blackwelder started off by pointing to a current reality, namely that the old health care system is broken, and patient-centered care is more of a misnomer. More often, care is centered on the practice, provider, or physician. A collaborative view of health care that truly focuses on the patient’s needs is the best means of improving outcomes.

Improving community-based care, Dr. Blackwelder said, is all about relationships, and there is no need to wait. It can be as easy as picking up the phone or meeting face-to-face with a pharmacist or physician. He emphasized that no single answer or solution to a patient’s care exists—it’s an evolving process that requires constant collaboration.

A lack of communication can make team-based care complex and confusing, noted Dr. Cross. Specifically, electronic medical records (EMRs) may not allow for easy transfer of information across systems.

“Wouldn’t it be nice if we were able to have the same records as physicians in their EMRs linked with medication records in pharmacies?” Dr. Cross said.

Medication reconciliation needs to be redefined, the speakers argued. There’s a medication list in the EMR, a list in the pharmacy, and a list in the patient’s wallet, and these are all pieces of truth, they said. What is missing is the ability to garner all this information in 1 place in order to understand what the patient is actually taking. In addition, home visits, the speakers added, are where the real medication lists reside. Reconciliation is not as simple as pushing a button on the computer. Once the true list is known, the next step is to review whether it is the list he or she is supposed to have.

The speakers noted that health care change is already taking place, and it’s up to pharmacists and physicians to “drive the train where it’s supposed to go.” Change can come from a bottom-up instead of a top-down approach. For example, change may start in pharmacy schools, where interprofessional education can teach students what they can expect post-graduation. Instead of a silo approach, students should learn experientially together. They will develop relationships because they will have to; students will be trained how to think as a team. This approach will usher in a new generation of pharmacists and physicians who will expect to work collaboratively in any setting.

Dr. Cross noted that no matter what setting a pharmacist is working in, “We are all community pharmacists [because we all serve a community]. My question for you is where is yours?”