Purpose:
The intent of this business plan is to implement cardiovascular risk reduction (CVRR) services with a full time ambulatory care pharmacist at the Pedigo Health Center with Eskenazi Health. By adding these services to the clinic, we hope to increase the overall health and well being of the homeless populations and increase accessibility in the under served area to those who need it.
Background:
Cardiovascular disease is the leading cause of death in America. Due to the mismanagement of primary disease states such as type 2 diabetes mellitus, hypertension, and dyslipidemia, the homeless population is at an increased risk of experiencing a cardiovascular event. Eskenazi strives to serve any patient regardless of where they come from, so our efforts are aimed towards providing care towards the homeless populations and preventing future hospitalizations.
Clinic:
The Pedigo clinic has aimed to provide holisitic care to the homeless populations. They have worked to engage with individuals and meet them in their health care needs. Currently they bring mental health and primary care services to the under served population to help with substance abuse and mental illness. 1 Now, they are seeking to implement CVRR services by an ambulatory care pharmacist to further assist and care for the homeless populations.
Evidence:
Ambulatory care pharmacists have been a crucial component of assisting patients with cardiovascular risk factors. Their efforts in helping manage primary disease states has improved patient outcomes such as reduction in A1C, lowered blood pressure and lipids, and increase rates of smoking cessation as well as decreasing total healthcare expenses.
Finances:
With the addition of this new position, one new ambulatory care pharmacist will be hired on at an anticipated starting salary of $125,000. The position at Pedigo, however, will only pay out 1/2 FTE, so the expected cost is $62,500. Regardless of whether the clinic adopts a model where the pharmacist spends one or two afternoons a week participating in shared-provider visits, we anticipate the position will be profitable by years end.
Marketing:
Advertising this service will mainly be done either by word of mouth or a referral by a physician. There will be outreach into the homeless communities at least twice a week (one morning and one afternoon) to inform individuals of this service. Patients who already attend the Pedigo clinic will be notified in follow up visits. If a patient were to visit the emergency department, the physician could refer them to Pedigo for increased management of their disease states.
Goals:
- Reduce cardiovascular associated events with the homeless populations
- Increase awareness of importance in managing primary disease states
- Increase medication adherence for homeless patients
- Decrease hospitalizations due to cardiovascular related events
- Improve management of primary disease states by reducing A1C, blood pressure, LDL cholesterol, and COPD exacerbation as well as increasing smoking cessation services.
Resources:
- https://www.eskenazihealth.edu/news/horizon-house-and-eskenazi-health-open-full-service-health-center