Meera Parkash, a clinical facilitator at Optum® and former head of medicines management at Bexley Clinical Commissioning Group, describes the obstacles holding back medicines optimisation in primary care — and explains why technology can be a catalyst for change
Effective medicines management can help save money, reduce inequalities and deliver better results for patients, particularly as the NHS grapples with the increasing rates of polypharmacy and associated risk of overprescribing.
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Pharmacists, in partnership with other primary care professionals, have a big role to play in this, but are the right mechanisms, capabilities and resources in place to help them do so? There’s certainly no lack of ambition in national policy-making — whether it’s through the launch of Pharmacy First, or written into last year’s 16 national priorities for medicines optimisation from NHS England. But if you speak to frontline pharmacists about their experiences, as we did last year, you get a sense of the obstacles.
Relationships within primary care are paramount. An encouraging development in recent years is the greater collaboration between pharmacists and other primary care professionals, particularly GPs, but there is still more to do to mature these relationships and give the pharmacy profession more visibility and profile within integrated care systems.
A lack of access to meaningful data for prioritising and driving decision-making is another common barrier for pharmacists — and so too is the lack of resource and capacity necessary to get through the sheer volume of work needed.
The Population360® tool
So, can technology help us move things forward? Optum has developed a new clinical support tool, Population360, which answers some of the practical challenges preventing integrated care boards, clinical pharmacists, and primary care prescribers from collaborating at scale.
Population360 helps teams to more rapidly understand risk across their entire patient population, making it easier to identify and act on cost-saving opportunities, signs of non-adherence, and critical safety issues related to medicines that may put patients at risk.
Supporting workflow management, it delivers live data daily, suggesting cost-effective, clinically-safe switches and the attached savings — offering a much more efficient way of managing priorities for action.
For clinical safety, it provides different types of alerts, based on clinical rules processed against the patient record, to identify patients with an avoidable medication error. The tool helps to identify patients quickly so that prescribing teams can act to reduce harm and prevent hospital admissions. As well as flagging nationally-established PINCER alerts, clinical rules can be customised to meet local prescribing priorities.
One of the things often lacking in practice and primary care network clinical systems is a useful throughput of data so that teams can see the impact of their actions. Population360 reporting highlights the number of patients, potential savings, admission avoidance, and number of safety alerts all in hand.
This makes it easier for teams to track progress, determine what’s working, and then have evidence-based conversations with patients, GPs and other stakeholders about next steps.
Applying population health management discipline
One of the exciting developments is applying technology and linked data together with population health management principles to address inequalities in prescribing practices. Population360 supports this.
The number one thing that our technologies can do for prescribers and pharmacists is provide a means of finding patients with specific characteristics.
Being able to add rules and filter the available data so that primary care teams can understand and support those cohorts of patients most at risk gives us the chance to tackle the inequalities we come across every day — this is where technology can be a game-changer.
Optum continues to work with pharmacists, GPs and ICB medicines optimisation teams to refine our products and find new ways of solving problems for primary care. If you’re interested in testing the new Population360 tool for your practice(s) please get in touch at askoptum@optum.com.
This article was prepared by Meera Parkash in a personal capacity. The views, thoughts and opinions expressed by the author of this piece belong to the author and do not purport to represent the views, thoughts and opinions of Optum.
