Improving Patient Access to Primary Care Providers Using a Pharmacist-Physician Co-Visit Model.

Abstract

Background: Implementation of a clinical pharmacist in the primary care setting can offset provider time spent managing chronic diseases using Collaborative Practice Agreements (CPAs). The pharmacist-physician co-visit model presents an opportunity for pharmacists to increase patient access to their primary care provider (PCP). Studies of the co-visit model show that co-visits increase clinic efficiency by allowing the PCP to see additional patients and achieve more health care goals compared with independent visits1-4. Objectives: The aim of this study was to increase patient access to their PCP by utilizing a pharmacist-physician co-visit model at the Madsen Health Center Family Medicine (MHC FM) Clinic. The primary outcome was to identify the number of co-visits completed compared to the number of possible co-visits, and the number of appointment slots made available. The secondary outcomes were to track the time spent with patients and to obtain provider feedback via a survey. Methods: The co-visit model was implemented as a 4-month pilot study at the MHC FM Clinic. Complex care appointments lasting 40 minutes were selected based on inclusion and exclusion criteria. Potential co-visit appointments were identified one week prior then provider consent was obtained to change the appointment into two separate 20-minute visits. Schedules were reviewed to determine if the appointment slot opened by the co-visit was filled by another patient. Upon completion of the study, a survey was distributed to providers to collect feedback. Results: A total of five co-visits were completed out of a possible 19 (26%). All the appointments made available were filled by another patient. On average, the provider and pharmacist spent 15 and 14 minutes with the patient, respectively. Conclusion: Implementation of the physician-pharmacist co-visit model increased the availability of the PCP to see more patients without disrupting clinic workflow and provider schedules.