Knowledge Bank

Objective: The purpose of this project was to describe pharmacy services in a patient-centered medical home to demonstrate pharmacists’ involvement in the evolving delivery of primary care. Design: This was a prospective, qualitative study. Setting and Participants: This project analyzed the work of eight pharmacists employed at a National Committee for Quality Assurance tier III patient-centered medical home associated with a large, academic medical center. Outcome Measures: The primary outcome was to identify and quantify the types of services completed by pharmacists in a patient-centered medical home. Secondary outcomes included determining the percentage of pharmacist recommendations accepted by providers and patients, the percentage of pharmacist interventions submitted for third-party reimbursement, and the average time spent per encounter. Results: Eight pharmacists (representing 4.0 full-time equivalents) facilitated 581 encounters over 20 days. Mean time spent per encounter was 20 minutes (± 19). The most common types of encounters were interdisciplinary visits (31.8%) and phone/secure portal communication (30.0%). Of 918 pharmacist recommendations made to providers, 830 (90.4%) were accepted and implemented. Of 412 pharmacist recommendations made to patients, 393 (95.4%) were verbally accepted. Thirty-nine percent of encounters were eligible for direct payor billing. Conclusion: Our data show that pharmacists working in a patient-centered medical home are effectively integrated within the evolving delivery of primary care. Consistent inclusion of pharmacy services should be readily supported in future models of health care reform.