CPESN® Tennessee Minimum Service Sets
All member pharmacies are capable of providing the following core services:
1. Adherence Packaging & Counseling: Assisting the patient with a system to help organize medications, take them at the correct time of day and improve patient compliance/adherence. This service may include the pharmacist working with the patients and/or their caregivers to determine an appropriate adherence packaging system such as bubble packing, medication strips, med planners, or automated medication planners with utilization of appropriate labeling as determined by the Board of Pharmacy.
2. Collection of Vital Signs: The ability to collect heart rate, respiration rate, temperature and blood pressure in your pharmacy for patients
3. Comprehensive Medication Review (10 step process):
1. Actively identify and recruit patients who are candidates for CMRs with chronic care management.
2. Utilize pharmacy information including patient notes, medication lists, patient vitals, or other clinical information that has been documented at the pharmacy.
3. Collaborate and communicate with other providers in order to receive additional clinical information including progress notes, labs, hospitalizations, discharge summaries, etc.
4. Schedule time with patients and inform patients what information they need to bring with them including current prescription medications, any over-the-counter medications/supplements and information given to them by other providers (e.g. result of office visit, discharge summary, current medication list).
5. Perform interview using motivational interviewing techniques and engage patients in a conversation in order to collect as much relevant clinical information to appropriately assess the patient.
6. Utilize the complete patient record developed during the previous steps, identify drug therapy problems, create a patient care/action plan, and communicate with other providers.
7. Implement a plan to resolve the drug therapy problems, determine patient educational and health coaching needs, and determine patients’ therapeutic goals, appropriateness of their drug therapy, and safety and efficacy of medications.
8. Document all patient care activities including note to prescriber.
9. Coordinate care with other providers.
10. Follow up with patients as determined by care/action plan.
4. Home Delivery: A pharmacy-provided delivery service, charges or restrictions may apply; call pharmacy for details
5. Immunizations: The ability to actively screen patients, educate, and provide the following ACIP recommended immunizations (or at a minimum refer to another provider) influenza, pneumococcal (both conjugate and polysaccharide), Tdap, and herpes zoster immunizations
6. In-Depth Counseling/Coaching: Additional counseling offered in the pharmacy, requiring a pharmacist or qualified staff member to step out of traditional pharmacy workflow in order to complete the activity
7. Medication Synchronization Program: The proactive process of timing a patient’s routine refills with a pharmacist’s clinical disease state management and monitoring for progression toward desired therapeutic goals. The purpose of medication synchronization is to ensure that patients are refilling and taking their medications as prescribed and to ensure that patients are achieving therapeutic goals with safe and effective medications. This process is not to be confused with automatic refill.
8. Personal Medication Record: The ability to create a comprehensive list of current patient medications manually or from dispensing software
9. Medication Reconciliation: The process of comparing a patient’s medication orders to all of the medications that the patient has been taking (active, chronic, as needed and OTC including herbal) to avoid medication errors. This process should be done at every transition of care. Pharmacists should assess for discrepancies, communicate with other providers/health-systems, and work closely with the patient to ensure that their current medications are intended and appropriate. Pharmacists will document that they performed the medication reconciliation, identified any discrepancies, and communicated with other providers as necessary.
The process includes 6 steps:
1. Develop a list of current medications.
2. Develop a list of medications to be prescribed.
3. Compare the medications on the two lists.
4. Make clinical decisions based on the comparison.
5. Communicate the new list to appropriate caregivers and to the patient.
6. Document medication reconciliation activities.