Community pharmacists capture crucial insights about a patient that can often be overlooked. But how can this data be used more efficiently in a way that enhances the patient care process?

The use of care plans allows pharmacists to document these insights in an impactful way in order to improve patient health outcomes.

Socioeconomic, demographic, and environmental factors are things that are not typically quantifiable – but they hold powerful details about the way an individual responds to care from health professionals.

By using care plans, you can take these factors and translate them into a code format that is universally understood. This allows consistent communication between every member of a patient’s health care team.

What is a Care Plan?

The Pharmacist’s Patient Care Process outlines the steps of practicing patient-centered care through collaboration, communication, and documentation.

PioneerRx’s pharmacy software has tools built in to workflow that lead you through every step of the process:

Source: Joint Commission of Pharmacy Practitioners
Source: Joint Commission of Pharmacy Practitioners

Any patient documentation is automatically translated into code format within the PioneerRx software.

ICD-10 codes are used by providers to codify medical diagnoses, and SNOMED codes codify clinical terminology within care goals and actions. These universal codes are already pre-loaded into the software system.

Collect

When onboarding new patients, all the information you collect should be updated in the patient’s Rx Profile. Important data to collect includes:

Patient Data: Date of birth, Contact information, Insurance, Demographics

Medication & Allergy History: List of current and past prescriptions, OTCs, Herbal products, and Dietary supplements; Drug allergies and intolerances

Clinical Status: Medical history, Vitals, Lab results, Physical assessments

Lifestyle/Socioeconomic Factors: Heath and wellness information, Lifestyle habits, Environmental factors, Beliefs, Preferences, Patient goals

Best Practice Tip: Any medication listed should always be associated with an indication (health condition)

Assess

Next, you’ll look at a patient’s full health picture to locate any gaps in care or opportunities for improvement.

PioneerRx calculates metrics like risk scores and adherence ratios to help you analyze the clinical effects of a patient’s therapy.

It is also important to look at immunization status and preventative care opportunities. These insights will help you determine the next steps in a patient’s care process.

Plan

Using the assessments made, you will then develop an individualized plan that will be outlined through Care Goals.

These goals are steps that need to be taken in order to reach the desired outcome for the patient. PioneerRx allows you to have pre-set alerts that can assign care goals to a patient based on their Rx Profile.

Using Categories and Rx Triggers, you can set parameters that will trigger a certain health plan.

Pre-Set Goal Examples: The software already has built-in care goals, such as:

  • Opiate Therapy Review
  • Rx Trigger will automatically add this Care Goal to patients presenting with a new prescription for an opiate agonist or opiate partial agonist in order to document that the pharmacist has checked the PMP for this encounter.

  • Administer Pneumococcal Vaccine
  • Rx Trigger will automatically add this Care Goal to patients 65 years or older who need the Prevnar 13 and/or Pneumovax 23 vaccines.

  • Use Statin in Diabetes Patients with Lifestyle Modifications
  • Rx Trigger will automatically add this Care Goal to patients who are on meds that can treat diabetes and are not currently taking a statin.
Custom Goals: You can also set up your own Rx Triggers using any combination of parameters.

Implement

Once a patient has a list of care goals, these will be implemented through Care Actions.

These are the documentation of actual steps taken to reach a patient’s goals. It will specify how and when you took action in patient health intervention, as well as noting any labs or vitals that were taken.

Submitting eCare Plans

The PioneerRx software will automatically take your documented care goals and actions and compile them into the correct format for an eCare Plan.

Then, you will be able to directly submit this to CPESN for reimbursement – straight from your patient profile screen.

Follow Up: Monitor & Evaluate

Once an eCare Plan is submitted, the next step is to continue following up with the patient and identifying new opportunities for clinical intervention.

PioneerRx also allows you to organize all of your incomplete care actions from any patients into a master queue. This is useful in having a complete view of what care actions need to be performed and their due dates.

This will keep you on track to complete and submit more eCare Plans.

PioneerRx users can also access PioneerRx University for a deeper dive into care plans. There you can find written step-by-step guides and video tutorials for successfully building care plans in the software.
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