One elemental piece of this program is safe and high-quality medication management. To support medication management, especially as we continue to add new at-home service offerings, Intermountain at Home is empowering pharmacists to fulfill more active, clinical roles and allow the prescribing, licensed individual practitioners (LIPs) more time to oversee the care and treatments of their patients. We’re working to enable and prepare pharmacists to enter into collaborative practice agreements (CPAs) with those prescribing providers. CPAs denote that authorized pharmacists have the appropriate training to provide clinical care in the related discipline, and give them permission to write and order laboratory tests; to write, order, and change the dosage or frequency of medications; and to monitor discharge plans and orders.
Intermountain at Home has been incorporating CPAs since 2017 to quicken the time for patients to start receiving IV and other infusions and medication therapies in the home. We’ve established no increase in hospital readmissions with pharmacists, compared to prescribing providers, managing at-home medications. Home infusion therapies in scope for CPAs have so far included the antibiotic Vancomycin to treat severe infections. We’re currently finishing the education and competency evaluations for pharmacists as well as dietitians to enter into CPAs for home-based Parenteral Nutrition for adults, and recently we’ve identified a need to expand Parenteral Nutrition to newborns.
CPAs are empowering pharmacists and providers to perform the roles they’re meant to—getting patients rapid access to the care they need in their own homes, which in turn is supporting care safety, quality, and patient experiences; preventing unnecessary hospital transfers; improving operational efficiencies; and minimizing costs.