November 2019
PACE Case: Pharmacogenomic Testing Utility in Mental Health

A 70-year-old female PACE participant has a past medical history of major depressive disorder (MDD), bipolar disorder, post-traumatic stress disorder, generalized anxiety disorder (GAD), gastroesophageal reflux (GERD), cerebrovascular accident from atrial septal aneurysm, chronic pain, and mild chronic kidney disease (CrCl 65 mL/min). She was a victim of domestic violence and has a history of prescription drug abuse. The participant has been admitted to the hospital multiple times for psychiatric reasons since the 1960s. Her most recent hospitalization was due to suicidal ideation and recurring MDD with GAD. She admits to medication non-adherence and is interested in improving her compliance.

The Pharmacist's Role in Understanding Adverse Drug Events

In a video filmed  during the 2019 NCPA Annual Convention in San Diego, California, Calvin H. Knowlton, BScPharm, MDiv, PhD, Chairman and Founder of Tabula Rasa HealthCare, and Chairman and Founder of CareKinesis discusses pharmacists' role in approaching adverse drug events and adverse drug reactions to improve patient care.

US Pharmacopeia's General Chapter <800> - Handling  Hazardous Drugs in Healthcare Settings

The US Pharmacopeia (USP) General Chapter <800> regulates the purchase, storage, distribution, and dispensing of Hazardous Drugs (HDs). The regulations do not effect HDs after they are dispensed to a patient by the pharmacy.  The requirement for labeling an HD as a "Hazardous Drug" states that it is only required when the drug is dispensed and transported to another healthcare facility (e.g., nursing home, other hospital department, physician's or veteran's office, etc.). How it is labeled (e.g., on the prescription, auxiliary label, or other) is at the discretion of the pharmacy's standard operating procedure.  If the drug is dispensed to a community dwelling participant (e.g.,  assisted living facility, group home, personal residence, etc.) then the final consumer package  does not require labeling. USP General Chapter <800> only applies to HD handling in healthcare  entities by their employees.

Since your PACE program services community dwelling participants, CareKinesis includes the
HD label on the final dispensed container. This may alleviate concerns about the participant's
unwillingness to take the medication. If there is a concern about a participant seeing the label,
the pharmacy can develop a less conspicuous labeling process that is noticeable to health care workers and less noticeable to the participant.

For more information, a copy of the 2016 National Institute for Occupational Safety and Health
(NIOSH) list, the 2018 update table, and to download a copy of USP General Chapter <800>, visit USP.org . If you have questions, please contact your Client Liaison.
Celebrating Success: LIFE St. Mary

Using CareKinesis' medication safety and pharmacy services, along with our electronic health record, EireneRx®, and health plan management services, LIFE St. Mary, Trinity Health Mid-Atlantic, decreased participant emergency room utilization by 16% and total hospitalizations by 27%. Furthermore, they reduced their medication error rate to below 1% within the first year of partnering with CareKinesis, a subsidiary of Tabula Rasa HealthCare (TRHC).

Read more about LIFE St. Mary's success story.
CareVention HealthCare News

2019 NPA Annual Conference



CareVention HealthCare was delighted to host the PACE Appreciation Dinner, as well as the NPA's annual Awards Luncheon, at the 2019 NPA Annual Conference in New Orleans, Louisiana, last month.


Join us in congratulating Gwendolyn Graddy, MD, Chief Medical Officer, PACE Southeast Michigan who was awarded the Richard O. Schamp, MD, Award at the dinner. Dr. Graddy exemplifies the commitment and caring that Dr. Schamp demonstrated throughout his years of serving PACE. Congratulations, Dr. Graddy!

