Implementation of a pharmacist-driven formulary management service within a community health-system insurance plan

2018 ◽  
Vol 75 (23) ◽  
pp. 1854-1856
Author(s):  
Chelsea A. keedy ◽  
Alix p. Schnibben ◽  
Joseph F. Crosby ◽  
Amanda C. L. McGlasson ◽  
Anne Misher
Keyword(s):  
Health System ◽  
Community Health ◽  
Management Service ◽  
Insurance Plan ◽  
Formulary Management

scholarly journals 57. Evaluating the Utility of a Penicillin Allergy Reconciliation Program within an Infectious Diseases Consult Population in a Community Health System

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S49-S50
Author(s):  
Bruce M Jones ◽  
Emily Plauche ◽  
Susan E Smith ◽  
Christopher M Bland
Keyword(s):  
Infectious Diseases ◽  
Health System ◽  
Community Health ◽  
Intervention Program ◽  
Primary Outcome ◽  
Panel Member ◽  
Penicillin Allergy ◽  
Secondary Outcome ◽  
Research Support ◽  
Research Grant

Abstract Background Penicillin allergy reconciliation is an important aspect of antimicrobial stewardship with ~10% of the population reporting a penicillin allergy. Our facility utilizes a Penicillin Allergy Reconciliation Program (PARP) led by an Infectious Diseases (ID) Pharmacist and pharmacy students to identify patients with penicillin allergies to reconcile and intervene when necessary. Information is collected by interview, electronic medical record (EMR) review, prescription outpatient fill history. This study evaluated reconciliations with and without a PARP in patients in a community health system. Methods This was a retrospective study that compared reconciliations performed on adult patients admitted at least once in 2019 with a self-reported penicillin allergy and ID physician consult at a hospital with a PARP (Institution 1) and one without a formal evaluation and intervention program (Institution 2) within the same community health system with same ID physicians. The primary outcome was documented reconciliation of a patient’s penicillin allergy during an inpatient visit in 2019. Reconciliation was defined as an edit or clarification (updating the severity, reaction, or comments section, as well as deleting) to a patient’s penicillin allergy in the EMR. The secondary outcome evaluated the percentage of total and ID consult patients with a penicillin allergy. Results There were 245 patients who met criteria and were included in the study, 113 from Institution 1 and 132 from Institution 2. For the primary outcome, there were 82 (72.6%) reconciliations at Institution 1 and 15 (11.4%) reconciliations at Institution 2 (p < 0.001). Interventions at Institution 1 and 2 resulted in 74 EMR updates and 8 removals and 14 EMR updates and 1 removal, respectively. Reconciliation was performed on the same visit as the ID consult in 59/82 patients (72%) at Institution 1 and 11/15 patients (73.3%) at Institution 2. All reconciliations at Institution 2 were made by pharmacist (10) or nurses (5). For the secondary outcome, 10.9% of patients with an ID consult and 12.6% of all patients admitted in 2019 had a penicillin allergy (p=0.027). Conclusion A PARP led by an ID pharmacist and students was an effective method to perform penicillin allergy reconciliations, even in the presence of active ID consultation. Disclosures Bruce M. Jones, PharmD, BCPS, ALK-Abello (Research Grant or Support)Allergan/Abbvie (Speaker’s Bureau) Christopher M. Bland, PharMD, FCCP, FIDSA, BCPS, ALK Abello, Inc. (Grant/Research Support)Biomerieux (Consultant)Merck (Consultant, Grant/Research Support, Advisor or Review Panel member, Speaker’s Bureau)Tetraphase (Speaker’s Bureau)

Three program enhancements to advance population genetic screening in a community health system during 2020

2021 ◽  
Vol 132 ◽  
pp. S360-S361
Author(s):  
Peter Hulick ◽  
Jared Hammernik ◽  
Nadim Ilbawi ◽  
Janardan Khandekar ◽  
Amy Lemke ◽  
...  
Keyword(s):  
Health System ◽  
Community Health ◽  
Genetic Screening ◽  
Population Genetic

Implementing a personalized medicine program in a community health system

2018 ◽  
Vol 19 (17) ◽  
pp. 1345-1356 ◽  
Author(s):  
Lynn G Dressler ◽  
Gillian C Bell ◽  
Karl D Ruch ◽  
Jennifer D Retamal ◽  
Paige B Krug ◽  
...  
Keyword(s):  
Personalized Medicine ◽  
Health System ◽  
Community Health

scholarly journals Capacitação de agentes comunitários de saúde: integração entre universidade e atenção básica

