Pharmacy eCare Plan Developed as a Valuable Tool

An electronic care plan is providing community pharmacists with a tool for clinically documenting patient care services and for communicating more efficiently with other providers.

An interoperable standard created to exchange information across the health care spectrum, the Pharmacist eCare Plan (PeCP) is gaining traction across the country.

A joint effort by multiple professional organizations, the PeCP’s development is led by the Pharmacy Health Information Technology Collaborative (Pharmacy HIT).

The PeCP is based on the HL7 standard and was adapted for community pharmacy use, according to Shelly Spiro, executive director of Pharmacy HIT.

Modifications focus on medication-use optimization, planning, and follow up, which may include drug therapy issues.

“A pharmacist doesn’t document the same way a physician documents. It’s a different step process,” Spiro said in an interview.

During a recent webinar hosted by the Pharmacy Quality Alliance (PQA), Pharmacy Times Editor-in-chief Troy Trygstad, PharmD, MBA, PhD, likened the PeCP to a Swiss Army knife in terms of its usability.

A PQA board member, he said that the system serves as an intermediary, translating a variety of data types and exchanging information pertaining to patient care.

The plan essentially allows pharmacies to receive and share information about active patient goals, health concerns, active medication lists, drug therapy issues, laboratory results, vitals, payer information, and billing for services.

“The rest of the world uses care plans. That needs to come to our shores in pharmacy world,” Trygstad said.

“We’re going to be in their world, and they’re going to be in our world," he said. "Those traditional [health care] lines are starting to break down.”

The PeCP allows every user to use his or her own system with data being input and received in different "languages."

“We’re making sure everybody is speaking the same language,” Trygstad said. “This is universally applicable and can be applied outside pharmacy.’

Although pharmacists are already familiar with telecommunications for processing claims and prescriptions, innovation with the PeCP will allow pharmacists access to a complete medication list, its advocates said.

The PeCP represents an evolved workflow system that will increase productivity, Spiro said.

“For the future, this is going to be the way our systems capture information," she said. “You need to utilize your system to pull out what information is needed.”

On January 11, 2019, the PeCP launched an informational website that is supported by the Community Pharmacy Foundation. The website is intended to generate awareness for the PeCP with sections geared toward laboratories, payers, pharmacists, technology companies, and other supporters.

Care planning has become an essential part of the health care system in the United States, as chronic diseases have been linked to the majority of health care, morbidity, and mortality expenditures, according to the website.

Most health care interventions are ongoing and last many years.

Chronic diseases are responsible for about 75% of the nation’s aggregate health care spending, as well as 96% of Medicare spending and 86% of Medicaid spending.

In fact, 45% of people in the United States suffer from at least 1 chronic disease, and more than two-thirds of all deaths are cause by 1 or more of 5 chronic diseases: cancer, chronic obstructive pulmonary disease, diabetes, heart disease, and stroke, according to the National Association of Chronic Disease Directors.

Medication use is the predominant intervention for chronic disease, according to the PeCP.

Care planning and follow up are required for effective medication use.

The PeCP also is positioning the pharmacy sector for payment reform, because it allows administrators and pharmacists to better communicate with insurers and other health care providers regarding claims and reimbursements, according to Trygstad.

A result for pharmacists could be less administrative work and more time spent caring for patients, as well as decreased expenses, he said.

“It’s so expensive right now to administer these programs, because we don’t have standards,” Trygstad said.

“Payers are becoming providers; providers are becoming payers," he said. "All these data streams need to come together.”

A PeCP pilot program was launched in North Carolina 2 years ago through the Community Pharmacy Enhanced Services Network (CPESN) with support from Community Care of North Carolina (CCNC) and the National Community Pharmacists Association.

According to Trygstad, who serves as CPESN USA executive director and vice president of pharmacy programs at CCNC, the project was a success, but the PeCP faces the challenge of getting the software solutions in place at pharmacies.

The pilot program had a great impact on the PeCP, Spiro said.

Its results included getting system vendors trained.

The PeCP has been in the works for more than a decade, Spiro said.

The collaborative effort is at the stage of being adopted by community pharmacies in other states and is starting to move across the United States.

The work CPESN is doing now is focused on implementation of the PeCP, Spiro said.