Design and implementation of population-based specialty care programs.

Area of Science:

• Health Services Research
• Population Health Management
• Clinical Pharmacy Practice

Background:

• Integrated healthcare systems offer unique opportunities for developing and scaling population-based specialty care programs.
• Clinical pharmacy services are crucial for ensuring safe, effective, and affordable care, particularly for high-complexity, high-cost patient populations.

Purpose of the Study:

• To review the development, implementation, and scaling of three population-based specialty care programs within a large integrated healthcare system.
• To highlight the integral role of clinical pharmacy services in optimizing care for specialty populations.

Main Methods:

• Review of three distinct specialty care programs: Home Phototherapy, Multiple Sclerosis Care, and KP SureNet.
• Leveraging an advanced electronic health record with disease registries and surveillance tools for care-gap identification.
• Integration of clinical pharmacists into multidisciplinary care teams to apply guidelines and identify opportunities for improved outcomes.

Main Results:

• The Home Phototherapy Program improved access to cost-effective nonpharmacologic interventions.
• The Multiple Sclerosis Care Program systematically applied clinical guidelines through pharmacist integration.
• KP SureNet utilized pharmacists and data analytics to prevent adverse drug events and ensure timely follow-up.

Conclusions:

• Integrated healthcare delivery models facilitate rapid innovation and expansion of pharmacy-involved population management programs.
• Clinical pharmacists are essential in enhancing the safety and effectiveness of care for specialty populations.
• Specialty care programs, supported by integrated systems and technology, improve quality, cost-effectiveness, and patient experience.