After identifying meaningful metrics that demonstrate the value of a telehealth pharmacy service and the pharmacists delivering the service, determining a strategy to share the results is important. Without sharing the metrics with leaders, their value and the effort expended to track the data will be wasted. As you prepare to share metrics within your organization, it is vital to identify those individuals who need to receive the communication. Consider key stakeholders such as departmental leaders within the pharmacy department, physicians’ group, or health system. You may also consider sharing data at the individual clinic level—sharing with office leadership and providers. If your organization has a telehealth or virtual health division, sharing your data with this team will also be meaningful. Outlining the timing and methods for sharing the data are also key considerations. Sharing data can demonstrate the success of a service and help spur further growth of the service.
A dashboard is a valuable tool to track, display, and share pertinent data. A dashboard provides a graphical representation of priority metrics that can be reviewed and digested at a glance. Dashboards are an effective means of communicating priority data to multiple groups. Managers can use them to share priorities and progress with their employees. They can also use them to communicate key metrics and progress to supervisors and even the executive-level leaders within a company, often referred to as C-suite due to titles. With thoughtful selection of the most important metrics, the same dashboard will be meaningful for both those on the front line and those with decision-making responsibilities.
Like identifying the right metrics, considering how your organization digests and displays data will be an important consideration when you are developing a dashboard. Focusing on key performance indicators (KPI) and those metrics that most clearly display the productivity and impact of ambulatory care is important when caring for patients virtually.
At Intermountain Healthcare based in Salt Lake City, Utah, a digital dashboard was created to display KPI for ambulatory care pharmacists (Figure 13.1). These pharmacists document encounters in the electronic health record, including key information about time spent with the patient, type of encounter (e.g., telehealth, face-to-face), and medication therapy problems identified and addressed. These data are drawn into the dashboard directly from the electronic data warehouse. Ambulatory care pharmacists, managers, and administrators can all access the dashboard at any time to view data. Continuous improvement efforts are reviewed and tracked using the digital dashboard. Managers and administrators use data from the dashboard to help document the value and productivity of ambulatory care pharmacists.
A fully digitized dashboard will likely not be your first step. Starting somewhere is important. If all you can do is track data in a spreadsheet and highlight a couple of metrics, it is worth showcasing that effort. The current version of the Intermountain ambulatory care dashboard is not where it started. Multiple iterations of the dashboard were tried before arriving at the current version.
Depending on the size of your organization, ambulatory care pharmacy team, and availability of information systems (IS) resources, an automated dashboard may not be feasible. Many ambulatory pharmacists or small ambulatory teams that are beginning services may find it easier to leverage spreadsheets and database tools when first starting. These platforms typically offer many tools for data manipulation and analysis. These strategies can also be standardized. If more than one pharmacist is providing the service, this will allow the same data to be collected across pharmacists and locations.
Once the data are analyzed, it can be presented using other methods such as slides or one-page summaries. Consider what control group your data could be compared to in order to demonstrate impact. For example, will you make a comparison to baseline patient data or standard of care? A downside of manual data collection and analysis is that it does have a built-in delay and is not available in real time as an automated dashboard would be. Even with standardization, there is the possibility that data may not be recorded in the same way or that there may be gaps in the data requiring manual look-up. It also can be very time consuming for pharmacists to complete and may decrease the top-of-license activities they are able to perform. Box 13.1 lists various options for data collection and analysis.
Potential Data Collection and Analysis Tools
REDCap (Research Electronic Data Capture)
Data analysis programs
Tool for telehealth pharmacy practice evaluation: A dashboard is ideal for data collection and display of metrics. Many services do not start out with a dashboard but leverage home-grown tools early on.
Never underestimate the impact of a powerful patient story. Data demonstrating success with clinics’ outcomes or financial wins are important. Layering in real stories about how pharmacists positively impact the lives of patients can be very powerful. The emotional pull of the stories coupled with positive data can be very persuasive.
You should identify patient success stories that are part of your telehealth pharmacy program. Storytelling can help demonstrate the success of your program and build support for continuing or expanding. Storytelling makes your data more real and more personal. It can evoke emotion.
Storytelling can occur in a variety of ways. It can be in the form of one to two patient vignettes to describe the success of your program. Alternatively, it can comprise several statements from the patient to demonstrate the importance of the service from the patient's perspective. Some organizations may also look to use a digital approach—making videos or posts on social media to highlight patient success stories. Sharing these stories with key stakeholders can create a ripple effect of sharing those stories throughout the organization.
Communication with the C-Suite
When communicating with the C-suite, it is important to understand what metrics and stories are going to have the greatest resonance. This is where having that understanding of organizational priorities, strategic planning, and reimbursement strategy is critical. The C-suite likely doesn’t need to hear all the metrics that are being tracked for a service—just those that align most closely with organizational priorities to make the information meaningful. Another consideration when communicating with the C-suite is to keep information concise. Provide the most relevant metrics and outcomes. Contemplate adding a patient success story or two. Be sure not to overload the C-suite with data and information. If you do not limit your information, the key points may be missed, and attention will be shifted to less important details. Consider limiting materials to a one-page handout or a handful of presentation slides. Use charts and tables when possible and limit the amount of text. If you have a dashboard that your C-suite has access to, providing the information to access that dashboard and the most relevant pieces is also important.
Often in healthcare organizations, physicians are a driving force behind the direction a healthcare system may take. Aligning your telehealth pharmacy practice service with a physician champion can be beneficial, especially if that individual can provide support within C-suite conversations. A physician champion may be able to provide you with insight into what metrics could be most relevant to the organization and also provide information on barriers you may encounter as you seek to use metrics and outcomes to continue or scale work within an organization.
Scaling the Work within an Organization
The disruption of the pandemic in 2020 propelled advancement of telehealth throughout healthcare. Continuing that advancement within ambulatory care pharmacy services requires an understanding of pharmacist productivity. Metrics are key to scaling your telehealth pharmacy practice service. They can help you understand what can be expected from each pharmacist. For example, a metric showing average time per patient encounter can inform how many patients a pharmacist could care for during a shift. Whether it is the amount of time per patient encounter or estimating a panel size of patients that a pharmacist could provide care for, it is important to have these estimates available when you are considering service expansion. This can help determine how many full-time equivalents (FTEs) would be needed to launch a service whether across several locations or across the health system.
When considering when and how to scale work throughout the organization, reviewing utilization patterns of existing resources can also be important. For example, do all existing pharmacists have a full schedule, or do some pharmacists have schedules that may be only 70% full or less? That open time may be able to be leveraged to support telehealth services for patients in another clinic location. In addition, looking at lead time for a new appointment slot for patients is another marker that can help determine existing capacity and potential for enlarging patient panel size. It is important that data reporting can provide this information in order to best determine a strategy for scaling services.