Increased collaboration with physicians means better health outcomes, but what does that look like in the real world? APhA and the CDC recently teamed up to create a guide for pharmacists and physicians on how to work together to achieve greater health outcomes. The guide describes “community-clinical linkages,” which are connections among the community, clinics, and other settings “where primary care is provided to improve population health.” The guide details two types of collaborative care models: medication therapy management (MTM) and collaborative drug therapy management (CDTM). It describes MTM as a patient-centered collaboration designed to enhance a patient’s benefits from medication and achieve therapeutic goals. CDTM is a more formal collaborative model in which pharmacists manage and monitor “drug therapy to optimize patient outcomes and safety.” The guide reviews the vast amount of data supporting both types of models. There are two large barriers to a collaborative care model, according to the guide. Traditionally, physicians and pharmacists worked separately from one another. In fact, the guide mentions a study conducted at a large teaching hospital that found that health-care providers from different disciplines caring for the same patient often did not even recognize one another. Because of this separation, it is often difficult for health-care providers to envision working together. Another barrier to this type of cooperation is a working payment model. The guide believes that the “linkages are not dependent on reimbursement to be effective or sustainable.” Many physician or pharmacist duties would remain the same in a cooperation, they would simply be more formalized. However, the guide does note that “realizing the full value of clinical pharmacy services” would require some sort of payment plan. The guide does not go into the specifics of how to do this, but does encourage pharmacists to become involved with one of the more than 700 accountable care organizations. To help guide the collaboration model, the CDC guide provides a helpful pneumonic device, LINKAGE: L: Learn about the community and clinical sectors I: Identify and engage key stakeholders from the community and clinical sectors N: Negotiate and agree upon goals and objectives of the linkage K: Know which operational structure to implement A: Aim to coordinate and manage the linkage G: Grow the linkage with sustainability in mind E: Evaluate the linkage For each of these steps, the guide provides helpful, specific tips to enable pharmacists and physicians to work more closely together. Using these tools, both health-care providers and patients could see more favorable health outcomes in the future. Source
