The U.S. healthcare system is transforming itself in order to increase quality, improve health outcomes and reduce costs.
It is estimated that 5 percent of patients account for more than 50 percent of total healthcare costs. These individuals, referred to as high utilizers or high-cost patients, account for a disproportionate share of both health services and spending.
Many times, high-utilizing populations have multiple complex health conditions and equally complex social and economic circumstances that inhibit their maintaining optimal health.
In order to address high utilization, many health systems are implementing innovative approaches, including services aimed at reducing homelessness, increasing access to healthy foods, teaching people how to self-manage their medical conditions or providing transportation to medical appointments.
These changes in the approach to care highlight the importance of collaboration among service providers. Partnerships that include doctors, first responders, law enforcement, schools, social service providers and others are essential for truly addressing the complex health and socioeconomic needs that can lead to improved health and reduced costs of care.
One example of an innovative approach is team-based medication management. People with complex medical conditions oftentimes have multiple medications they are supposed to manage. Many such people have a hard time keeping track of which medications they are supposed to take at what times, or they simply choose not to take the medications as their doctor prescribes.
In addition, when a patient sees multiple doctors for multiple health needs, it is possible the doctors will prescribe medications that don’t interact well together. Therefore, it is unsurprising that medication management is one of the most important and often overlooked challenges for reducing avoidable and expensive trips to the emergency department.
In order to improve medication management, health systems are practicing ‘team-based medication management, and the team can integrate doctors, care coordinators, pharmacists, patients and patients’ families into the medication care team.
Pharmacists have the unique capability of ensuring that each patient’s medications are individually assessed to determine that they are appropriate for the patient, effective for the medical condition and safe, given comorbidities and other medications being taken. In addition, pharmacists are uniquely able to recognize when patients are not taking medications as prescribed by their doctors because patients will not come in for their refills.
Including pharmacists on the care teams reduces adverse drug reactions and increases medication compliance. Similarly, including patients and their families as a part of the care team allows the patient to understand their medical condition and take control of their health.
Beth Frailey is the community health coordinator at Dallas County Public Health.
