As the integration of PACT in VA has progressed, recognition has increased that, in order to complete the medical home concept, strong links to specialty care were needed. Recognition that the CPS has a long history of being imbedded in specialty care granted pharmacy a unique opportunity to assist in bridging the known gaps between the two.

Surveys of our CPS personnel demonstrated that they already had scopes of practices and served as nonphysician providers embedded in nearly 40 different medical subspecialty settings, including common referral areas such as endocrinology, cardiology, infectious disease, mental health, hepatology and pain management. When a primary-care provider refers a patient to a specialty clinic in VA, it is often the CPS who collaboratively manages that patient with the specialists to achieve therapeutic goals.

With a national shortage of both primary care and specialty providers in areas that are pharmacotherapy intensive, the CPS can play a critical role in bridging the gap and transitioning the patient back and forth as necessary.

This role improves access to both provider groups and has been shown to improve patient outcomes. This ability has been greatly enhanced by the placement of the CPS in PACT, as the CPS can facilitate medication management on behalf of the team and its patients.

Conclusions

We’ve been successful during the last two years in standardizing practices and enhancing refresher training for our highly skilled CPS workforce. This has resulted in widespread adoption of this collaborative-care model, a trend we hope to continue in 2013 and well beyond.

Pharmacists in VA are well-positioned to address many roles in a healthcare system that has broad needs for comprehensive medication management. As the medication experts on drug information, medication selection for specific diseases and medication safety, they represent a strong resource for our primary- and specialty-care teams.

The CPS in the nonphysician-provider role is a valuable member of VA’s transformation to team-based care that is improving both access and outcomes. These individuals will continue to play an irreplaceable role in caring for our nation’s veterans today and for years to come.