2020 ◽  
Vol 11 (3) ◽  
pp. 349-359
Author(s):  
Amanda Brait Zerbeto ◽  
Leonardo De Carvalho ◽  
Thaís Amanda Rossa ◽  
Daniel De Paula
Keyword(s):  
Health System ◽  
Continuing Education ◽  
Community Health ◽  
Engineering Students ◽  
Health Workers ◽  
Unified Health System ◽  
Local Problems ◽  
Health Concept ◽  
Institutional Relations ◽  
Training Community

O Projeto Rondon tem criado oportunidades, especialmente na saúde, para que universitários interajam com comunidades vulneráveis, socializando saberes e discutindo soluções coletivamente. O Agente Comunitário de Saúde (ACS) é um personagem fundamental na implementação do Sistema Único de Saúde (SUS), fortalecendo a integração entre os serviços de saúde e a comunidade. Mesmo com muitos avanços, a formação dos ACS permanece um desafio. Este estudo relata a experiência de um projeto de extensão na elaboração, desenvolvimento e realização de uma capacitação para ACS no município de Lindoeste, Paraná. As oficinas foram elaboradas multidisciplinarmente por acadêmicos de enfermagem, nutrição, psicologia e engenharia ambiental. Adotou-se o conceito ampliado de saúde, abordando conceitos do SUS, promoção e prevenção, educação ambiental, nutrição, humanização, além de demandas locais. A utilização de metodologias ativas e de temas relacionados à comunidade permitiram a troca de saberes, criando um espaço em que todos puderam expor suas opiniões e assim buscar soluções para os problemas locais. O desconhecimento dos ACS sobre os conceitos do SUS foi um desafio para o aprofundamento da discussão, moldando o debate muitas vezes num modelo pedagógico clássico. Um ponto positivo foi a integração e colaboração entre os ACS a partir do entendimento dos impactos que o processo de trabalho pode trazer ao município. A partir da capacitação dos ACS, ficou evidente a importância de os projetos de extensão estarem em consonância com as necessidades do território que, no presente trabalho, revelou a necessidade de elaboração e realização da educação continuada dos ACS. Palavras-chave: Sistema Único de Saúde; Atenção Primária à Saúde; Educação Continuada; Relações Comunidade-Instituição Training community health workers: integration between university and primary healthcare   Abstract: The Rondon Project has provided opportunities, especially in the health area, for university students to interact with vulnerable communities, share knowledge, and discuss solutions collectively. The Community Health Worker (CHW) plays a key role in implementing the Brazilian Unified Health System (Sistema Único de Saúde - SUS), strengthening the integration between health services and the community. Even with many advances, the education of CHWs remains a challenge. This study reports an extension project's experience in elaborating, developing, and accomplishing training for CHW in Lindoeste, Paraná state, Brazil. The workshops were developed in a multidisciplinary manner by nursing, nutrition, psychology, and environmental engineering students. The expanded health concept was adopted, addressing SUS concepts, health promotion, prevention, environmental education, nutrition, humanization, and local demands. The use of active learning methods and community-related themes allowed for knowledge sharing, creating an environment where everyone could express their opinions and seek solutions to local problems. CHW's lack of knowledge about SUS concepts was a challenge to deepen the discussion, often shaping the debate in a traditional way. A positive point was the integration and collaboration among CHW, which were carried out in understanding the value of the collaborative workflow for their community. This experience highlighted the importance of the extension project being in tune with the demand of the territory, which in the present work revealed the need to elaborate and carry out continuing education of the CHW. Keywords: : Unified Health System; Primary Health Care; Continuing Education; Community Institutional Relations

Abstract 14681: Comparative Study Between International Guidelines in Detecting Pediatric Familial Hypercholesterolemia Through a Unique Community Health System in Kagawa, Japan

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Keiji Matsunaga ◽  
Asako Mizobuchi ◽  
Hayato Tada ◽  
Tsuyoshi Sasaki ◽  
Yoshihiro Asano ◽  
...  
Keyword(s):  
Health System ◽  
Community Health ◽  
Familial Hypercholesterolemia ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hereditary Disease ◽  
International Guidelines ◽  
Number Of Children ◽  
Lipid Clinic ◽  
Lipid Screening

