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© 2016 by the American Pharmacists Association. All rights reserved.

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Let's Talk Tech: Addressing Unmet

Needs

Shelly Spiro RPh, FASCP, Pharmacy HIT Collaborative

Kimberly Braxton Lloyd, Pharm.D., Assistant Dean of Health Services, Auburn University Harrison School of Pharmacy

Mary Ann Kliethermes, BS Pharm, PharmD., Vice-Chair, Professor Chicago College of Pharmacy, Midwestern University

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Disclosures• Shelly Spiro declares no conflicts of interest, real or apparent, and

no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

• Kimberly Braxton Lloyd declares no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

• Mary Ann Kliethermes declares co-ownership of Clinical Pharmacy Systems, Inc.

The American Pharmacists Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

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• Target Audience: Pharmacists

• ACPE#: 0202-0000-16-036-L04-P

• Activity Type: Knowledge-based

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Learning Objectives• Describe examples of interoperable electronic health

record (EHR) systems that can be accessed by pharmacists.

• Identify EHR functionalities that impact pharmacy-based patient care services.

• Explain strategies that pharmacists can use to leverage information available through EHR systems to improve the quality and efficiency of pharmacist-based patient care services.

• Explain how pharmacists can use information available through EHRs to improve outcomes on quality measures, including meaningful use criteria.

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What data sources may be used by pharmacists to collect patient-specific information BEFORE meeting

with a patient for a baseline MTM consultation?(Mark all that apply)

A) Data imported from Pharmacy Benefit Management (PBMs)

B) Clinical data collected from employer wellness programs

C) Laboratory reports imported from lab contractors

D) Progress notes and labs sent from other healthcare providers


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Pharmacists may currently have access to interoperable health IT resources in

which type of practice settings?(Mark all that apply)

A) Hospitals

B) Integrated healthcare settings

C) Federal government-based hospitals and outpatient care centers

D) Patient-centered medical home care models with interprofessional care teams that are paid for performance

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How can Healthcare IT be usedto help pharmacist identify, measure, assess,

plan, act, and follow-up on medication-related quality indicators?

(Mark all that apply)

A) Use ICD-10 codes in claims to identify patients with chronic disease

B) Use pharmacy claims to identify patterns of non-adherence

C) Compare medical and pharmacy claims to ID gaps in care

D) Use claims to ID potential medication-related problems (MRPs)

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For optimal utilization of IT in the ambulatory setting it is most important to have a

clear understanding of:(Mark all that apply)

A) Your patient population

B) Your patient care workflow

C) The quality measures you are responsible for

D) Patient information you need to collect

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SNOMED CT codes may be used to transfer information in which step of the

patient care process?(Mark all that apply)

A) Collect

B) Assess

C) Plan/implement

D) Monitor and follow up

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Pharmacy Health Information Technology

Collaborative

Pharmacists and Health IT

Presenter: Shelly Spiro RPh, FASCPPharmacy HIT Collaborative, Executive Director

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Collaborative Overview

• 9 Professional Pharmacy Associations• Represents over 250K members in all practice

settings

Founding Organizations

• AACP-ACCP-ACPE-AMCP-APhA-ASCP-ASHP-NASPA-NCPA

Members

• Surescripts – NCPDP – RelayHealth – ScriptPro – OutcomesMTM – Amgen – Pfizer-GreenwayHealth- Cardinal Health/Fuse

Associate Members

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Vision- Mission

• The US healthcare system is supported by meaningful use of Health Information Technology (HIT) and the integration of pharmacists for the provision of quality patient care.

Vision

• To advocate and educate key stakeholders regarding the meaningful use of HIT and the inclusion of pharmacists within a technology-enabled integrated health care system.

Mission

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Goals

• Ensure HIT supports pharmacists in health care service delivery

Access

• Achieve pharmacists’ integration within health information exchange

Connectivity

• Support national quality initiatives enabled by HITQuality

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Key Value Points

• The Collaborative seeks to maximize the opportunities for the improvement of patient health and medication outcomes through effective and efficient integration of pharmacist patient care services that are documented in electronic health records and shared through local, state and regional health information exchanges.

• At the request of national pharmacy organizations, the Collaborative ensures that the pharmacy profession is at the appropriate HIT tables.

• The policy development aspects of the Office of the National Coordinator for Health IT (ONC) are now influenced through the active participation of the Collaborative.

