AIMM’s most recent A3 Collaborative cohort of pharmacy-led multidisciplinary teams shared their journey of discovery, challenges, perseverance, and accomplishment during a virtual webinar event. The challenges created by the COVID-19 pandemic were significant and interrupted current priorities and planned approaches of participating health care organizations’ comprehensive medication management (CMM) initiatives. Despite unprecedented setbacks and abrupt changes, the A3 teams pushed forward, completing the collaborative experience and learning more about their own strengths, generating the momentum to keep moving forward.
The fourteen participating health care organizations in this recent A3 Collaborative are a representation of how the pharmacy community across the country stood up and responded to the COVID pandemic. Instead of shrinking back from responsibilities when the crisis hit, pharmacy, represented in health systems, communities, federally qualified health centers, critical access hospitals, and professional organizations, showed up with increase force and asked: what gaps can we fill?
Real Progress for Real Change
The A3 Collaborative participants celebrated and acknowledged the triumphs completed during these unparallel times for our national health care system and patients we serve. Many remarked that, with adaptation and creativity, they were able to keep with their challenging demand to meet the public health crisis head on, while still meeting the medication-related therapy needs of their patients. The following are several examples shared by teams describing how they were quickly able to adapt, respond, and champion innovative solutions, and how it is likely to impact the way care is delivered forever, and often for the better:
- Telehealth visits went from being stuck in perpetual “discussion mode” with executive leaders to swift implementation with appropriate securities in place. Pharmacy services quickly transitioned to virtual visits. Pharmacists remarked that they are more efficient; there is no “tracking people down in halls” and response time is faster through secure, virtual communications.
“Patients appreciate not having to make the trip for an office visit that can as easily be conducted virtually.”
- Swift and favorable regulatory changes allowed for provider organizations to bill for virtual visits.
“It was an opportunity to prove what we already knew: telemedicine can be an effective and efficient part of the care delivery system, and produce favorable outcomes.”
- Increase distribution and use of remote monitoring devices for patients with chronic diseases, such as diabetes and hypertension.
“This removed the need for patients to make frequent visits to our office. It also provided us (pharmacists and providers) the patients’ data in real time, so we could assess the patient’s condition faster and bring them in sooner if we noticed an issue rather than wait for next visit.”
- Identify new partners for collaboration and to reduce burden and provider burnout.
“A partnership with a local college of pharmacy to set up a call center allowed our overburdened, medical clinic to triage medication-related calls to them. The pharmacists staffing the call center were able to offer education around COVID-19 to most of the callers, allowing the clinic staff to address more immediate concerns around illness and medications.”
- Classes that were typically held onsite at a clinic or in a hospital pivoted to a virtual arrangement.
“Our health system did some ‘re-norming’ to our typical onsite classes. We anticipated and prepared how to manage and conduct outreach to the patients who were not responsive to this new arrangement. We learned that for many, the virtual class was more convenient.”
Carrying Momentum Forward
A3 Collaborative participants reflected on major lessons learned and how to take encountered set backs as a means to adjust what they are doing to continue to move forward in their CMM services. They identified gaps in the delivery system and stepped in to create a bridge. Consensus for many of the participating organizations is that they were able to reframe their roles in light of the crisis COVID created and thus, expand their value. By leveraging the new normal the pandemic created, A3 Collaborative participants shared how they grew programs and created opportunities even with restricted and minimized resources:
- COVID-19 pushed the envelope with our disease management programs to where we really wanted to be. It allowed us to expand our services to rural and underserved areas with the opportunity to conduct virtual visits.
- We demonstrated working with a physician that we can streamline processes in a more consistent manner and learn the value of collecting data to show what we are doing. Now we will hire a pharmacy technician position to help us.
- We have reinforced our thinking about how we document our interventions and then how best to articulate them so that others can see how our services are a component to the success of the entire health care team.
- This past year we reset with a new team and started to collect data. This energized our team. It was slow to get started but once the data started to confirm what we were doing, you’re no longer complacent and you can now show others what you are doing.
- We learned that our original vision of our health system was not picture perfect. As we continue to enhance our services our program morphs into something so much greater than expected.
AIMM’s Commitment to this Work
Participating health care organizations in the A3 Collaborative represent a mix of care settings and patient populations. It includes large, integrated health systems, federally qualified health centers, and community health centers, critical access hospitals, specialty clinics, and professional state organizations. Patient populations include urban and rural, underserved communities and communities with an abundance of health care options. All of the A3 Collaborative participating organizations in this recent cohort weathered the impact of COVID-19, and continues to do so. While many organizations were quick to hit the “pause button” on daily routines due to COVID, A3 Collaborative participants did not. Instead, AIMM increased the number of convenings to support teams. We continued with our regularly scheduled meetings and offered a series of additional, special topic webinars to help teams manage the onset and pressure of their continued work day amidst a national public health crisis. AIMM program development coaches worked one-on-one with organizations to adapt to a schedule and order of work that best met the organization where they were in that immediate moment.
“Unlike other organizations who withdrew involvement or halted programming, our A3 Collaborative became even more engaged and created space for collaboration specific to the COVID crisis. AIMM stepped up and addressed immediate challenges in a timely manner. Engagement and support were even more important now than before. Our AIMM coaches helped keep us accountable to our mission.” – Josh Feldmann, Envision Pharmacy Consulting (Iowa)
Toni Fera, PharmD
A3 Collaborative Project Lead & Development Learning Coach
The A3 Collaborative is a national learning collaborative experience designed to support health care organizations integrate comprehensive medication management services into primary care delivery. Each participating organization begins the collaborative experience developing a bold aim making their CMM services a strategic part of their organization’s agenda. They then systematically work towards that aim over a 12-month time period. At the end of each collaborative, participating organizations are able to articulate the organization’s journey to achieving their CMM aim.
At this time, AIMM is committed to designing a new and innovative strategic course that amplifies the scale of our collaborative work, invites more partners to the table, and offers resources and coaching to help to create financially sustainable models that accelerate expansion. Continue to follow us on Facebook and Twitter to learn more.