Choe collaborates to bring health care to patients in Michigan

Abstract

Hae Mi Choe, PharmD, was away from home on a business trip when her daughter, who was into polymer clay at the time, wanted to show her the latest using FaceTime on her iPad. The daughter zoomed in, and Choe could see every detail. Hae Mi Choe, PharmD, was away from home on a business trip when her daughter, who was into polymer clay at the time, wanted to show her the latest using FaceTime on her iPad. The daughter zoomed in, and Choe could see every detail. “Go get a pill,” Choe said suddenly.“What pill?”“Go downstairs and get Dad’s vitamins.”Choe’s daughter went downstairs, found the vitamins, and focused the iPad on them. “I could see the color, the imprint, and everything,” Choe recalled in an interview with Pharmacy Today. “And I thought, I wish I could do this with Mrs. Jones.”Inspiration from life doesn’t magically transform from a concept into something functioning; after Choe made the connection, she figured out how to take the wish and distill it into reality to test the concept. The result was starting a pilot project in tele-health in which a pharmacist partners with home health services for home-bound patients with medication issues. It’s just one among Choe’s many innovations that take the health care system to the patient.As the Director of Pharmacy Innovations & Clinical Practices for the University of Michigan Health System (UMHS) Faculty Group Practice, the health system’s physician group practice; Director of Ambulatory Care Pharmacy Transformation in the UMHS Department of Pharmacy; and Clinical Associate Professor of Pharmacy at the University of Michigan College of Pharmacy, Choe is advancing the role of pharmacists in the ambulatory care setting, within the patient-centered medical home (PCMH) and the accountable care organization (ACO) models, and in the community pharmacy setting.On September 15, Choe was presented with a 2014 Pinnacle Award in the Individual Award for Career Achievement category by the APhA Foundation at a ceremony at APhA headquarters. (For more information about the other two award winners, see page 53 of October’s Today.)“It’s so exciting to see our pharmacy profession move in the direction that it’s moving,” Choe said. “I’m hoping, through this article, that others would be challenged and motivated to advance our profession in a similar way, and to join the army that’s moving forward with this vision.”Pioneer in pharmacy integrationUMHS is a health system and academic medical center in the Ann Arbor, MI, area with 990 beds across three hospitals, 40 outpatient locations with more than 120 clinics, and an extensive home care operation, according to the UMHS website.Hired at UMHS in 1999, Choe created the first integrated ambulatory care pharmacy practice there; integrated pharmacists in the PCMH model across all 15 primary care clinics and three specialty clinics within UMHS, establishing collaborative practice agreements; and developed and implemented new reimbursement models for pharmacists’ patient care services.Choe said of her staff: “I can set the stage, but my colleagues are the true stars. I feel so privileged to work with them.”View Large Image Figure ViewerDownload (PPT)Looking ahead, she is collaborating with Blue Cross Blue Shield of Michigan (BCBS MI) to develop a statewide initiative called the Michigan Pharmacy Quality Consortium that, if approved, will open up “so many new jobs for pharmacists to do clinical practice in an ambulatory setting. It will improve the outcomes of our patients in Michigan” by improving the optimal use of medication, she said. “In doing so, I think we will reduce overall health care costs.”Developing the know-howAt the dawn of her journey as a clinical pharmacist, Hae Mi Choe, PharmD, pointed out, she had yet to learn the knowledge needed to navigate in that space where she leads collaboration among pharmacists, physicians and other health care team members, and payers today.Her role 15 years ago was to develop a clinical practice in her clinic working with physicians to improve the care of their patients. She knew how to deliver diabetes services and comprehensive med review services. She knew how to talk to the local physicians. But “could I go and talk with CEOs of different health systems and try to convey what pharmacists contribute to their organization and advise them on how to integrate pharmacists? I probably, one, wouldn’t have a forum to do that,” Choe said. “Two, [I wouldn’t be] given the opportunity to network at the executive level of other organizations.”To get to where she is today, Choe had to gain experience and insight and pick up skills. “You need to understand the barriers our patients are facing and find ways to work through these barriers to achieve best possible outcomes. Through this process, you can relate and understand the pain points of our physicians who manage these patients,” she said. “Putting these pieces together, and then you’ve got to top it with where is our health care moving towards now”—for example, understanding all those quality metrics on which health care providers are getting measured and hence paid. “Understanding that landscape is a very important insight you need to have” before approaching CEOs.Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT)Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT)Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT)With “unfailing support” from Spahlinger and James Dalton, BSPharm, PhD, Choe said, “we’re able to innovate and create programs to improve the health of our patients.”View Large Image Figure ViewerDownload (PPT)Choe and a former student pharmacist counsel a patient.View Large Image Figure ViewerDownload (PPT)Connecting with patientsIn the UMHS model, pharmacy teams consist of pharmacists, pharmacy residents, and student pharmacists, with support from clinic panel managers, and are jointly salaried by the Department of Pharmacy, College of Pharmacy, and Faculty Group Practice, according to an October 2014 Advisory Board Company report on Integrated Pharmacy Models in Primary Care.Patients are identified through pharmacist screening of disease registries and, increasingly, physician referrals as a program matures. Clinical triggers include diabetes, hypertension, polypharmacy, and/or not being on evidence-based medications. Pharmacists and primary care providers collaborate on a single medication list, progress notes, and a medication plan. The pharmacist’s initial visit with the patient is in person, and follow-up visits may be by phone.Choe prefers that the first appointment be face to face. “There’s something about face-to-face interaction that really builds relationships and creates awareness and understanding,” she said. “Once I’ve established that initial connection with the patient, I can further assess if phone consults would be a viable option” for some patients because they won’t have to drive and spend money on gas, take time off from work, or find a babysitter.Her drive to shape health care around the patient’s needs doesn’t stop there. “To be able to connect with patients, I need to understand what matters to the patient in that moment,” Choe said. “Shifting the focus of the visit to say, ‘Given these issues, what would you like to talk about today?’“ Then, we can prioritize what’s important and relevant to the patient rather than my own checklist.”“I’m hoping that others would be challenged and motivated to advance our profession in a similar way and to join the army that’s moving forward with this vision.”Clinical outcomes include a 0.9% decrease in glycosylated hemoglobin (A1C) for patients with a baseline A1C > 7%, and a 1.8% decrease for those with a baseline A1C > 9%.The majority of the program’s costs are absorbed by practices with support from the Department of Pharmacy and the College of Pharmacy. A new reimbursement process for clinical pharmacy services through the multipayer initiative generates revenue by using G codes that allow nonphysicians to bill for services.“The College [of Pharmacy] is excited about the transformative initiatives in ambulatory care that Dr. Choe is pursuing,” said University of Michigan College of Pharmacy Dean James Dalton, BSPharm, PhD. “We are working hard to help her achieve her vision by supporting an additional PGY2 [postgraduation year 2] residency, solidifying her role within the physician Faculty Group Practice, and providing resources to ensure others are aware of this innovative model of pharmacy practice from a medical and scholarly perspective.”New challengesAt the end of July, the POM ACO board approved Choe’s role in the POM ACO as the pharmacy program director to expand the UMHS model. “Integrating clinical pharmacy services across 11 other health systems and physician organizations is what I’m charged to do,” Choe said. “And that’s not my experience because at U of M, everything’s integrated” with the same medical records and a leadership structure that ties it all together at the top. Under the POM ACO, however, these 11 other physician organizations may consist of multiple small private physician offices and have different medical records. “It’s a whole different ballgame I’m learning.”Choe’s pharmacists include Jolene Bostwick, PharmD; Marie Marcelino PharmD; and Anne Yoo, PharmD (left to right).View Large Image Figure ViewerDownload (PPT)Choe also has extended the model to include community pharmacy. UMHS and CVS Health launched a joint pilot initiative in two CVS/pharmacy stores. A community pharmacist from each store was trained for 3 months at UMHS in the PCMH model and then returned to the community to provide the same services using UMHS electronic medical records. The pilot pharmacists can open up medical records in the pharmacy, look up the patient’s labs, look at the last note, and if needed, send a quick note to the physician through the record; the physician can receive the message and reply to the pharmacist, at which point the pharmacist can contact the patient and make the medication change.“This is the true collaborative model that I envision community pharmacists to play a role in,” Choe said. “Given their access to patients, community pharmacists have greater opportunities to touch our patients in a more meaningful way. We’re looking forward to expanding this type of collaboration in the future.The futureDown the road, Choe said, she would love to become more involved in the policy process to help drive the profession—not just by being on the receiving end and responding or reacting to a policy, but by actually influencing policy to ensure that pharmacists are included.