By Marc Stranz
Chief Clinical Officer
BioMatrix Specialty Pharmacy
Continuity of Care (COC) is a concept centered on the quality of care patients receive over time. Unfortunately, some populations are predisposed to issues with continuity – including those serving in our armed forces.
Frequent moving, prolonged separation and challenges related to military health benefits can impede the continuity of care for members of the military and their families. One analysis found that 44% of military families caring for children with special healthcare needs did not receive assistance coordinating care across providers.(1)
Military families have also reported approval delays and issues related to receiving prescription medicine or special medical equipment for their child.
Though military families face COC challenges, specialty pharmacies are uniquely poised to help navigate these issues – preserving continuity and improving health outcomes.
Studies show when continuity is high, outcomes improve.(2) Fewer emergency room visits, increased adherence to therapy, improved patient satisfaction, and lower overall healthcare costs are just a few of the documented results when continuity is present.(3) Continuity of care was rated as a top priority by patients and caregivers dealing with chronic health conditions.(4) Though the importance of COC is widely acknowledged, maintaining it in a fragmented health system can often be difficult.
Specialty pharmacies play an important role in continuity of care. Medication therapy management (MTM) is one of the primary tools a specialty pharmacy wields to positively influence COC. The American College of Clinical Pharmacy defines MTM as, “A distinct service or group of services that optimize therapeutic outcomes for individual patients.” Broadly speaking, this involves tailored clinical assessments, focused patient education, and interventions designed to promote adherence, reduce side-effects, and avoid negative drug interactions. A well-designed MTM program provides patients the tools and knowledge to effectively manage their condition based on individual circumstance. Over time, clinical assessments, dispensation, and utilization data provide a comprehensive view of patient response to prescribed therapy.
Experienced specialty pharmacies understand high levels of patient engagement are required for MTM programs to be effective. Through ongoing communication, clinical and support staff at the specialty pharmacy develop a detailed understanding of the day-to-day challenges faced by patient and caregiver. For military families, this could mean proactive planning with the pharmacy before a move or deployment to avoid interruptions in care. Working together, pharmacy and patient anticipate and mitigate potential disruptions to therapy. Beyond filling a monthly prescription, the specialty pharmacy becomes an advocate and partner in the ongoing management of chronic health conditions.
Patients access healthcare and medication across a range of disciplines and locations. This is especially true in populations that move frequently and with individuals who have chronic health conditions. Coordinating care across healthcare access points is another way specialty pharmacies impact COC. Leveraging detailed clinical knowledge with individualized patient information, pharmacists help providers fine tune treatment plans and promote communication across healthcare channels. Highly trained care coordination teams including billing and intake support clinicians in promoting continuity. These professionals promote COC by helping patients understand their coverage, coordinating complex health benefits, securing prompt authorization for prescribed therapy, and providing access to resources reducing barriers to care. Using a collaborative approach, the specialty pharmacy team proactively coordinates services between patient, provider, payer, and other community-based resources to overcome challenges, maintain continuity, and promote safe, effective care.
Continuity of care is a critical component of quality healthcare for all consumers. Specialty pharmacies with a well-defined MTM program and high levels of patient engagement are well equipped to maintain COC in the complex and ever-changing healthcare environment. By tailoring programs to meet the unique needs of specific populations predisposed to continuity challenges – such as military families – specialty pharmacies are bridging gaps, promoting communication, and ultimately helping to produce the positive outcomes continuity of care is best known for.
REFERENCES
“Experience of Children with Special Health Care Needs in Tricare.” Https://Www.tricare.mil/Survey/Hcsurvey/childIssueBriefJan27_rev.Pdf, Health Care Survey of DoD Beneficiaries. Nd.
Walraven, Carl Van, et al. “The Association Between Continuity of Care and Outcomes: a Systematic and Critical Review.” Journal of Evaluation in Clinical Practice, vol. 16, no. 5, 2010, pp. 947–956., doi:10.1111/j.1365-2753.2009.01235.x.
Wick, J. “Broadening Pharmacy’s Role: Continuity of Care.” Pharmacy Times, 2006, www.pharmacytimes.com/publications/issue/2006/2006-05/2006-05-5537.
Sav, Adem, et al. “The Ideal Healthcare: Priorities of People with Chronic Conditions and Their Carers.” BMC Health Services Research, vol. 15, no. 1, 2015, doi:10.1186/s12913-015-1215-3.
