______________________________________________________=
__________________
The sixth full coalition meeting of SOS Rx was held on
October 6, 2004, and included more than 55 participants. The meeting was held in the George=
Meany Conference Room at the
Presentati=
on
Dr. Mark McClellan, Administrator of the Centers for
Medicare and Medicaid Services, spoke to the coalition about current CMS
programs and initiatives. A question and answer session followed Dr.
McClellan’s comments.
Highlights from his presentation and the discussion are listed below=
.
&nbs=
p;
·
CMS supports SOS Rx efforts to ensure that
seniors use medications safely and effectively
·
E-prescribing – By 2009 all Medicare
prescriptions must be filed electronically; this is a requirement for drug
plans but not physicians.
Recognition of the challenge of educating patients about E-prescribi=
ng
and electronic health records without instilling fear in them.
·
Personalized care for Medicare beneficiaries
– CMS is working on improving knowledge of benefit coverage, including
preventive care.
·
The creation of a patient portal by CMS will
allow beneficiaries access through the Internet to benefit information,
including claims, deductibles, unused benefits, and if they are due for a
medical test or procedure.
·
The need to provide beneficiaries more
information on drug safety – including drug recalls and specific safe=
ty
issues.
·
Recognition that providing a drug benefit is=
not
enough, must also provide the tools to use the drugs safely and effectively,
including medication therapy management.&n=
bsp;
CMS is currently working on regulations for the Medication Therapy
Management Program.
·
Discussion of information management and the
need for CMS to coordinate with other institutions as they develop their
information technology capabilities. =
Discussion=
of
Action Agenda
Progress reports from each workgroup representing the =
four
action agenda projects were given.
After each presentation there were questions
and discussion. Set forth bel=
ow is
a summary of each action agenda project and the discussions.
1.
Clearinghouse of Safe Practices on High-Risk Situations – Lou
Diamond, Medstat
Project Summary:
Develop a clearinghous=
e of
safe practices for high-risk situations in the outpatient medication arena.=
The
clearinghouse will be a comprehensive dynamic resource to which healthcare
professionals can turn for guidance on safe practices to be followed when
prescribing certain medications.
The clearinghouse will also contain consumer-friendly versions of the
safe practices. To initiate this project, NCL convened a subgroup of coalit=
ion
members and external experts to participate in a one-day meeting on March 3=
0,
2004, to frame the scope of the project.
The progress report by Lou Diamond included review of a
Power Point presentation outlining the need, rationale, objectives, and pha=
ses
of development for the clearinghouse. SOS Rx is currently seeking a partner
organization with the capacity to help develop and house the clearinghouse.=
In
the last month letters were sent out to several organizations inviting them=
to
become a partner. Follow up a=
nd
additional outreach to potential partners will continue. Discussion with coalition members
included the following:
·
The intent of clearinghouse is to provide a
quality source for information on high-risk medication use in the outpatient
setting. There is a need for
quality evidence-based information on this issue to be organized and
accessible.
·
Clearinghouse will include public and private
sector research reports, plus generalizable
information from other settings.
There will be some level of synthesis of information for the
clearinghouse. An expert
panel could help develop the syntheses.
· Host for the clearinghouse must be partner t= hat can maximize use, has credibility, management skills and content experts. <= o:p>
·
The clearinghouse will focus on safe use of
medications, systems that need to be in place at every level of health care,
dosing, monitoring
·
Need to consider barriers to consumers ̵=
1;
how messages will be created and communicated to them.
·
Liability issue – need to clearly state
the purpose of the clearinghouse to avoid liability
·
Coalition consensus for moving forward with
developing the clearinghouse =
Next Steps:=
=
1) Find
organization to develop a prototype of the clearinghouse,
=
2) Use
prototype to obtain funding for pilot,
=
3) Develop
and test pilot, and
=
4) Secure
funding for the full clearinghouse.
2. Personal Medication Record –=
Andy Barbash =
Project Summary:
With a personal medica=
tion
record a patient is able to keep track of all medications (Rx, OTCs) as wel=
l as
vitamins and herbal supplements he or she may be taking, regardless of the =
prescriber of the medications. While there are various initiatives
ongoing, standards and uniformity are needed to ensure that such records are
consumer-friendly, useful and easily incorporated into the health care
experience. After reviewing an
inventory of current initiatives on personal medication records, an expert =
panel
met in June 2004 to determine what information is critical to include in a
PMR. A model PMR has been dev=
eloped
based on the panel’s findings.
The coalition will promote the use and adoption of the model PMR by =
all
stakeholders, including consumers.
A public education campaign will encourage consumers to use personal
medication records.
The progress report by An=
dy Barbash noted that after the experts meeting in June,=
two
draft templates were developed and circulated to the PMR working group. Based upon the group’s comme=
nts,
the templates were revised and are now accessible on the SOS Rx website.
Discussion by the coaliti=
on
included the following:
·
There is a need for a broad-based campaign on
this issue. This PMR is a bes=
t-case
example of a PMR. The June 3rd meeting
participants brought their expertise on this issue to the table, and helped
create a model PMR template.
·
The broad message of this campaign is that
consumers should keep track of their medications. “Here are some ways to do th=
is
(templates), but there are other ways as well. Whatever method you decide to help=
you
keep track, make sure it requires this set of information.”