“We need more people,” she concluded. “It’s going to take a whole lot of people to move our profession in a very radical and dramatic way.” “Go get a pill,” Choe said suddenly. “What pill?” “Go downstairs and get Dad’s vitamins.” Choe’s daughter went downstairs, found the vitamins, and focused the iPad on them. “I could see the color, the imprint, and everything,” Choe recalled in an interview with Pharmacy Today. “And I thought, I wish I could do this with Mrs. Jones.” Inspiration from life doesn’t magically transform from a concept into something functioning; after Choe made the connection, she figured out how to take the wish and distill it into reality to test the concept. The result was starting a pilot project in tele-health in which a pharmacist partners with home health services for home-bound patients with medication issues. It’s just one among Choe’s many innovations that take the health care system to the patient. As the Director of Pharmacy Innovations & Clinical Practices for the University of Michigan Health System (UMHS) Faculty Group Practice, the health system’s physician group practice; Director of Ambulatory Care Pharmacy Transformation in the UMHS Department of Pharmacy; and Clinical Associate Professor of Pharmacy at the University of Michigan College of Pharmacy, Choe is advancing the role of pharmacists in the ambulatory care setting, within the patient-centered medical home (PCMH) and the accountable care organization (ACO) models, and in the community pharmacy setting. On September 15, Choe was presented with a 2014 Pinnacle Award in the Individual Award for Career Achievement category by the APhA Foundation at a ceremony at APhA headquarters. (For more information about the other two award winners, see page 53 of October’s Today.) “It’s so exciting to see our pharmacy profession move in the direction that it’s moving,” Choe said. “I’m hoping, through this article, that others would be challenged and motivated to advance our profession in a similar way, and to join the army that’s moving forward with this vision.” Pioneer in pharmacy integrationUMHS is a health system and academic medical center in the Ann Arbor, MI, area with 990 beds across three hospitals, 40 outpatient locations with more than 120 clinics, and an extensive home care operation, according to the UMHS website.Hired at UMHS in 1999, Choe created the first integrated ambulatory care pharmacy practice there; integrated pharmacists in the PCMH model across all 15 primary care clinics and three specialty clinics within UMHS, establishing collaborative practice agreements; and developed and implemented new reimbursement models for pharmacists’ patient care services.Looking ahead, she is collaborating with Blue Cross Blue Shield of Michigan (BCBS MI) to develop a statewide initiative called the Michigan Pharmacy Quality Consortium that, if approved, will open up “so many new jobs for pharmacists to do clinical practice in an ambulatory setting. It will improve the outcomes of our patients in Michigan” by improving the optimal use of medication, she said. “In doing so, I think we will reduce overall health care costs.”Developing the know-howAt the dawn of her journey as a clinical pharmacist, Hae Mi Choe, PharmD, pointed out, she had yet to learn the knowledge needed to navigate in that space where she leads collaboration among pharmacists, physicians and other health care team members, and payers today.Her role 15 years ago was to develop a clinical practice in her clinic working with physicians to improve the care of their patients. She knew how to deliver diabetes services and comprehensive med review services. She knew how to talk to the local physicians. But “could I go and talk with CEOs of different health systems and try to convey what pharmacists contribute to their organization and advise them on how to integrate pharmacists? I probably, one, wouldn’t have a forum to do that,” Choe said. “Two, [I wouldn’t be] given the opportunity to network at the executive level of other organizations.”To get to where she is today, Choe had to gain experience and insight and pick up skills. “You need to understand the barriers our patients are facing and find ways to work through these barriers to achieve best possible outcomes. Through this process, you can relate and understand the pain points of our physicians who manage these patients,” she said. “Putting these pieces together, and then you’ve got to top it with where is our health care moving towards now”—for example, understanding all those quality metrics on which health care providers are getting measured and hence paid. “Understanding that landscape is a very important insight you need to have” before approaching CEOs.Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT)Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT)Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT)With “unfailing support” from Spahlinger and James Dalton, BSPharm, PhD, Choe said, “we’re able to innovate and create programs to improve the health of our patients.”View Large Image Figure ViewerDownload (PPT)Choe and a former student pharmacist counsel a patient.View Large Image Figure ViewerDownload (PPT) UMHS is a health system and academic medical center in the Ann Arbor, MI, area with 990 beds across three hospitals, 40 outpatient locations with more than 120 clinics, and an extensive home care operation, according to the UMHS website. Hired at UMHS in 1999, Choe created the first integrated ambulatory care pharmacy practice there; integrated pharmacists in the PCMH model across all 15 primary care clinics and three specialty clinics within UMHS, establishing collaborative practice agreements; and developed and implemented new reimbursement models for pharmacists’ patient care services. Looking ahead, she is collaborating with Blue Cross Blue Shield of Michigan (BCBS MI) to develop a statewide initiative called the Michigan Pharmacy Quality Consortium that, if