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Related Experiment Videos

Formularies in integrated health systems: Fallon Healthcare System

S B Cano1

  • 1Department of Pharmacy, Fallon Healthcare System, Worcester, MA 01606, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|February 1, 1996
PubMed
Summary

Integrated health systems manage drug formularies across different care settings. Coordinated formulary decisions consider system-wide needs, impacting drug use in ambulatory and inpatient environments.

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Area of Science:

  • Health Services Research
  • Pharmacy Management
  • Integrated Health Systems

Background:

  • Integrated health systems present unique challenges for formulary management due to diverse patient populations and care settings.
  • A Massachusetts integrated health system comprises a physician group practice, HMO, hospital, long-term care facility, and other entities, each with distinct operational levels.

Purpose of the Study:

  • To describe the implications of formulary management within a Massachusetts integrated health system.
  • To examine how two distinct formularies influence drug therapy across various system components.

Main Methods:

  • Analysis of formulary governance and decision-making processes within the integrated health system.
  • Description of the two primary formularies: Fallon Clinic's for HMO patients and Saint Vincent Hospital's for hospital and long-term care facility patients.

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  • Examination of drug review processes, nonformulary requests, and collaborative efforts between formulary committees.

    • Main Results:

    • Two distinct formularies (Fallon Clinic and Saint Vincent Hospital) govern drug therapy for the majority of patients.
    • Both formularies mandate formal drug review and have structured processes for nonformulary requests.
    • Coordinated formulary decision-making considers system-wide needs, influencing drug selection (e.g., enoxaparin, oral agents).

    Conclusions:

    • Despite ongoing operational integration, collaborative information exchange occurs between formulary committees.
    • Formulary management is coordinated to address system-wide needs, ensuring continuity of drug therapy.
    • The clinic's formulary influences ambulatory drug use, while the hospital's formulary impacts inpatient and subacute care drug use.