Health Care as a Team Sport: Connecting Care across the Health Continuum

CVS Health’s Dr. William Shrank, Senior Vice President, Chief Medical Officer, Health Systems Alliances and Chief Scientific Officer, recently authored a commentary about collaborations between pharmacies, retail clinics and health systems for the newly launched “Insight Center,” a publication of the New England Journal of Medicine and the Harvard Business Review. The article highlights the importance of collaborating across the health care system as we shift to outcomes-based care, and discusses how collaboration can help us manage population health with greater precision. In the article, he emphasizes that collaborations with retail pharmacies and clinics can help health systems improve quality care and lower health care costs. For more information about how these collaborations work read below.

At CVS Health, we like to think of health care as a “team sport,” with pharmacists and retail health providers playing a collaborative role in helping patients manage chronic diseases and access key preventative care such as vaccinations, smoking cessation and weight loss counseling. We partner with health providers to support the entire continuum of care and have forged clinical collaborations with more than 60 major health systems and health care providers across the country.

Together, we’re working to increase access to care and help improve medication adherence. We do this by enabling communication between the secured electronic health record systems for us and our provider affiliates. This allows us to share data regarding prescriptions and MinuteClinic® visits, as well as report on medication adherence interventions conducted by CVS pharmacists.

How It Works: A Patient’s Experience

Here’s an example of how these collaborations work:

Martin, 56, is diagnosed with high blood pressure and prescribed a daily anti-hypertensive by his primary care physician. He fills that prescription at his local CVS Pharmacy®, but within a week, he’s forgotten to take the medication several times.

When he does take the medication, he experiences an uncomfortable dry cough. Martin thinks this may be a cold, so when he visits his CVS Pharmacy to re-fill his high blood pressure medication, he also stops by the MinuteClinic, where the provider determines that the cough is a medication side effect and suggests that he talk with his primary care provider about an alternative option that doesn’t cause side effects. And, because he’s not taking his medicine as prescribed, it has taken longer for Martin to need his first re-fill. The pharmacist notices the delay and counsels him about the importance of medication adherence when his prescription is ready. She also suggests that he measure his blood pressure regularly, and shows him how to use the blood pressure cuff near the pharmacy.

Martin schedules an appointment with his primary care provider for the following week. Because CVS Pharmacy and MinuteClinic are affiliated with Martin’s primary care provider, all of this information is shared with his doctor via his electronic health record. During his doctor’s visit, Martin can expect a more tailored and informed conversation as well as a new prescription for another therapy that won’t cause a dry cough, which will help him stay adherent and lower his risk for heart disease and stroke.

MedStar Health: Collaboration in Action

One example of our team-based care model is our affiliation with MedStar Health, which serves Maryland and the Washington, D.C. region. As part of the Million Hearts® campaign, a public-private partnership dedicated to preventing one million heart attacks and strokes by 2017, MedStar is building a team-based approach for addressing high rates of hypertension and improving blood pressure care for adults living in Washington.

Through our clinical collaboration, CVS Health is providing prescription and visit information to MedStar providers for their patients who use CVS Pharmacy or MinuteClinic. In addition, our pharmacists are counseling MedStar patients who have been identified as non-adherent or at risk for non-adherence and offering tailored interventions to help them get back on track such as aligning maintenance prescription re-fills so all medications are ready together for pick-up. And, all of the data from these interventions will be provided back to the patient’s primary care provider to provide a more holistic view of the patient and aid in clinical decision-making. Together, we’re working to address non-adherence issues early to help more patients stay on track with their treatment for high blood pressure.

What’s Next?

We believe that our clinical collaborations demonstrate the value of a team-based care model that benefits patients, providers and payers. And as the health care system continues its rapid transformation, we are continuing to find new ways to connect the dots in health care as we strive to improve patient care and health outcomes while controlling costs.