approved, will open up “so many new jobs for pharmacists to do clinical practice in an ambulatory setting. It will improve the outcomes of our patients in Michigan” by improving the optimal use of medication, she said. “In doing so, I think we will reduce overall health care costs.”Developing the know-howAt the dawn of her journey as a clinical pharmacist, Hae Mi Choe, PharmD, pointed out, she had yet to learn the knowledge needed to navigate in that space where she leads collaboration among pharmacists, physicians and other health care team members, and payers today.Her role 15 years ago was to develop a clinical practice in her clinic working with physicians to improve the care of their patients. She knew how to deliver diabetes services and comprehensive med review services. She knew how to talk to the local physicians. But “could I go and talk with CEOs of different health systems and try to convey what pharmacists contribute to their organization and advise them on how to integrate pharmacists? I probably, one, wouldn’t have a forum to do that,” Choe said. “Two, [I wouldn’t be] given the opportunity to network at the executive level of other organizations.”To get to where she is today, Choe had to gain experience and insight and pick up skills. “You need to understand the barriers our patients are facing and find ways to work through these barriers to achieve best possible outcomes. Through this process, you can relate and understand the pain points of our physicians who manage these patients,” she said. “Putting these pieces together, and then you’ve got to top it with where is our health care moving towards now”—for example, understanding all those quality metrics on which health care providers are getting measured and hence paid. “Understanding that landscape is a very important insight you need to have” before approaching CEOs.Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT)Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT) Developing the know-howAt the dawn of her journey as a clinical pharmacist, Hae Mi Choe, PharmD, pointed out, she had yet to learn the knowledge needed to navigate in that space where she leads collaboration among pharmacists, physicians and other health care team members, and payers today.Her role 15 years ago was to develop a clinical practice in her clinic working with physicians to improve the care of their patients. She knew how to deliver diabetes services and comprehensive med review services. She knew how to talk to the local physicians. But “could I go and talk with CEOs of different health systems and try to convey what pharmacists contribute to their organization and advise them on how to integrate pharmacists? I probably, one, wouldn’t have a forum to do that,” Choe said. “Two, [I wouldn’t be] given the opportunity to network at the executive level of other organizations.”To get to where she is today, Choe had to gain experience and insight and pick up skills. “You need to understand the barriers our patients are facing and find ways to work through these barriers to achieve best possible outcomes. Through this process, you can relate and understand the pain points of our physicians who manage these patients,” she said. “Putting these pieces together, and then you’ve got to top it with where is our health care moving towards now”—for example, understanding all those quality metrics on which health care providers are getting measured and hence paid. “Understanding that landscape is a very important insight you need to have” before approaching CEOs.Clockwise from top: Choe selects a medication; meets with Connie Standiford, MD, and David A. Spahlinger, MD; and connects with a patient.View Large Image Figure ViewerDownload (PPT) Developing the know-howAt the dawn of her journey as a clinical pharmacist, Hae Mi Choe, PharmD, pointed out, she had yet to learn the knowledge needed to navigate in that space where she leads collaboration among pharmacists, physicians and other health care team members, and payers today.Her role 15 years ago was to develop a clinical practice in her clinic working with physicians to improve the care of their patients. She knew how to deliver diabetes services and comprehensive med review services. She knew how to talk to the local physicians. But “could I go and talk with CEOs of different health systems and try to convey what pharmacists contribute to their organization and advise them on how to integrate pharmacists? I probably, one, wouldn’t have a forum to do that,” Choe said. “Two, [I wouldn’t be] given the opportunity to network at the executive level of other organizations.”To get to where she is today, Choe had to gain experience and insight and pick up skills. “You need to understand the barriers our patients are facing and find ways to work through these barriers to achieve best possible outcomes. Through this process, you can relate and understand the pain points of our physicians who manage these patients,” she said. “Putting these pieces together, and then you’ve got to top it with where is our health care moving towards now”—for example, understanding all those quality metrics on which health care providers are getting measured and hence paid. “Understanding that landscape is a very important insight you need to have” before approaching CEOs. At the dawn of her journey as a clinical pharmacist, Hae Mi Choe, PharmD, pointed out, she had yet to learn the knowledge needed to navigate in that space where she leads collaboration among pharmacists, physicians and other health care