Dr Crystal Zhou Discusses Incorporating Pharmacists Into the Cardiology Care Team

Patients who cardiologists see once every few months are getting handed over to pharmacists who can monitor them more frequently and get them to their goals, said Crystal Zhou, PharmD, assistant professor of Clinical Pharmacy at the University of California, San Francisco (UCSF).

Transcript

In what ways are doctors and other health care providers turning to pharmacists more that is leading to an expanded role of pharmacists in care delivery?

So, I feel like our cardiologists are turning more and more over to us for some of their chronic disease state management patients. So those they're not able to see every 1 to 2 weeks. So as an example, someone with uncontrolled hypertension, cardiologists are so busy, they can see the patients maybe every month, every 3 months, maybe even every 6 months, given the patient load.

But when they refer the patients over to our pharmacy team, we're able to see them maybe every 1 to 2 weeks and follow up with the patient, report back to our cardiology providers and monitor that very, very closely. So, I think with the increasing patient load that's become really helpful for our cardiologists.

As more of health care is paid for through value-based payment arrangements, how should pharmacists be included in the care team to meet the metrics tracked in these contracts and improve care to patients?

Billing has kind of been the bane of our existence. It's been really difficult to build for our individual services, and even if we do bill, it's just really not enough.

So, I think value-based care is really the next step to incorporating pharmacists in billing. And maybe a simple example would be if we can manage all of cardiology’s hypertension patients and get them to goal, then the pharmacy team or the cardiology team will get a lump sum that could be shared among pharmacists, and that might be more beneficial than billing per patient or per encounter, as we've thought about in the past.

Right now, at UCSF, we're actually billing in a facility fee. But it's not enough to cover the visit or the salary of the pharmacist, obviously, but it's better than nothing.