• The Collaborative is an important catalyst for the development of standard clinical terminology codes (e.g. SNOMED CT) that assist pharmacists in the documentation of their patient care services into electronic health records.

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Pharmacy HIT Collaborative

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www.pharmacyhit.org

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The Roadmap for Pharmacy Health Information Technology Integration in

U.S. Health Care

Pharmacy Health Information Technology Collaborative

http://www.pharmacyhit.org/pdfs/11-392_RoadMapFinal_singlepages.pdf

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2014-2017 Strategic Plan

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http://www.pharmacyhit.org/index.php/strategic‐plan


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Pharmacy Health Information Technology Collaborative

Roadmap for Pharmacy Heath Information Technology Integration in U.S. Health Care 2014-2017 is an updated version of the update to the Pharmacy Health Information Technology Collaborative’s revised 2011-2015 Roadmap. It provides guidance to provider organizations, policymakers, vendors, payers, and other stakeholders striving to integrate pharmacy HIT into the national (U.S) HIT infrastructure. The revisions align the roadmap to the Collaborative’s 2014-2017 strategic plan, vision, and mission. A synopsis of the document provides a shorten overview of the Roadmap.

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http://www.pharmacyhit.org/pdfs/RoadmapUpdate_2015.pdf 20

• Volunteer through Collaborative’s Work Groups

– Billing and documentation coding

– Workflow and HIEs

– Adoption and Implementation of Pharmacists HER

Collaborative’s Work

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• Association's guidelines incorporate into Standards

– SDO’s

• Virtual involvement

• Health Level Seven (HL7) www.HL7.org

• NCPDP Collaborative Workspace http://dms.ncpdp.org/

– State HIEs

– Continuity of care document (CCD) using cCDA

• National Council for Prescription Drug Programs (NCPDP) Recommendations for Use of the HL7 Consolidated CDA Templates for Pharmacy Version 1. Ø,

http://www.ncpdp.org/NCPDP/media/pdf/NCPDP_Recommedations_for_Use_CCDA.pdf


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Committees and Work Groups

• Steering Committee – Oversees WG activities

• Value Set Committee

• 100 volunteers– WG1 ‐ Professional Service Claims and Codes

– WG2 ‐ Professional Service Documentation and Coding

– WG3 ‐ Communication Standards

– WG4 – Pharmacist EHR

• Develop guidance documents

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• Billing Codes and MTM Use Cases– MTM CPT

– Transitional care management services (TCMS) and Complex chronic care coordination services (CCCCS)

– Support team‐based (multidisciplinary) patient care

Terminology Projects

http://www.pharmacyhit.org/pdfs/worksho

p-documents/W

G1-Post-2014-02.pdf

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http://www.pharmacyhit.org/pdfs/workshop-documents/W

G1-Post-2015-01.pdf

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SNOMED CT for Pharmacists’ Medication Management• Pharmacy HIT Collaborative project

• Medication Therapy Management (MTM) value set – Search under SNOMED browser

– Topic: Medication Therapy

– More than 270 MTM clinical terms

• Other types of pharmacy value sets being considered by Pharmacy HIT Collaborative

• Pharmacist eCare Plan project

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• Association's guidelines incorporate into Standards

– SDO’s (NCPDP‐HL7)

– State HIEs

• Collect – Document – Exchange


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• Guidance Documents Examples (www.pharmacyhit.org )

– Medication Therapy Management Services Clinical Documentation: using a structured coding system – SNOMED CT

– Documenting Comprehensive Medication Management in Team‐Based Models Using SNOMED CT Codes

– Environmental Scan of Pharmacogenomics Coding: Current Practice and Barriers


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JCPP Pharmacists’ Patient Care Process

• The figure depicts a proposed standardized pharmacist patient-

centered collaborative care process for pharmacists providing medication

therapy management (MTM) services. • The pharmacists’ patient care process

described in this illustration was developed by examining a number of

key source documents on pharmaceutical care and MTM.

• Patient care process components in each of these resources were

catalogued and compared to create the following process that

encompasses a contemporary and comprehensive approach to patient-

centered care that is delivered in collaboration with other members of

the health care team.

Source: Pharmacists’ Patient Care Process, May 29, 2014. https://www.accp.com/docs/positions/misc/JCPP_Pharmacists_Patient_Care_Process.pdf..