team members, and payers today. Her role 15 years ago was to develop a clinical practice in her clinic working with physicians to improve the care of their patients. She knew how to deliver diabetes services and comprehensive med review services. She knew how to talk to the local physicians. But “could I go and talk with CEOs of different health systems and try to convey what pharmacists contribute to their organization and advise them on how to integrate pharmacists? I probably, one, wouldn’t have a forum to do that,” Choe said. “Two, [I wouldn’t be] given the opportunity to network at the executive level of other organizations.” To get to where she is today, Choe had to gain experience and insight and pick up skills. “You need to understand the barriers our patients are facing and find ways to work through these barriers to achieve best possible outcomes. Through this process, you can relate and understand the pain points of our physicians who manage these patients,” she said. “Putting these pieces together, and then you’ve got to top it with where is our health care moving towards now”—for example, understanding all those quality metrics on which health care providers are getting measured and hence paid. “Understanding that landscape is a very important insight you need to have” before approaching CEOs. Connecting with patientsIn the UMHS model, pharmacy teams consist of pharmacists, pharmacy residents, and student pharmacists, with support from clinic panel managers, and are jointly salaried by the Department of Pharmacy, College of Pharmacy, and Faculty Group Practice, according to an October 2014 Advisory Board Company report on Integrated Pharmacy Models in Primary Care.Patients are identified through pharmacist screening of disease registries and, increasingly, physician referrals as a program matures. Clinical triggers include diabetes, hypertension, polypharmacy, and/or not being on evidence-based medications. Pharmacists and primary care providers collaborate on a single medication list, progress notes, and a medication plan. The pharmacist’s initial visit with the patient is in person, and follow-up visits may be by phone.Choe prefers that the first appointment be face to face. “There’s something about face-to-face interaction that really builds relationships and creates awareness and understanding,” she said. “Once I’ve established that initial connection with the patient, I can further assess if phone consults would be a viable option” for some patients because they won’t have to drive and spend money on gas, take time off from work, or find a babysitter.Her drive to shape health care around the patient’s needs doesn’t stop there. “To be able to connect with patients, I need to understand what matters to the patient in that moment,” Choe said. “Shifting the focus of the visit to say, ‘Given these issues, what would you like to talk about today?’“ Then, we can prioritize what’s important and relevant to the patient rather than my own checklist.”“I’m hoping that others would be challenged and motivated to advance our profession in a similar way and to join the army that’s moving forward with this vision.”Clinical outcomes include a 0.9% decrease in glycosylated hemoglobin (A1C) for patients with a baseline A1C > 7%, and a 1.8% decrease for those with a baseline A1C > 9%.The majority of the program’s costs are absorbed by practices with support from the Department of Pharmacy and the College of Pharmacy. A new reimbursement process for clinical pharmacy services through the multipayer initiative generates revenue by using G codes that allow nonphysicians to bill for services.“The College [of Pharmacy] is excited about the transformative initiatives in ambulatory care that Dr. Choe is pursuing,” said University of Michigan College of Pharmacy Dean James Dalton, BSPharm, PhD. “We are working hard to help her achieve her vision by supporting an additional PGY2 [postgraduation year 2] residency, solidifying her role within the physician Faculty Group Practice, and providing resources to ensure others are aware of this innovative model of pharmacy practice from a medical and scholarly perspective.” In the UMHS model, pharmacy teams consist of pharmacists, pharmacy residents, and student pharmacists, with support from clinic panel managers, and are jointly salaried by the Department of Pharmacy, College of Pharmacy, and Faculty Group Practice, according to an October 2014 Advisory Board Company report on Integrated Pharmacy Models in Primary Care. Patients are identified through pharmacist screening of disease registries and, increasingly, physician referrals as a program matures. Clinical triggers include diabetes, hypertension, polypharmacy, and/or not being on evidence-based medications. Pharmacists and primary care providers collaborate on a single medication list, progress notes, and a medication plan. The pharmacist’s initial visit with the patient is in person, and follow-up visits may be by phone. Choe prefers that the first appointment be face to face. “There’s something about face-to-face interaction that really builds relationships and creates awareness and understanding,” she said. “Once I’ve established that initial connection with the patient, I can further assess if phone consults would be a viable option” for some patients because they won’t have to drive and spend money on gas, take time off from work, or find a babysitter. Her drive to shape health care around the patient’s needs doesn’t stop there. “To be able to connect with patients, I need to understand what matters to the patient in that moment,” Choe said. “Shifting the focus of the visit to say, ‘Given these issues, what would you like to talk about today?’