CareMore, a primary-care provider for Medicare and Medicaid beneficiaries that is owned by the Blues insurer Anthem, has been working with teams for a while, but recently integrated pharmacists into most of its 50 care centers, creating a new set of challenges.
One of the bigger changes under the new workflow is that pharmacists are now part of the huddle every morning with the nurse practitioner and medical assistant team members to review patient cases for that day. The pharmacist informs the nurse practitioner about patients who haven't picked up their prescribed medications or offers insights on medications that should be changed or stopped because of a particular condition. Another part of the pharmacist's job is educating colleagues about the latest guidelines for certain drugs.
Shenil Patel, a pharmacist who works at CareMore's Downey (Calif.) Care Center, said it has been rewarding to be a resource for his colleagues, although he confessed that he did face some hurdles initially.
He had to adapt to the unique working style of each nurse practitioner and physician. Some co-workers will take Patel's advice and immediately run with it, while others prefer further discussion. "Every person has a specific way of wanting things done, or certain ways they want things communicated to them, so (I've worked on) just understanding their side and how I can provide that information so it's easier for everyone," he said.
He's also improved how he communicates with his co-workers so that he's clearer and stronger with his recommendations. A big part of Patel's job is talking with practitioners and specialists about patient-care plans and the medications he thinks are the best option for a particular situation.
Another challenge in team-based environments arises when clinicians don't immediately trust the other members' decisions because they haven't worked together before. Patel's colleagues overcome that hurdle by keeping the process transparent, said Jacqueline Constantino, a nurse practitioner at CareMore who works with Patel.
She is in constant communication with Patel and other team members to discuss their recommendations. They also share notes through the electronic health record system.
"We're all on the same page," she said. "We know how fragile our patients can be and how important it is to communicate regularly with each other to avoid any complications."