Nurses play pivotal care-coordination role to optimize clinical outcomes, save $$s

As we prepare to mark National Nurses Week on May 6-12, some of us may flash on the image of Florence Nightingale, considered the mother of modern nursing, while we mark the 200th birthday of “the lady with the lamp” on May 12. Others may think of a more modern-day nurse who’s left a lasting impact on their lives.

Those dedicated, skilled front-line caregivers thankfully still exist, especially during this difficult time as we battle a worldwide pandemic. But today, some nurses leverage their skills to play an even broader role, coordinating the care delivered by their own team and across a patient’s other providers.

There’s no question that delivering coordinated, value-based care today can be complicated and at times chaotic. Striving to provide truly patient-centered care that minimizes errors and waste while optimizing clinical, financial and satisfaction outcomes can involve a myriad of general practitioners and specialists, physical therapists, pharmacists and other healthcare and social services professionals. Just keeping a patient’s medications and their medications and adherence straight is challenging enough.

That’s why many of our RxLive patients go to providers who include care coordinators in a central role…typically nurses who leverage their broad clinical skills to free up providers’ time while ensuring the patient is being served appropriately.

A window into the patient’s world

Likewise, RxLive has our own staff of clinical care coordinators (CCCs) who work with our provider clients’ care coordinators and other members of their team to be, in effect, a “traffic cop” to help focus efforts on medication management and related issues. Our CCC cops guide the many things needed to encourage and empower patients to take their medications as prescribed. We also use our regular consults to be in effect a “window” into the patient’s world at home, subtly looking for clues as to their social determinants of health.

For instance, is a patient short on funds or mental/physical capabilities to fill and take their medications as their providers wish? Do they have enough money and are willing and able to have a balanced diet and proper food storage (such as a refrigerator and freezer) that will positively contribute to their health? Do they have someone who can be counted on to check in on them and their needs, take them to appointments, and support other concerns that can make the difference between good health and a health crisis? There are a huge number of factors that must be taken into consideration when trying to optimize not only a patient’s medications and adherence, but other lifestyle factors that have a dramatic impact on success.

Especially with high-risk patients with multiple conditions in an aging population, care coordinators today are simply essential to delivering value-based care.

Though their role continues to evolve, today’s RxLive’s clinical care coordinators:

  • Contact and book patients who have been referred by their doctor’s office to speak with a clinical pharmacist for comprehensive medication management.
  • Use the practice’s EHR to communicate back to the office-based care team that the RxLive consult has been performed and provide a single source in the patient’s record for encounters and recommendations.
  • Follow up on outstanding questions/to-dos after a consult has been completed, such as transferring prescriptions to a more-affordable pharmacy or mail order; following up on needed refills; tracking down insurance formularies to determine which of potential medication choices is covered and at what price by a patient’s insurance plan; letting the office’s care manager know what outstanding issues need to be followed up on; and assisting with booking follow-up appointments.

During National Nurses Week, we salute nurses delivering care everywhere, including those who make the complex nature of patient-centered care simpler and more attainable for providers and patients alike. We thank you all for your ongoing service!

(For more information on RxLive comprehensive medication-management services including clinical care coordination, call us at 866.234.4974.)

Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.