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Patient Process of Care

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• Pharmacists’ Workflow

– Workflow of Pharmacist Clinical Documentation Process in Pharmacy Practice Settings

– System Vendor Checklist for Pharmacist Clinical Documentation Workflow

Guidance Documents

http://www.pharmacyhit.org/pdfs/works

hop-documents/WG3-Post-

2014-03.pdf

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2015-01.pdf

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• Pharmacists’ EHR Certification

– Pharmacist Electronic Health Record (EHR) Implementation Guide for Community Practice

– Electronic Health Record Certification: Making the Pharmacists’ Case to System Vendors

Guidance Documents

http://www.hl7.org/documentcenter/public/st

andards/informative/13-

294_HITSbook_HL7_Web.pdf

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2015-01.pdf


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Pharmacist EHR Certification

• Adopting Health Level 7 International (HL7) EHR functionality– HL7 EHR‐S Functional Model Release 1

– NCPDP/HL7 Pharmacist/Pharmacy Provider EHR Functional Profile

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Access-Connectivity-Quality

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http://www.pharmacyhit.org/SWF/11‐392_RoadMapFinal.html

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Contact:

Shelly Spiro

Executive Director, Pharmacy HIT Collaborative

[email protected]

www.pharmacyhit.org

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Healthcare IT in the Community Setting

Kimberly Braxton Lloyd, Pharm.D.

Assistant Dean of Health Services

Auburn University’s Harrison School of Pharmacy

Auburn, Alabama

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My Focus

• Outline challenges of providing MTM in the community without integrated HIT resources:– Developing interprofessional relationships

– Obtaining patient care data from providers

– Exchanging healthcare IT

• Gaps in data

• Processing delays

• Lack of integration of healthcare IT systems

• Communicating remotely with other providers

– Internal challenges within the community pharmacy

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My Focus (continued)

• Provide examples of how these challenges CAN be overcome:– Developing collaborative relationships with other

community healthcare providers

– Obtaining resource utilization data from payors

– Requesting records from other healthcare providers and other sources

– Identifying EHR solutions for the community pharmacy practice setting


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• Discuss community practice workflow:– Training staff how to document effectively

– Communicating effectively with other healthcare providers (science and art)

– Adjusting workflow to diversify services

– Selecting HIT resources for setting

– Developing billing procedures (TPA vs. PBM)

– Ensuring follow-up and continuity of care

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• Discuss utilizing existing HIT in community settings to identify patient care needs:– Potential or real MRPs

– Health and wellness needs

– Gaps in care

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My Practice Setting:

Auburn University Pharmacy Health Services (PHS)

• Three full-service community pharmacies (all closed-door, own use):– AU Student Pharmacy (AUSP)

– AU Employee Pharmacy (AUEP)

– State of Alabama Employee (SEIB) Pharmacy

• Two clinics– AU Pharmaceutical Care Center (AUPCC)

– State of Alabama Employee (SEIB) Clinic

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My Practice Setting:

PHS (continued)

• A Statewide Pharmacy Network– Alabama Pharmacy Services Network (APSN)

• Two residency programs– PGY-1 Ambulatory Care Residency

– Community Pharmacy Residency

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Integrated Health IT • Integrated health IT EHR solutions are

available to pharmacist in a number of practice settings:– Hospitals

– Integrated healthcare systems

– Integrated interprofessional teams with capitated $

– Federal government hospitals / outpatient care clinics

• Providers share a common EHR that facilitates record review, patient care, documentation, and interprofessional communication

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Pharmacist-Provided Patient Centered Care (PPPCC) in the Community Setting

• Community pharmacist practitioners face different challenges– The patient is the connectivity between practitioners

– Interprofessional relationships between pharmacists and other members of the patient’s healthcare team have not always been formed (independent practitioners)

– Pharmacists must develop a relationship with their patient’s practitioners

• PCPs

• Specialists


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(PPPCC) in the Community Setting (continued)

• Interprofessional relationship building is the starting point- the foundation. The next challenge is HIT:– Integrated IT solutions are not often established

between independent community practices

– Pharmacists often must request manual transfer of healthcare data

• Patient consent / HIPAA required

• Can be slow and delayed

• Must be integrated into existing HIT

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• Pharmacists can also obtain data from other sources, especially if contracted to provide MTM for a specific population:– Payors can facilitate data exchange between

contracted vendors and the pharmacists with whom they contract for PPPCC

• TPAs

• PBMs

• Lab Contractors

• Employer-based health screening data

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• The patient can facilitate data collection and sharing with the pharmacist for MTM