CareVention team members and clients presented educational sessions on the following topics:
  • Development of PACE from Exploration through Implementation
  • Diagnostic Power: Optimizing Medicare Capitation
  • Proactive Action: The Antidote to Reactive Care
  • If We Build It, They Will Come: PACE 2.0 Preparing for Growth
  • Transitions of Care: What Puts Participants at Highest Risk Following a Hospital Discharge?
  • A PACE Program's Story About Using Business Intelligence Tools to Meet PACE 2.0 Initiatives and Improve Outcomes
  • CMS Data Universe: Practical Approaches to Gathering Data for a Successful Audit and Approaches to Adjustments Post Audit
  • Preparing for State Encounter Data: A Case Study in Colorado
  • Cannabis: Participant Use Despite PACE
  • Quality Services Promote Financial Growth
  • Organizational Change Transformation: One PACE Program's Journey to Creating a Culture of Fearless and Continuous Process Improvement
  • Vendor Contracting and Oversight for PACE Organizations
If you missed a session and would like to view the slides, contact us.

Clinical Advisory Panel Meeting

On September 19 - 20, CareVention HealthCare hosted the 13th Clinical Advisory Panel (CAP) meeting in Orlando, bringing together PACE Medical Directors from across the country. This year's meeting was hosted by Jacques Turgeon, BPharm, PhD, Chief Executive Officer, and Veronique Michaud, BPharm, MSc, PhD, Chief Operating Officer, of our TRHC Precision Pharmacotherapy Research & Development Institute in Lake Nona, Orlando. Attendees toured the Institute and earned CME, ACPE, and CNE credits in educational sessions. Post-meeting participant surveys showed high ratings for the educational sessions. For questions about the CAP, please contact your Client Liaison.

Cognify | Mediture Announces Partnership with AlayaCare's End-to-End Home Care Platform



Cognify | Mediture has partnered with AlayaCare to offer users of PACElogic and TruChart access to AlayaCare's End-to-End Home Care Platform at a discounted price. AlayaCare provides innovative cloud-based home care software that includes clinical documentation, administrative functionality, family portals, a home care app, virtual care and remote patient monitoring, and optimization and artificial intelligence. For information, email [email protected] or [email protected].


New Capstone Offerings

Capstone recently launched three new offerings - Clinical Documentation Excellence Online Education, Medical Director Training, and the Medicare Revenue Cycle Report. Contact [email protected] for detailed information and questions.

Rebranding News - PeakTPA and CareVention Consulting



Peak Health Plan Management and eClusive, providers of third party administration services (TPA), have combined and now operate as PeakTPA. PeakTPA processes insurance claims and provides "back office" services to healthcare organizations for optimized financial management and regulatory compliance. Services include claims adjudication, enrollment management, accounts receivable, and more.

Capstone Performance System's Technical Assistance Center (TAC) is now CareVention Consulting. CareVention Consulting works with organizations at every stage of PACE, from exploring and developing through improving operations. The team has decades of combined PACE-specific experience, coupled with a collaborative approach that uniquely equips them to help make organizations successful in all phases of PACE-related growth. CareVention Consulting is an NPA-member TAC.
The Whole-Food Plant-Based Diet - What Every Practitioner Should Know

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During the CAP meeting in September, Orsula V. Knowlton, PharmD, MBA, President, CareKinesis, presented a CE session titled "The Whole-Food Plant-Based Diet - What Every Practitioner Should Know". The presentation explained the potential root cause of diet as it relates to cancer, cardiovascular disease, diabetes, and obesity, and identified the dietary recommendation conflicts that exist in the U.S. Case studies describing the potential role for the prescribing of a whole-food plant-based diet in PACE and a listing of the food content of a whole-food plant-based diet were also included. The presentation is available for download.

The following are also recommended articles:
It's Survey Time!

CareKinesis greatly appreciates client feedback. We want to know what we're doing well and how we can improve. Our next client survey will be distributed soon - please be on the lookout!
Networking with CareKinesis

We always enjoy the opportunity to meet with our clients in person, and look forward to seeing you at the following event:

  • November 6 - CalPACE Member Dinner, Sacramento, California
Keep an eye out for a list of 2020 events in upcoming issues of this newsletter!
Upcoming Webinars

November
  • 14 - EireneRx 101 (Webinar)
  • 19 - Safety of Antiarrhythmic Agents in the Elderly (CE Accredited Clinical Webinar)
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