Introduction: Familial hypercholesterolemia (FH) is an autosomal hereditary disease found in patients who have elevated low-density lipoprotein cholesterol (LDL-C) from birth. Early detection and treatment of FH during childhood potentially reduces the risk of premature cardiovascular events. In Kagawa prefecture, a unique community health system, involving three steps, has been conducted to prevent lifestyle-related diseases for 10-year-old children. This system includes universal lipid screening, selection by pediatricians, and next-generation sequencing (NGS) of FH-related genes in hospitals. The aim of this study is to compare 3 international guidelines to detect pediatric FH with this unique community health system in Kagawa. Methods: In Kagawa prefecture, the universal lipid screening of approximately 8,000 children at 10 years of age is performed annually, covering over 90% of the target group. After excluding secondary hypercholesterolemia, pediatric clinics introduced children with LDL-C >140mg/dL to 4 designated hospitals to perform NGS. We applied the guidelines of the Dutch Lipid Clinic Network (DLCN), Simon Broome (SB), and the Japanese Atherosclerosis Society (JAS) to children who received NGS in the unique community health system in Kagawa. Results: We performed NGS for 46 children from January 2018 to February 2020 (LDL-C 186.0±50.3 mg/dL; Male/F 27/19) and 26 (57%) had FH genetic mutations (23 LDL-R and 3 PCSK9 mutations). Seventeen children met FH criteria for DLCN (35%), 10 for Simon Broome (22%), and 11 for JAS (24%), respectively. The combination of NGS and either of the 3 guidelines increased the number of children diagnosed as FH up to 31 (67%). Conclusion: International guidelines detected only half of pediatric FH who were diagnosed by the unique community health system in Kagawa. Further investigation will be required to build an effective universal screening system for pediatric FH.

Electronic Unified Health System: opportunities for improvement

2020 ◽  
Vol 42 ◽  
pp. e48190
Author(s):  
Camila Santana Justo Cintra Sampaio ◽  
Yolanda Dora Martinez Évora
Keyword(s):  
Health System ◽  
Community Health ◽  
Health Information ◽  
Health Information System ◽  
Family Health ◽  
Evaluation Instrument ◽  
Professional Activities ◽  
Unified Health System ◽  
The People ◽  
Informed Consent Form

This study aimed to develop and evaluate a prototype with opportunities for improvement for the e-SUS Primary Care module, integrated in the proprietary system used at the research site, with a view to improving the health information system. It is an applied research, with a qualitative approach, in the action-research modality. The population consisted of all (30) Community Health Agents assigned to six Family Health Centers in the city of Ribeirão Preto, State of São Paulo, Brazil and six computer experts, who agreed to participate in the research by signing the Informed Consent Form. The study was developed in three stages. Stage 1 - Knowledge brought by the Community Health Agent (CHA): observation, by the researcher, of the execution of professional activities in the Electronic Unified Health System of Primary Health Care and unstructured interview, between May and July 2016; Stage 2 - Construction of the prototype with opportunities for improvement for the e-SUS AB module. We used the AXURE RP Pro 7.0 software. Stage 3- Evaluation of the prototype by the CHA and computer experts. An evaluation instrument was developed considering the specifications described by ISO/IEC 25010, 9241 and 14598 with the parameters: poor, fair, good and excellent. The results show the importance of knowing the aspects related to the way of working, or behavior, that can influence the final quality of the data inserted in the Health Information Systems. In the same way, such systems aim to obtain inputs for the definition of the requirements and goals of usability, in order to meet the different user roles identified, and also reinforces the relevance of looking at own systems, acquired in the private market or developed in the municipality. The rapprochement between the researcher and the people involved in the investigated situation allowed for the detection of gaps between the indispensable components to carry out the actions that aim to consolidate computerization in health and, above all, to outline potential solutions to the problems identified.

scholarly journals 202. Implementation and Three-Year Results of Antimicrobial Stewardship Program in a Three Hospital Community Health System

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S88-S88
Author(s):  
Nikunj Vyas ◽  
Cindy Hou ◽  
Marianne Kraemer ◽  
David Condoluci ◽  
Deborah Cunningham ◽  
...  
Keyword(s):  
Health System ◽  
Community Health ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program
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