·
The behavior change we hope to achieve is th=
at
we want patients to start keeping track of all of their medications. If there are positive downstream e=
ffects
of this action, then that’s great.&n=
bsp;
However, the campaign itself is not focusing on use of patient
medications. Coalition members advised the group that when we are seeking a
behavior change the messages to consumers need to be carefully crafted.
·
Connecting for Health is considering holding=
a
meeting for those working in this area. The purpose of the meeting would be=
to
develop a common framework and ensure that our consumer messages are not
conflicting.
Next Steps:
=
1) Continued
coordination with other initiatives on integrating PMR with other efforts
(National Health Council, Connecting for Health),
=
2) Obtain
funding for consumer testing of templates and production,
=
3) Obtain
funding to develop and test campaign messages, and
=
4) Identify
partners for pilot use of one or both templates.
3. Promoting Electronic Prescrib=
ing - Will Lang, American Assoc=
iation
of Colleges of Pharmacy
Project Summary:
To accelerate the use of E-prescribing the project will 1) adopt guid= ing principles that define and encourage a patient role, 2) promote various ong= oing initiatives supportive of those principles, 3) launch a public awareness campaign to educate patients about the flaws inherent in the current system, and 4) disseminate information to patients about the potential benefits of E-prescribing. The full coalition will then approve and coordinate a media campaign to publicize the recommendations of the work group. The coalition will educate patients about the benefits of E-prescrib= ing and their roles as health care consumers in advancing its use. <= o:p>
Will Lang <=
span
class=3DGramE>reported on the joint meeting between eHealth
Initiative (EHI) and SOS Rx on September 15th that focused on the
consumer’s role in promoting E-prescribing. The summary of the meeting will be
available on the SOS Rx website once finalized. The group focused on identifying t=
he
“pain points” for the consumer in the prescribing process, and =
how
E-prescribing will benefit consumers. Because consumers have a lack of
information on E-prescribing, there is a need to fill that gap and educate
consumers on the benefits of E-prescribing so that they can eventually pres=
sure
providers to adopt such a system.
Discussion =
by
coalition members focused on the importance of having coordinated consumer =
messages
on E-prescribing. The coalition also approved continuing to work with EHI a=
s we
develop a consumer education campaign on E-prescribing. The coalition welcomes suggestions=
for
funding opportunities.
Next Steps:=
=
1) Finalize
summary of SOS Rx – EHI meeting on September 15th and post=
on
SOS Rx website,
=
2) Continue
to explore the concept of E-prescribing from the consumer perspective, and
provide comments to relevant agencies and policy decision-making bodies,
=
3) Develop
a framework strategy and timeline for the development of a public education
campaign on E-prescribing with SOS Rx E-prescribing work group and continued
collaboration with EHI, and
=
4) Obtain
funding for the campaign.
4. Con=
sumer
Action– Targeting high-risk situations - Jill Pierce, American Med=
ical
Women’s Association Foundation
Project Summary:
This project will educate consumers about the risks of various prod=
ucts
interacting with certain high-risk medications, such as warfarin. A public education campaign will t=
arget
consumers taking high-risk medications and inform them that other prescript=
ion
and non-prescription medications they may be taking (OTCs, dietary suppleme=
nts,
herbals), as well as some foods, could interact with the prescribed medicat=
ion. Consumers will be provided with a =
framework
for discussing the risk of interactions and the importance of monitoring, w=
ith
their doctor, pharmacist or other health care professional. The campaign will also target prov=
iders
and dispensers to 1) reaffirm the importance of interaction messages to
patients and 2) provide them with techniques that can be used to enhance
awareness and message compliance among their patients. While w=
arfarin
will be the drug of initial focus, the resulting campaign will be a template
that could be customized and applied to education used for other high-risk
medications.
The progress report noted=
that at
the last full SOS Rx coalition meeting it was decided to develop a broader
campaign to reach all stakeholders prescribing and monitoring warfarin. Also
based on the discussion at the last meeting, a campaign framework document
which sets forth the background and evidence base for this project is now
available on the SOS Rx website. A consumer research fi=
rm,
Bearing Point, has been hired to inform the education campaign. An outline of the research plan in=
cludes
the following elements: data
gathering on target population, conducting interviews with system stakehold=
ers
(medical directors of health plans, managers of anti-coagulation clinics),
conduct focus groups with patients taking warfarin,
conduct focus groups with providers, formulating messages based on the
research, disseminating messages, evaluation of =
the
campaign. An advisory group of
coalition members will help guide the campaign. There was a general request to the=
group
for data on warfarin users. The coalition approved moving forw=
ard
with the campaign.
Discussion by coalition m=
embers
included:
·
Offers to provide data on warfarin
users.
·
Evaluation of the campaign should include a
review of patient outcomes and not just patient awareness.
Next Steps:
1=
) Finalizing
agreement and research plan with Bearing Point,
2=
) Move
forward with implemention of the research plan,=
3=
) Finalize
and convene advisory group,
4=
) Obtain
additional funding.
Other:
·
Members may access the members-only section =
of
the SOS Rx Web site by using the following. User name: coalition Password: seniorsafety04
·
NCL will keep the coalition updated on the
status of the various projects through email distributions and the Web site=
.
·
The next full meeting of the coalition will =
be
on January 12, 2005, from 10 am – 2 pm (EST) at the George Meany Conference Room,