• Develop a comprehensive med list

• Bring all medication bottles

• Obtain copies of medical records

• Collect data from patient portals

• Request visit summaries

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SO IN THE ABSENCE OF INTEGRATED IT:There are alternative resources pharmacists can use to COLLECT data needed for PPPCC.…

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• After data is obtained, the pharmacists must meet with the patient and review all data and collect more information:

• Review subjective and objective data

• Discuss medication use

• Identify potential or real MRPs

• Develop a prioritized problems list

• Develop an action plan (MAP)

• Document care– Documentation is MANDATORY!

– Community pharmacies must have an EMR

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Pharmacies should select an EMR. Our documentation must reflect the level of care that we provide. When billing for professional services, the documentation must be in place to support the fees billed (consistent with other professional providers).


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• The final step in the patient care process is effective communication with other members of the patient’s healthcare team:– Effective communication is key

• Type of communication should be considered:

– Initial assessment

– Follow-up care

– Brief visit

• What is the best method to share information effectively, efficiently, etc.?

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FINALLY: We must EFFECTIVELY COMMUNICATE our assessments, prioritized problem list, plans, recommendations, etc. with the prescriber(s) and other members of the healthcare team.

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Effective Communication is Key

• When communicating with a physician for a recommendation:

– Be informative

– Be concise and specific

– Refer MD to more comprehensive documentation if needed

– Provide contact information for discussion

• Prospectively establish communication expectations:

– Method (FAX, e-mail, phone, text, etc.)

– Frequency

– Types of issues

– Standard reports (annual summaries, etc.)

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There Might Be Internal ChallengesAll community pharmacists might not embrace the opportunity to provide PCC for various reasons- some think it is futuristic- but it is real, it is now:

• Develop work flow that work in practice setting

• Use pharmacy staff effectively– Scheduling

– Correspondence

– Tracking records requests

– Data entry and scanning

• Use technology to identify care needs– Gaps in care

– MTM needs

– Quality indicators

• Develop collaborative relationships

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Identify EHR That Meets Needs

• Pharmacy HIT solutions are available and more are being developed to facilitate community services– The pharmacy EHR must be designed to:

• Host a full medical record

• Store subjective and objective data

• To maintain an up-to-date medication record

• Allow documentation of prioritized problem list

• Prints patient summaries

• Develops clinical summaries for other providers

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EHR Should Have Reporting Capabilities:

PHS’s EHR allows clinical analytics to facilitate identifying patients who need PPPCC


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EHR Should Have Reporting Capabilities:

PHS’s EHR Analytics can be conducted from population level down to patient specific level and

can compare year to year results.

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Other Resources:

– EHR should have meaningful use reporting

– PQA / EQUIPP

– Payor provided reports

– Patient referral from providers

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Healthcare IT in the Community Setting

Kimberly Braxton Lloyd, Pharm.D.

[email protected]

http://www.auburn.edu/academic/pharmacy/phs/index.html

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Guide to Utilizing IT in the Ambulatory

Setting

Mary Ann Kliethermes, BS, PharmD

Vice-Chair, Professor

Chicago College of Pharmacy

Midwestern University

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My Focus

• Explain strategies that pharmacists can use to leverage information available through EHR systems to improve the quality and efficiency of pharmacist-based patient care services.

• Explain how pharmacists can use information available through EHRs to improve outcomes on quality measures, including meaningful use criteria.

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Pharmacists’ Patient Care Process

http://www.pharmacist.com/mtm_library


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IT Needs to Support Workflow

http://www.pharmacyhit.org/pdfs/workshop-documents/WG3-Post-2014-03.pdf

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ASTM International E31 Standards

Adapted from http://www.astm.org/COMMIT/E31HealthInfandEHRStdsTraining.pdf

Registration

Encounter

Assessment

Treatment plan

Clinical decision

Encounter disposition

Orders

Test results

Observations

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It is actually pretty complex

https://healthit.ahrq.gov/sites/default/files/docs/citation/examining-the-relationship-between-health-it-and-ambulatory-care-workflow-redesign-final-report.pdf

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CollectThe pharmacist assures the collection of necessary subjective and objective information about the patient in order to understand the relevant medical/medication history and clinical status of the patient. Information may be gathered and verified from multiple sources. Collect:• A current medication list and medication use history for

prescription and nonprescription medications, herbal products, and other dietary supplements

• Relevant health data that may include medical history, health and wellness information, biometric test results, and physical assessment findings

• Patient lifestyle habits, preferences and beliefs, health and functional goals, and socioeconomic factors that impact access to medications and other aspects of care

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Step one of workflow

http://www.hitsp.org/ConstructSet_Details.aspx?&PrefixAlpha=4&PrefixNumeric=32

COPYRIGHT NOTICE © 2008 ANSI. This material may be copied without permission from ANSI only if

and to the extent that the text is not altered in any fashion and ANSI’s copyright is clearly noted.

