Leveraging Pharmacy-Led Population Health to Improve Outcomes and Reduce Costs
In this interview, Dovena Lazaridis, PharmD, shares insights on building scalable pharmacy models that extend beyond dispensing, highlighting how population health frameworks and real-time data integration are transforming value-based care.
Please introduce yourself by stating your name, title, and any relevant clinical experience you’d like to share.
Dovena Lazaridis, PharmD: I'm Dovena Lazaridis. I have the privilege of serving as the director of ambulatory and population health pharmacy services at Memorial Healthcare System.
Under my leadership, I have had an immense amount of pleasure and honor in being able to build programs that support patients throughout the organization in medication access, optimization, and adherence.
How has Memorial operationalized DrFirst medication fill data to proactively identify and engage at-risk patients, and what processes ensure that this information translates into timely, effective interventions?
Lazaridis: This is a great question. At Memorial Healthcare System, we have embedded the DrFirst medical history platform into our electronic health system, which is Epic.
For us, every clinician team member now has real-time access to fill history. We can support patients before, during, and after visits. Additionally, we have been able to layer on the population health platform, through which we can now scan entire populations. Doing that, we can identify those who are at risk for medication nonadherence and act proactively to identify and resolve their barriers. We take the information findings and we integrate that into the fabrics of our broader program. That helps us to identify patients and build programs around those identification points.
We can do longitudinal surveillance. That information helps to serve as a lever for us to activate evidence-based interventions to bridge gaps and resolve medication therapy problems.
How does a population health framework allow you to address broader issues like polypharmacy, cost barriers, and health literacy?
Lazaridis: Population health, for us, forces us to look beyond the prescription. We look at the root of the barriers of health. I think many people believe that the most common medication therapy problems are around dosing errors and duplicate medications, but what we've actually found is that most of the problems revolve around social barriers.
Factors like access, affordability, literacy, and patient understanding are a lot of the key problems that we find. Our framework allows pharmacy team members to play a very critical role in that. I will stress that success comes when those insights are embedded as part of the entire care team. To give you an example of that, when we're able to identify these patients with medication access cost barriers, we're able to leverage medication access specialists who are dedicated to supporting those patients in getting free drugs and helping them to enroll and get access to copays and such. For our system, we have been able to generate a significant amount of savings directly for the patients.
In addition, we invest in our clinicians. We invest in their ability to not only identify but also resolve social barriers like health literacy. We invest in educating patients in a way that makes sense to them, sometimes even in their own language. The key is making sure that they understand why their treatment matters.
What have been the biggest challenges in building and sustaining a population health pharmacy program, and what new opportunities has it created for improving outcomes and reducing costs?
Lazaridis: The biggest challenge has been around proving that pharmacy programs are not just distribution driven.
They're not just cost-containment or support functions; we want to prove that they're scalable and that they can be successful models that should be leveraged as strategic tools in health care transformation. As a population health leader, being able to overcome those barriers is critical. It did open a lot of doors for deeper provider collaboration, health care collaboration, and payer alignment.
Because of those results, we've been able to even move to creating a population health product from our organization that we've dubbed a chronic disease program. This product is designed to support health entities and their populations. It's now being leveraged by at-risk organizations, such as accountable care organizations (ACOs) and health plans, as a solution to improve outcomes and reduce costs for their own members or at-risk lives. This is where, again, having the right type of technology is important because what started as just a hospital initiative is now a product being adopted by health care entities to transform populations at scale. They're also populations that may not have information that's feeding into our system because they weren't necessarily patients who were using our health institution.
That's where platforms like DrFirst have been really helpful because now I can take that information, I know my members, and using that DrFirst platform, I can have a real-time understanding of where those patients are from an adherence perspective, and I can leverage that for us to make interventions.
How do you see the role of pharmacists evolving in value-based care models, and what unique contributions can they make in driving medication adherence and population health success?
Lazaridis: In alignment with my last points, pharmacists are no longer just dispensing. I don't want to limit it to pharmacists because we do have, as I stated, medication access specialists who also support the broader team, but pharmacists are now able to be at the center of closing the gap between prescriptions written and outcomes achieved. They bring data expertise. We are trusted by patients. There is this relentless follow-through that drives adherence and keeps patients healthy.
I can give you an example. A family member of a patient reached out maybe 2 days ago and shared an instance in which they were recently treated at a health care institution for a procedure. They left without pain medications. The patient was a mother who was in extreme pain. Our pharmacists and pharmacy care team members were able to support them more proactively, bridge that gap, and get them what they needed. They were so very grateful. These are the types of things that, as health care organizations, pharmacists are well positioned to support and should be positioned to do.
I can tell you that pain is the number one cause of people seeking care at a health entity. So, I'm fairly certain that would have led to the patient going back to the emergency department, and that would have led to higher costs. As we think about evolving value-based care, we need to ensure that the right stakeholders are in place, such as pharmacists and pharmacy care team members, and that they can support these efforts in a broader way.
Is there anything else you hope our audience takes away from this interview?
Lazaridis: As a health care leader, my focus has always been on population health strategy. In alignment with everything I spoke about, the question is how we leverage data, technology, and team-based care to close gaps that keep patients from getting healthier. That's what this partnership is about. For me, choosing a technology partner is about ensuring that we have the right partnerships and tools to allow our clinicians and our team members to be able to do their role successfully.
I'll also say that, as a board-certified pharmacist, I'd like to stress how often underutilized pharmacy team members are in this space of value-based care and population health. I know firsthand how pharmacists and the staff members can serve as powerful tools. I've had very personal experiences of my own where being integrated within the care of a patient has made a dramatic difference, particularly around medications, cost literacy, and access.
Pharmacist should be interfacing with physicians, nurses, and care managers. For me, it's the big picture. How do we build systems that turn information to action across the entire care team?
