Aligning health systems for continued success in specialty pharmacy

Compass Rose™ Implementation in a Large Academic Medical Center

Background

Compass Rose™, a case management tool developed by Epic®, was designed to track various patient coordination tasks, outreaches, and outcomes. This report describes the implementation of Compass Rose™ within an internal health-system specialty pharmacy (HSSP) and changes in care coordination metrics before and after implementation. To the best of our knowledge, this is the first study of its kind to discuss the implementation of Compass Rose™.

Objectives

The goals of this study were to describe the implementation process of Compass Rose™ at an internal HSSP and compare staff satisfaction before and after Compass Rose™ as the primary outcome.

Methods

This was an Institutional Review Board exempt, retrospective cohort study conducted between June 2022 to December 2022 that assessed staff satisfaction, refill documentation time, prescription turnaround time, and patient satisfaction pre- and post- Compass Rose™ implementation through survey administration, observed time studies, and internal data reports. The process of Compass Rose™ implementation was also described and discussed.

Results

24 specialty pharmacy staff members participated in the Compass Rose™ implementation survey. No statistically significant differences were observed in either staff satisfaction (3.96 ± 0.95 versus 3.70 ± 0.69, p = 0.29) or predicted versus actual challenge of implementation (3.67 ± 1.17 versus 3.09 ± 0.96, p = 0.064). There was no significant difference in refill documentation time pre- versus post- Compass Rose™ implementation (4.22 ± 3.15 minutes versus 4.10 ± 2.36 minutes, p = 0.82); however, there was a statistically significant increase in prescription turnaround time post implementation (2.59 ± 2.85 days versus 2.69 ± 2.35 days, p = 0.002).

Conclusion

Compass Rose™ implementation had no significant impact on staff satisfaction, patient satisfaction, or overall refill documentation time. Prescription turnaround time increased, which could be due to significant workflow changes with Compass Rose™ or several other contributing factors such as increased prescription volume and training new staff during this period.Benefits of Compass Rose™ included standardization of workflow, ability to quantify staff performance and clinical impact, and increased transparency regarding care provided by the specialty pharmacy team.

Health-system specialty pharmacy role and outcomes: A review of current literature

DISCLAIMER

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

PURPOSE

Specialty medications can have life-altering outcomes for patients with complex diseases. However, their benefit relies on appropriate treatment selection, patients' ability to afford and initiate treatment, and ongoing treatment optimization based on patient response to therapy. Mounting research demonstrates the benefits of the health-system specialty pharmacy (HSSP) in improving specialty medication access, affordability, and outcomes. The purpose of this rapid review is to describe the currently reported role and function of HSSP pharmacists and outcomes reported with use of the HSSP model, and to identify gaps in the literature where more information is needed to better understand the HSSP model and outcomes.

SUMMARY

Current literature describes the role of HSSP pharmacists in facilitating patient access, affordability, and initiation and maintenance of specialty medications. Though it is clear HSSP pharmacists are involved in treatment monitoring, often through utilizing the electronic health record, more information is needed to elucidate the frequency, method, and extent of monitoring. Despite several valuable continuity of care services reported to be provided by HSSPs, the breadth and degree of standardization of these services remains unclear. There is minimal literature describing HSSP education and research involvement. HSSPs have reported significant benefits of this patient care model, as demonstrated by higher adherence and persistence; better clinical outcomes; financial benefits to patients, payers and the health system; better quality of care; higher patient and provider satisfaction with services, and highly efficient specialty pharmacy services. More literature comparing clinical and diagnosis-related outcomes in HSSP versus non-HSSP patients is needed.

CONCLUSION

HSSPs provide comprehensive, patient-centered specialty medication management that result in improved care across the continuum of the specialty patient journey and act as a valuable resource for specialty clinics and patients beyond medication management. Future research should build on the current description of HSSP services, how services affect patient outcomes, and the impact HSSP network restrictions.