Medications are a primary therapeutic option for patients. Despite advances in treatments and growing evidence supporting best use, gaps in care related to medication use remain, resulting in substantial patient burden (cost, morbidity and mortality) and economic waste in an already stretched health care system. Careful evaluation of medication use within the real-world setting is an essential component of understanding gaps in medication therapy, the underlying reasons for these gaps and the impact of these gaps on patient care.
With a fuller understanding of the problem, the Center for Pharmacy Innovation and Outcomes (CPIO) aims to address medication gaps in care, leverage a highly evolved health IT infrastructure, apply robust data including patient-reported information, a growing genomic reservoir, and deploy trained and highly skilled clinical pharmacists. The CPIO is equipped to take advantage of the integrative health care environment at Geisinger and study the real-world effects of medications and the impact of provision of health services.
The CPIO is focused on translational outcomes and health care redesign across the following areas of interest:pharmacy services, pain and addiction management, medication adherence and safety, specialty/biologics, applied pharmacogenomics, pharmacoeconomics and outcomes, and population health.
Improving Transitional Care through Communication between Pharmacists
In an effort to cut the rate of preventable rehospitalizations for patients discharged from Geisinger facilities, researchers in the CPIO have initiated a study supported by the National Association of Chain Drug Stores Foundation evaluating the impact of pharmacist transmission of information from the inpatient to the outpatient setting on patient outcomes.
Pharmacist-led Familial Hypercholesterolemia Multidisciplinary Clinic
In collaboration with primary care providers and specialists at Geisinger, we are developing a patient and family member care process for our patients diagnosed with familial hypercholesterolemia. The Medication Therapy Disease Management (MTDM) pharmacists are providing medication reviews and adjustments to help patients reach their treatment goals.
Within the past 15 years, the United States has witnessed a 300 percent increase in the incidence of deaths due to prescription drug overdose. A common source of prescription drugs is the medicine cabinet where unused, unneeded or expired medications account for a large component of the abused supply. In partnership with the Pennsylvania District Attorney's Association, the Pennsylvania National Guard, regional law enforcement and local schools and universities, Geisinger is leading an effort to make available medication take-back boxes at convenient locations within the community. Our researchers in the CPIO are leading the effort and studying the effects of expanded boxes on public health.
Geisinger Health System opened a pharmacist-led Medication Therapy Disease Management (MTDM) Chronic Pain Clinic in 2012 to help patients better manage their pain and identify/prevent addiction. The multidisciplinary clinic is comprised of administrators, primary care and interventional pain physicians, pharmacists, registered nurses and social workers/addiction counselors. Our goal is to help patients decrease their pain so they can reach important life goals.
Having a complete, accurate medication list that is transparent to health care providers and the patient is the principal goal in designing MedTrue. In a multidisciplinary effort led in part by Michael Evans and Eric Wright, MedTrue is a comprehensive medication adherence database and web-based application intended to serve as a single source for medication reconciliation, adherence monitoring and patient engagement support to help improve primary and secondary adherence.
Optimizing High-Cost Biologic Treatments for Patients with Multiple Sclerosis
Patients with multiple sclerosis (MS) will receive reliable delivery of the best practices designed by an evidence-based care path based on disease severity to deliver on the promise of value-based care. In addition, a 360-degree view of every MS patient is needed to assess the impact and quality of this program. Payers will be confident that their health care spending is well-stewarded and delivering on outcomes and preventing exacerbations that is important to patients and families. The infrastructure developed to manage high-cost biologics for MS, including the data capture applications, analytics and health IT tools, will be built to be scalable and extensible to enable efficient spread of this program to other high-cost therapeutics across the Geisinger Health System.
Center for Pharmacy Innovation and Outcomes
Geisinger Precision Health Center
190 Welles Street, Suite 128
Forty Fort, PA 18704
Geisinger Health System
100 North Academy Avenue
Danville, PA 17822