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Department of Veterans Affairs PBM Drug Accountability Conference San Antonio, TX

Department of Veterans Affairs PBM Drug Accountability Conference San Antonio, TX May 11 - 13, 2010. VA Consolidated Mail Outpatient Pharmacy. Stephen J. Lewis RPh Associate Director Murfreesboro, TN Department of Veterans Affairs Consolidated Mail Outpatient Pharmacy.

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Department of Veterans Affairs PBM Drug Accountability Conference San Antonio, TX

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  1. Department of Veterans Affairs PBM Drug Accountability Conference San Antonio, TX May 11 - 13, 2010 VA Consolidated Mail Outpatient Pharmacy Stephen J. Lewis RPh Associate Director Murfreesboro, TN Department of Veterans Affairs Consolidated Mail Outpatient Pharmacy

  2. Maximizing Use of CMOP

  3. Department of Veterans Affairs Consolidated Mail Outpatient Pharmacy To serve veterans through the safe, cost-effective, timely and efficient fulfillment of prescriptions in support of the provision of care. CMOP Vision • Partner with VA Medical Center customers in the provision of integrated and seamless care • Continuously improve quality processes and service provided • Ensure the highest level of integrity and accountability • Contribute as members of VA Pharmacy community • Contribute as members of the Pharmacy Profession • Be a “visible” component yet a transparent presence in the patient-centric pharmacy process • Continuously plan and prepare for response to emergent need both locally and nationally • Innovate, Automate, and Transform the provision of Prescription Benefit to veterans CMOP Mission

  4. Memorandum of Understanding Defines Roles for VA Medical Centers and CMOP  • Initial review of the order • Medication profile review • Patient consultation • Verification of patient address • Daily transmission of orders • Reporting of errors and patient complaints • Notification of changes in product utilization • Verification of order transmissions • Accurate and timely processing of orders • Investigation, trending, and feedback for all errors and patient complaints reported • Cancellation of order with explanation to the Medical Center, when applicable • Proper inventory control • Provision of cost reports Medical Center CMOP

  5. Life of a VA CMOP Mail Outpatient Prescription Provider Orders Medication/Supplies Patient Receives Medication/Supplies 1+ Hrs 10 Hrs 12 to 48 Hrs 48+ Hrs Awaiting Order Verification by VAMC CMOP Filling Delivery of Product to Patient Awaiting Transmission of Order to CMOP Goal: delivery to patient within 10 days of provider or patient request

  6. CMOP Production Area Breakdown • Tablet/Capsule Dispensers (16%) Baker and Others • Automatic tablet/capsule counting • Improved tablet/capsule delivery to eliminate miscounts • Controlled Substances (6%)ADU, AutoMed-Fast Fill, and Others • Accurate automated counting • Complete inventory every 24 hrs • Unit of Use Dispensers (70%)Knapp and SI Dispen-SI-Matic • Highest efficiency with fewest errors • Outsource Contractors (1%) Medline and McKesson • Large, heavy, or bulky non-drug products • Data security compliant with VA standards • Bulk Dispensing (4%) • Special shipping needs • Manual Dispensing (3%) • Low use products

  7. CMOP Core Metrics Report

  8. Production Monitors

  9. vaww.apps.cmop.va.gov

  10. Vaww.apps.cmop.va.gov/CMOPNationalWebApplicationv2/

  11. Maximizing CMOP Utilization • Address hygiene. Incorrect addresses are a cost to all, from destruction of drug costs, to return to shipper costs for certain packages. $180M per year on shipping alone. • For example, at Mid-South CMOP over the last six months over 8,100 packages have been returned. This is just controls. • 3,824 Unclaimed • 1,779 Address issues • 1600 Three attempts made • 336 Refused • 203 Deceased. • Etc…

  12. Maximizing CMOP Utilization • Knowing what’s on the CMOP formulary. • Low use cancel backs. Do you really want to un-mark them? • Running Pro-Clarity routine to determine products that could reach CMOP MOU threshold. • Contacts at your local CMOP for product addition. • //vaww.apps.cmop.va.gov/CMOPProductLine/ • Know your local transmit to CMOP time. • Know your station number.

  13. Cancel Report by Percent of Total FY10

  14. Medications Canceled Back 3/10

  15. Product Line Search

  16. Back Ordered Items

  17. Maximizing CMOP Utilization • Just in Time products: • Do you know what products your CMOP has as Just in Time? • Can you utilize that process for your patients? • Lowers local inventory holding cost and risks. • Usually overnight/next day service to the patient from the CMOP. • May in fact get to the patient at the same time local VA could get it to the patient.

  18. //vaww.apps.cmop.va.gov/cmopmedline/medline.aspx • Med/Surg Items and Low Use Items. • What does your CMOP carry? • Are your items turned on? • Are you ordering the correct pack size? • Does your drug file reflect CMOP pk size?

  19. QUESTIONS

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