TABLE 3.
Interview Respondent Quotes on the Use of Health Information Technology and Integration of Pharmacists
| Use of HIT |
| Limited use of HIT |
| “And that’s probably why you’ll see our hands-on approach, it’s because of the weaknesses of the electronic transfer of information, it’s not very reliable.” (Hospital, ACO 1) |
| “As far as medication use, I’m not sure our IT system has really addressed that …” (Physician, ACO 8) |
| Intermediate use of HIT |
| “We build a two-way interface with our preferred hospitals. We know our hospitals use that because we can see in the discharge notes that they are looking at patients’ medication lists.” (Provider, ACO 6) |
| “We’ve got some technology … that’s able to pull data from different EHRs. We look at patients … that are on [multiple] medications.” (Physician, ACO 7) |
| Multifaceted or complex use of HIT |
| “We’ve got a lot of informatics, population health initiatives and registries. We can quickly identify patients who are not meeting objective goals of chronic disease management.” (Hospital, ACO 2) |
| “We’ve got several mobile apps that are very detailed in showing the patients what they’re on, what it costs, and what the alternatives are.” (Integrated, ACO 11) |
| “We are an HIMSS stage 7 organization. We have a pharmacist IT team that manages the entire medication profile [and] supports safe prescribing of medications.” (Integrated, ACO 12) |
| Integration of Pharmacists |
| Beginning or intermediate integration of pharmacists |
| “One of our larger regions brought in a pharmacist in one practice to really get a handle on the prescribing habits. And I think it was in a six-month period, saved just that one practice a quarter of a million dollars, not to mention better care delivery.” (Hospital, ACO 3) |
| “We embed clinical pharmacy in two of our primary care practices so that the clinical pharmacists are actually seeing patients. So, that’s a pilot program … ” (Hospital, ACO 4) |
| “I think the pharmacists would generally like to have more involvement in trying to assist the physicians with some of these things. But it can be hard to justify new positions [or] resources within pharmacy to actually be dedicated for that purpose since it’s not necessarily a money-making endeavor.” (Integrated, ACO 11) |
| Broader integration of pharmacists |
| “When I’ve talked to other delivery systems, we have a bigger investment than most in clinical pharmacists. So, every practice site has an embedded clinical pharmacist. The practices consider the clinical pharmacist a member of the team.” (Physician, ACO 6) |
| “I’ve got a team of about 12 pharmacists. Each of them is assigned different topics or subject matter areas … [They are] really focused mainly on what’s happening in our clinics and hospitals. We have several pharmacists that sit on our P&T committee.” (Integrated, ACO 9) |
| “[It is] very high on our list in terms of making sure that we are having our pharmacists practice at the top of their license.” (Integrated, ACO 12) |
ACO = accountable care organization; EHRs = electronic health records; HIMSS = Healthcare Information and Management Systems Society; HIT = health information technology; IT = information technology; P&T = pharmacy and therapeutics.