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Bridging Care Gaps With Clinical Pharmacists: Q&A With Vidhi Patel

Vidhi Patel, PharmD, BCPS, is a Clinical Pharmacist with Cureatr. In this position, she provides specialized clinical pharmacist services through direct interactions with patients and the healthcare team. She works with the Clinical Services team to facilitate the achievement of both a high level of customer satisfaction and implementation of Cureatr's telepharmacy service initiatives. Dr. Patel became a full-time member of the Cureatr team in December.

In this interview, Dr. Patel explains why she joined Cureatr, what she loves about her work as a clinical pharmacist, why clinical pharmacists should take the lead on post-discharge medication management, how organizations can better maximize the value of adding clinical pharmacists to the patient care team, and what she believes patients appreciate most about clinical pharmacists.

Q: In your journey as a clinical pharmacist, what led you to Cureatr?

residency-vidhiDr. Vidhi Patel: Prior to joining Cureatr, I ran a coumadin clinic in Chicago. The focus of the clinic was to monitor and manage the medications that patients take to prevent blood clots, particularly, warfarin, but we treated the whole patient. I developed very good relationships with all my patients, so when they came into the clinic, they felt comfortable speaking to me about other concerns and challenges.

When I saw the posting for the clinical pharmacist position at Cureatr, I viewed it as an opportunity to expand on something I was already doing at the clinic and support even more patients. The company's comprehensive care approach that provides clinical pharmacists autonomy to treat the entire patient and help with the patient's care in any and every way we can is what drew me to Cureatr.

Q: What do you love about being a clinical pharmacist?

VP: The impact we have on patients. When we initially interact with patients, they tend to be a bit overwhelmed to say the least, especially those who have just left the hospital. Leading up to discharge, there is so much going on for the patient and so many people talking to them. Oftentimes, there is a pharmacist who talks to them about their medications, but this can further add to information overload and contribute to a lack of comprehension about the importance of their medications and adherence.

I love that we are able to, in partnership with our counterparts on the inpatient side, help the patient more safely transition to their next care stage. We have an opportunity to step in and essentially hit the reset button on their medication regimen. We can go through each medication, review its purpose, ensure patients understand how and when to take their medications, and identify and address any issues of concerns. Ultimately, we help optimize such a crucial part of the patient's care.

There are a variety of settings we can do this in, but we most often see patients right after they get out of the hospital. This is a time when a patient is most likely to be overwhelmed, frustrated, or experiencing any number of emotions associated with a health crisis — emotions that can lead to transition gaps and treatment failures. Even when patients are given correct instructions at discharge, there are no assurances during this highly charged period that they will fully understand what they need to do.

As clinical pharmacists, we help bridge that gap and clarify concerns. We also double check the appropriateness of their therapy and optimize it. It's an amazing position to be in and one where we get to do a tremendous amount of good.

Q: What are some of the biggest challenges you face as a clinical pharmacist?

VP: We sometimes get questions from patients about our role and its purpose, especially from those who are visited by pharmacists on the inpatient side or those who have already visited with their physician for post-discharge follow up. The question I find challenging is, "I've already talked to so and so. Why are you calling?" When I get this question, I explain our role. I like to say we're a second set of eyes. We're here to review your medications with you, address any questions or concerns that you have about your regimen, and make sure what you are taking and how you take it is appropriate. When we find something of concern, we can serve as a bridge between the patient and their provider to resolve the issue.

Q: Why are clinical pharmacists in the best position to take the lead on medication management following discharge?

VP: Thankfully, we tend to connect with patients shortly after they leave the hospital. This is the transition period when there is often the biggest misinterpretation of medication information or miscommunication between the care team and patient. By catching patients not long after they are discharged, usually in their home, they're often able to think more clearly than they could when still in the hospital. They also have the medication information they received at the hospital fresh in their mind. This is the best time and place to talk through their medications and ensure patients are in the best position to adhere to their regimen.

Q: What can healthcare organizations do to better integrate and leverage the skills of clinical pharmacists?

VP: One of the best ways is for organizations to prepare their patients to get a call from us. We all know about the many different types of scams that occur through phone calls. Some of our older patients are especially weary of getting unexpected calls and hesitant to share personal information. For organizations using a service like ours, it can be helpful in the follow-up section of discharge paperwork to include a reminder that a clinical pharmacist will be calling the patient. Patients can also be informed verbally at discharge that they should anticipate such a call. This way, when the patient receives the call from a Cureatr Clinic clinical pharmacist, it's not surprising and not perceived as a scam.

Q: Can you share a few experiences of how your work with patients has resulted in improved health outcomes?

VP: There has been several occasions where I identified a duplication of therapy. We recently had a patient who underwent knee surgery and was prescribed two anti-inflammatories. This could be very dangerous. I've been able to identify medications that were not going to be absorbed appropriately for kidney function and catch patients who had decided on their own to stop a medication because they didn't think it was necessary anymore. I've been able to talk to providers to clarify whether patients needed to stop or start a therapy.

I've also been able to help patients get some of their medications, such as by providing a coupon that lowered the cost of the prescription so that the patient could afford it. I've called pharmacies on behalf of patients to learn about medication and refill availability and informed patients when they could pick up their medications. With our autonomy, these are little things that improve medication adherence and make a big difference in the long run.

Q: What have you found that patients value the most about the services and support they receive from clinical pharmacists?

VP: There's somebody who cares for them. Sometimes patients feel a little forgotten following discharge. They've received all this attention in the hospital, but once they leave, they can feel alone, vulnerable, and overwhelmed. We help them in this moment of need by talking through their situation with them, providing guidance on their medications, and optimizing their pain management. We're an addition to what was hopefully an excellent inpatient care team.

The patients who value clinical pharmacists the most are those who need to go to the hospital but may lack an established outpatient care team. These are the patients who often feel the most vulnerable following discharge. The physicians patients see in the hospital often only work in the hospital. These physicians may follow up briefly following the acute, inpatient stay, but then the patient needs to find one or more physicians and specialists for support outside of the hospital. In our role, we can be a resource to walk them through finding these providers. In fact, some of our clinical pharmacists have personally found physicians for patients. They've taken the time to go to the website of the patient's insurance plan, navigate to a list of covered providers, and review the patient's options. I think this is phenomenal.

Our ability to provide such an experience is one of the reasons why it's so rewarding to work here at Cureatr and within the Cureatr Clinic. Everything the company is doing and how we approach patients is unique for a telehealth platform — especially how involved and comprehensive we're able to be through talking with patients over the phone. These capabilities and the flexibility to do whatever we feel is necessary to help our patients is what has impressed me most about Cureatr.

Whitepaper: Medication Management Challenges and Opportunities for Payers and Providers

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