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Additional Information to Collect



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Information likely already in an EMR

COPYRIGHT NOTICE © 2008 ANSI. This material may be copied without permission from ANSI only if and to the extent that the text is not altered in any fashion and ANSI’s copyright is clearly noted.

http://www.hitsp.org/ConstructSet_Details.aspx?&PrefixAlpha=4&PrefixNumeric=32

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How do you get this information?

Ability to log onto the EMR and level of access

• Security clearance• Secure password access• Communication software for secure access

Obtain EMR data

• Information exchanges• Other means

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Health information exchange

$547,703,438 distributed to every state $ territories in 2011

Funding Purpose• Create and implement up-to-date privacy and security requirements for

HIE • Coordinate with Medicaid and state public health programs to establish

an integrated approach • Monitor and track meaningful use HIE capabilities in their state • Set strategy to meet gaps in HIE capabilities • Ensure consistency with national standards

https://www.healthit.gov/providers-professionals/health-information-exchange/getting-started-hie

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Illinois

http://www.illinois.gov/sites/ilhie/Pages/What-is-the-ILHIE.aspx

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Status of Exchanges

https://www.healthit.gov/policy-researchers-implementers/hie-bright-spots

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In our lifetime?DirectTrust a collaborative non-profit association of

150 health IT and health care provider organizations to support secure, interoperable health information

exchange

identified the following trends in 2016

Patients will have greater access to their clinical records, and they will be able to more freely and

easily move those records whenever and to whomever they choose.

Reliance on Direct exchange for secure, interoperable transfers of patient health information

between & among providers for care coordination will continue to grow.

https://www.directtrust.org/directtrust-identifies-six-trends-for-electronic-health-information-exchange-and-interoperability-in-2016-2/


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http://www.effectivehealthcare.ahrq.gov/ehc/products/33/1186/DEcIDE38_Toolkit_20120711.pdf

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Can your system receive this information and how do you want to view it?

www.cpsirx.com

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Gaps and updates collected during the visit

Document and share

new or changed

information

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AssessThe pharmacist assesses the information collected and analyzes the clinical effects of the patient’s therapy in the context of the patient’s overall health goals in order to identify and prioritize problems and achieve optimal care. Assess:• Each medication for appropriateness, effectiveness, safety, and

patient adherence• Health and functional status, risk factors, health data, cultural

factors, health literacy, and access to medications or other aspects of care

• Immunization status and the need for preventive care and other health care services, where appropriate

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Step 2 of the workflow• Identify the patient’s medication related

problems

Document and share

new or changed

information

Document and share

new or changed

information

Document and share identified

medication related

problems information

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SNOMED CT Codes for assessment



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What may this look like?

www.cpsirx.com 80


www.cpsirx.com

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PlanThe pharmacist develops an individualized patient-centered care plan, in collaboration with other health care professionals and the patient or caregiver that is evidence-based and cost-effective.

The plan:

• Addresses medication-related problems and optimizes medication therapy

• Sets goals of therapy for achieving clinical outcomes in the context of the patient’s overall health care goals and access to care

• Engages the patient through education, empowerment, and self-management

• Supports care continuity, including follow-up and transitions of care as appropriate

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Step 3 of the workflow

• Develop an individualized patient-centered care plan

Document and share

new or changed

information


medication related


Document and share

plan of care

83http://www.pharmacyhit.org/pdfs/workshop-documents/WG2-Post-2014-03.pdf 84


www.cpsirx.com


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Implement

The pharmacist implements the care plan in collaboration with other health care professionals and the patient or caregiver. The pharmacist:• Addresses medication- and health-related problems, and

engages in preventive care strategies, including vaccine administration

• Initiates, modifies, discontinues, or administers medication therapy as authorized

• Provides education and self-management training to the patient or caregiver

• Contributes to coordination of care, including the referral or transition of the patient to another health care professional

• Schedules follow-up care as needed to achieve goals of therapy

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• Implements the care plan in collaboration with other health care professionals

Document and share

new or changed

information


medication related


Document and share

plan of care

Document and share

your actions to

implement plan

87http://www.pharmacyhit.org/pdfs/workshop-documents/WG2-Post-2014-03.pdf

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www.cpsirx.com

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Follow-up: Monitor and Evaluate

The pharmacist monitors and evaluates the effectiveness of the care plan and modifies the plan in collaboration with other health care professionals and the patient or caregiver as needed.

