Improving Patient Outcomes Through a High Touch Model of Care

At the recently-held Pharmacy Quality Alliance annual meeting in Baltimore, Maryland, several speakers addressed medication adherence barriers for hepatitis C patients and presented pharmacist intervention strategies for improving patient outcomes and reducing costs in patients with newly prescribed hepatitis C medications.

In this clip, Jennifer Strohecker, PharmD, BCPS, who is Senior Director MHI Pharmacy, Clinical Operations, discusses a high touch model of care broken down into 4 key steps that pharmacists can use to improve outcomes.

Transcript:

There’s a model that we’ve developed within my team called a high touch model of care and there are 4 basic elements of this that I think are critical to improving outcomes in patients today. The first piece of this is going back to the basis of having an interactive conversation. We’ve often in pharmacy defaulted to telling people what to do — “This medicine is for your hepatitis c,” “You need to take this medicine twice a day” “It may cause a little bit of stomach upset, if it does, take it with food.” Instead of approaching it that way, ask open ended questions. “Do you know why you’re using this medicine?” “Tell me how you’re taking this medicine,” “What do you know about the side effects of this medication?” Then you’re able to actually engage in an interactive conversation which can hopefully address concerns that the patient has and maybe lack of knowledge that they might have about their disease or the treatment they are experiencing. The other element of this, and the 2^nd of the 4 steps, would be a repeated conversation. Oftentimes we give bite size information and we only say it once. We choose snippets of information in health care and provide it to a person one time. What we’ve found to be most effective is when we’re able to follow up with some of the messaging or the questions that we’ve asked on our first encounter to make sure that the person understands it and they’re doing what they should be doing in order to achieve their goals in therapy. On a month-to-month basis, for example, if the person is to come into the pharmacy every 30 days, ask them “Tell me what you know about your medicine,” “Tell me how you’re taking this medicine,” “Are you experiencing any problems with using this medicine?” So those are opportunities to provide repeated follow up coaching and address any barriers that may exist. The third piece, which is part of that open-ended conversation that’s interactive, is really personalizing care. Each patient is individual. They have different needs, different concerns, and maybe even different barriers that they present with. When we’re able to have an interactive conversation that can be repeated, we can personalize care and understand what a unique patient’s needs may be. And in doing so, we can then do the 4^th thing, which is identify what barriers exist. With this, we have to actively understand that barriers may be in place and can actually change over time. So once we identify what those barriers might be, it might be “Wow, I didn’t understand that I was supposed to do that,” and now with that knowledge, they can resolve that barrier.

And the other pieces might be to be the one to be proactive when you identify a barrier like “I need a new refill,” or “I’m having a side effect, and this is troublesome to me.” The pharmacist can be proactive in coordinating care to help resolve that barrier.