Ambulatory Pharmacists Bridge Clinical, Financial Gaps in Value-Based Care Models: Caroline Vovan, PharmD, CDE

Caroline Vovan, PharmD, CDE, director of ambulatory care pharmacy at the Providence Clinical Network in California, shares key takeaways from last week's Institute for Value-Based Medicine® (IVBM) event held in partnership with Providence.

She also highlights the role of ambulatory clinical pharmacists in value-based care models, a topic she explored further in her presentation, "How Ambulatory Clinical Pharmacy Is Essential in a Value-Based Care Health System."

This transcript was lightly edited; captions were auto-generated.

Transcript

Overall, what were your biggest takeaways from last week's IVBM event?

Last week, it was over in California, in Irvine, and it was so nice to see the presenters and the audience come from a lot of sectors of Providence. We had Ty Gluckman, MD, MHA, from the inpatient side, talking about congestive heart failure from the hospital's point of view.

Sophia Humphreys, PharmD, MHA, BCBBS, she's a pharmacist from the specialty pharmacy side, so there's that retail specialty side, and she talked about diabetes. Then, Mike Skafi, RPh, MSQA, he is our pharmacist who talked a lot about pharmacy drug analytics on the inpatient side, and John Ngo, PMP, talked a lot about finances and bringing together data.

What I really got out of this event was that it was really nice to see everyone, not just in a social environment, but more importantly, that all of these different parts of health care, different parts of pharmacy, can actually have more opportunity to work closely together. We have so [many] things that we're doing and a lot more things to share with each other than we already are.

As described in your presentation, what is the role of ambulatory clinical pharmacists within a value-based care model?

I would put it into 3 parts, the first 2 being more clinical parts and the more traditional role as a clinical pharmacist on the ambulatory care side. We are really trusted providers by the physicians. The physicians also see us, and the patients, too, see us, as clinicians, where we really do know how to manage diabetes and other difficult cardiovascular diseases, like congestive heart failure, hypertension, [and] hyperlipidemia.

Our biggest role clinically with the physician’s health care team is to be able to take some of that work off their plate so they have access to see patients who have more acute issues [who] need to definitely be seen by the physician, whereas we're seeing more of the chronic patients who need a lot more of the hand holding. I do really think that this is value added.

The second clinical role is really keeping our patients out of the hospital by managing those disease states that I just talked about, but also our population health side really outreaches our patients. It's with our pharmacy technicians and students, where they're talking to them on the phone, making sure they're adherent to their medications, asking them, "Is there a reason why you can't take it? Is it too expensive? How can I help you?" That is a value to the system, as well, if the patient is able to stay out of the hospital.

Then, the third one is financial, which is not always so obvious that our ambulatory care pharmacists can do. Medications now are costing more and more, exponentially. The expensive medications keep coming out. I can't even find new medications in the pipeline now that [are] less than $5000 per dose.

As pharmacists, we really do know our medications, and we know the cost of the medications. We are not only helping the patients' pocketbooks, but we also want to help our medical group or our health systems' pocketbooks, as well.