“ Then, we can prioritize what’s important and relevant to the patient rather than my own checklist.”“I’m hoping that others would be challenged and motivated to advance our profession in a similar way and to join the army that’s moving forward with this vision.” Clinical outcomes include a 0.9% decrease in glycosylated hemoglobin (A1C) for patients with a baseline A1C > 7%, and a 1.8% decrease for those with a baseline A1C > 9%. The majority of the program’s costs are absorbed by practices with support from the Department of Pharmacy and the College of Pharmacy. A new reimbursement process for clinical pharmacy services through the multipayer initiative generates revenue by using G codes that allow nonphysicians to bill for services. “The College [of Pharmacy] is excited about the transformative initiatives in ambulatory care that Dr. Choe is pursuing,” said University of Michigan College of Pharmacy Dean James Dalton, BSPharm, PhD. “We are working hard to help her achieve her vision by supporting an additional PGY2 [postgraduation year 2] residency, solidifying her role within the physician Faculty Group Practice, and providing resources to ensure others are aware of this innovative model of pharmacy practice from a medical and scholarly perspective.” New challengesAt the end of July, the POM ACO board approved Choe’s role in the POM ACO as the pharmacy program director to expand the UMHS model. “Integrating clinical pharmacy services across 11 other health systems and physician organizations is what I’m charged to do,” Choe said. “And that’s not my experience because at U of M, everything’s integrated” with the same medical records and a leadership structure that ties it all together at the top. Under the POM ACO, however, these 11 other physician organizations may consist of multiple small private physician offices and have different medical records. “It’s a whole different ballgame I’m learning.”Choe also has extended the model to include community pharmacy. UMHS and CVS Health launched a joint pilot initiative in two CVS/pharmacy stores. A community pharmacist from each store was trained for 3 months at UMHS in the PCMH model and then returned to the community to provide the same services using UMHS electronic medical records. The pilot pharmacists can open up medical records in the pharmacy, look up the patient’s labs, look at the last note, and if needed, send a quick note to the physician through the record; the physician can receive the message and reply to the pharmacist, at which point the pharmacist can contact the patient and make the medication change.“This is the true collaborative model that I envision community pharmacists to play a role in,” Choe said. “Given their access to patients, community pharmacists have greater opportunities to touch our patients in a more meaningful way. We’re looking forward to expanding this type of collaboration in the future. At the end of July, the POM ACO board approved Choe’s role in the POM ACO as the pharmacy program director to expand the UMHS model. “Integrating clinical pharmacy services across 11 other health systems and physician organizations is what I’m charged to do,” Choe said. “And that’s not my experience because at U of M, everything’s integrated” with the same medical records and a leadership structure that ties it all together at the top. Under the POM ACO, however, these 11 other physician organizations may consist of multiple small private physician offices and have different medical records. “It’s a whole different ballgame I’m learning.” Choe also has extended the model to include community pharmacy. UMHS and CVS Health launched a joint pilot initiative in two CVS/pharmacy stores. A community pharmacist from each store was trained for 3 months at UMHS in the PCMH model and then returned to the community to provide the same services using UMHS electronic medical records. The pilot pharmacists can open up medical records in the pharmacy, look up the patient’s labs, look at the last note, and if needed, send a quick note to the physician through the record; the physician can receive the message and reply to the pharmacist, at which point the pharmacist can contact the patient and make the medication change. “This is the true collaborative model that I envision community pharmacists to play a role in,” Choe said. “Given their access to patients, community pharmacists have greater opportunities to touch our patients in a more meaningful way. We’re looking forward to expanding this type of collaboration in the future. The futureDown the road, Choe said, she would love to become more involved in the policy process to help drive the profession—not just by being on the receiving end and responding or reacting to a policy, but by actually influencing policy to ensure that pharmacists are included.“We need more people,” she concluded. “It’s going to take a whole lot of people to move our profession in a very radical and dramatic way.” Down the road, Choe said, she would love to become more involved in the policy process to help drive the profession—not just by being on the receiving end and responding or reacting to a policy, but by actually influencing policy to ensure that pharmacists are included. “We need more people,” she concluded. “It’s going to take a whole lot of people to move our profession in a very radical and dramatic way.”