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Ascension Illinois

Expanding Access and Elevating Care: The Success of the Pharmacotherapy Clinics Across a Community Hospital Healthcare System

Andrius Cepenas, PharmD, BCACP; Julie Foglio, PharmD, BCACP, BCPS; Leigh Martin PharmD, BCACP, BCPS, CDCES; Courtney Carey PharmD, BCACP, CDCES; Bethany Denny PharmD

Ascension Illinois
Chicago, Illinois

The Pharmacotherapy Clinic program was established in response to the pressing challenges faced by non-profit community hospitals, including limited access to care, medication affordability concerns, and penalties for suboptimal clinical outcomes.  These hospitals often serve underprivileged populations, where health disparities exacerbate medication adherence and complicate chronic condition management.  The purpose of the clinic strives to improve patient outcomes through chronic disease state management, enhance the patient care experience, and facilitate medication access with a dedicated pharmacy team. The four central goals of the Pharmacotherapy Clinic are to improve medication access for patients in need, provide comprehensive medication management to patients with uncontrolled chronic disease states, reduce 30-day hospital readmission rates for high-risk patients, and serve as a financially viable service within the community hospital network to foster growth.

In January 2020, the first Pharmacotherapy Clinic was established at a single community hospital.  The Pharmacotherapy Clinic was designed as a pharmacist-managed outpatient clinic within a community hospital's outpatient department where ambulatory care clinical pharmacy specialists provide comprehensive care to patients.  Through a collaborative practice scope of services policy, Pharmacotherapy Clinic pharmacists evaluate and modify drug therapy regimens while providing guidance to patients to achieve health goals.  The Pharmacotherapy Clinic offers three types of patient care visits: chronic disease management visits, post-discharge visits, and employee medication management visits for high-risk associates. These services are referral-based, ensuring a comprehensive and coordinated approach to care.  Strategically launching at disproportionate share hospitals allowed the Pharmacotherapy Clinic to leverage the federal 340B drug program, delivering crucial community benefits and alleviating medication costs to patients in need.  The launch of the program marked a pioneering step in the 15-hospital community health system.

Since its inception, the Pharmacotherapy Clinic program has expanded to seven community hospitals within the 15-hospital network.  In just over three years, the Pharmacotherapy Clinics completed more than 13,000 clinic visits, provided over $2.1M in medication assistance, achieved a 30-day readmission rate of 4%, and obtained A1C control in 90% of its diabetic population.  The clinic generated $38.5M in realized revenue and $20.8 million in net benefit for the community health system, demonstrating not only financial viability and sustainability, but playing an integral role to the survival of many safety-net community hospitals within the network.

The Pharmacotherapy Clinic contributed to the advancement of pharmacy practice and healthcare technology. It created new roles for pharmacy team members, including Pharmacotherapy Clinic pharmacists and patient care coordinators, leading to the establishment of a PGY2 Ambulatory Care Residency program.  The success of the program helped pave the way for the expansion of other ambulatory pharmacy practices, such as embedded specialty pharmacists, population health pharmacists, and transition of care pharmacists.  It successfully embraced telehealth technology prior to the COVID-19 pandemic, serving as a model for the broader healthcare system.

The Pharmacotherapy Clinic has proven to be a transformative and innovative program that addresses the significant healthcare challenges faced by non-profit community hospitals and can serve as an inspiration and blueprint for other healthcare institutions looking to enhance patient care.

 

Ascension Illinois Left to Right: Courtney Carey, Leigh Martin, Andrius Cepenas, Julie Foglio, Bethany Denny