Monitor and evaluate:• Medication appropriateness, effectiveness, and safety and patient

adherence through available health data, biometric test results and patient feedback

• Clinical endpoints that contribute to the patient’s overall health• Outcomes of care, including progress toward or the achievement of

goals of therapy

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• Monitors and evaluates the effectiveness of the care plan and modifies

Document and share

new or changed

information


medication related


Document and share

plan of care

Document and share

your actions to

implement plan

Document and share

monitoring changes and

outcomes


91http://www.pharmacyhit.org/pdfs/workshop-documents/WG2-Post-2014-03.pdf

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www.cpsirx.com

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https://pbrn.ahrq.gov/sites/default/files/docs/01%2028%2015%20Practical%20Insights%20on%20Meeting%20Objectives%20of%20Meaningful%20Use%20III%20_sxf.pdf

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https://pbrn.ahrq.gov/sites/default/files/docs/01%2028%2015%20Practical%20Insights%20on%20Meeting%20Objectives%20of%20Meaningful%20Use%20III%20_sxf.pdf

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AHRQ Report On Health Information Exchange

http://www.effectivehealthcare.ahrq.gov/ehc/products/572/2154/health-information-exchange-report-151201.pdf 96

Complexity of what must be built

https://healthit.ahrq.gov/sites/default/files/docs/publication/2014-jason-data-for-individual-health.pdf


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Complexity of what must be built

https://healthit.ahrq.gov/sites/default/files/docs/publication/2014-jason-data-for-individual-health.pdf 98

Summary of what you may need to send out


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Key Points

• It is critical to articulate the elements of the patient care process and your workflow

– Data you need to perform your services

– Service(s) to be provided and IT needs that complement and support your workflow

– What data collected by you and output of your services are then to be shared with others who are part of the patients care team

• These are complex processes that require bi-directional communication between pharmacists and IT, as well as team communication and often the expertise of a pharmacist trained in IT

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Key Points: The future is now!

• Stay current on health IT on the national level– Pharmacy HIT: http://www.pharmacyhit.org

– Be involved in a pharmacy organization

• Stay current on health IT on the state level– Search activity in your state

– Be involved with your state pharmacy organization

– Make sure your state pharmacy organizations are involved in state health IT initiatives

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What data sources may be used by pharmacists to collect patient-specific information BEFORE meeting

with a patient for a baseline MTM consultation?(Mark all that apply)

A) Data imported from Pharmacy Benefit Management (PBMs)

B) Clinical data collected from employer wellness programs

C) Immunization reports from public health sources

D) Progress notes and labs sent from other healthcare providers

102

Pharmacists may currently have access to interoperable health IT resources in

which type of practice settings?(Mark all that apply)

A) Hospitals

B) Integrated healthcare settings

C) Federal government-based hospitals /outpatient centers

D) Patient-centered medical home care models with interprofessional care teams that are paid for performance

ALL OF THE ABOVE


103

How can Healthcare IT be usedto help pharmacist identify, measure, assess,

plan, act, and follow-up on medication-related quality indicators?

(Mark all that apply)

A) Use ICD-10 codes in claims to identify patients with chronic disease

B) Use pharmacy claims to identify patterns of non-adherence

C) Compare medical and pharmacy claims to ID gaps in care

D) Use claims to ID potential medication-related problems (MRPs)

104

For optimal utilization of IT in the ambulatory setting it is most important to have a

clear understanding of:(Mark all that apply)

A) Your patient population

B) Your patient care workflow

C) The quality measures you are responsible for

D) Patient information you need to collect

105

SNOMED CT codes may be used to transfer information in which step of the

patient care process?(Mark all that apply)

A) Collect

B) Assess

C) Plan/implement

D) Monitor and follow up