Being Successful in the Emerging Healthcare Environment
e sat down to write this column and noticed a new report from the Institute of Medicine (IOM). If you recall, the IOM brought us the Quality of Healthcare in America report series in the early 2000s. This series included Crossing the Quality Chasm, which outlined fundamental ﬂaws in how healthcare is delivered in this country. In the new report, the IOM ﬁnds that while our healthcare system has seen an “explosion in knowledge, innovation, and capacity to manage previously fatal conditions,” we still struggle with fundamentals like “quality, outcomes, cost, and equity.” The IOM’s report (found at http://bit.ly/ QiOY6H) indicates that the 2009 total for unnecessary health-related spending topped $750 billion, which is $100 billion more than the 2009 budget for the Department of Defense. Information technology was, again, singled out as an important tool to address the inadequacies in our healthcare system. Important to note is that both patients and providers are identiﬁed as target users of information technology. We also continue to follow developments related to the national efforts to implement electronic health records (EHRs) in hospitals and physician ofﬁces. The Stage 2 requirements for meaningful use of EHRs were released in August and are a major focus for health-system pharmacists. Under the government’s plan, hospitals and providers (i.e., physicians) must use EHRs in speciﬁc ways and meet certain metrics to qualify for incentive funds to offset the cost of purchasing and implementing these systems. “Meaningful use” is the label for the methods and metrics that hospitals and providers must meet. While meaningful use clearly targets hospitals and physician ofﬁces, the topic is not exclusionary to community pharmacy practice. In fact, as other providers become more connected digitally, community pharmacists have the opportunity to share in these data for 42
Brent I. Fox, Pharm.D., Ph.D.
Bill G. Felkey, M.S.
the beneﬁt of their patients and the enhancement of their own practice. Pharmacists will always ﬁnd value in having access to meaningful-use data whenever possible. Moreover, both the IOM report and the continued efforts for widespread EHR adoption are clear reminders that our healthcare system is dynamic. From our positions in a university setting, we have the opportunity to look at the big picture and focus on future directions for pharmacy practice by examining developments in policy, patient care, IT, regulations, and related domains. While we do not customarily delve into political implications, we acknowledge that the upcoming presidential election could also bring about signiﬁcant change. Notwithstanding the election, the IOM report and meaningful-use developments prompted us to focus this installment on what it might take to be successful in the emerging healthcare landscape.
Engaging the Patient The ﬁrst step is, of course, to deﬁne success.