- Email: [email protected]
Interdisciplinary Collaboration: Volunteers in Health Care: Helping Patients in Need
INTERDISCIPLIN ARY COLLABORA TION
Volunteers in Health Care: Helping Patients in Need H. Denman Scott
Working together, pharmacists and physicians can use a new Web site, RxAssist.org, to help uninsured low-income patients secure free or reduced-price medications from pharmaceutical companies' patient assistance pro,grams. RxAssist is one component of Volunteers in Health Care (VIH), a nonprofit national resource center whose purpose is to promote voluntary efforts to care for uninsured and medically underserved patients.
specialist referral networks, insurance plans, hospitalphysician practice partnerships, and physician-public health department collaboration. I One of many lessons learned from "Reach Out" was that volunteer-led projects have a great need for peer-topeer interaction so that partici-
•(1(( volunteers ~
Background In the absence of legislative solutions to the lack of universal health care coverage in the United States, the Robert Wood Johnson Foundation initiated a demonstration program in 1993 to encourage physician leadership of community efforts to care for uninsured and underserved patients. Under this program, which was titled "Reach Out: Physicians' Initiative to Expand Care to Underserved Americans," 39 physician-led projects recruited some 11,000 physicians. Over its 4-year life, "Reach Out" provided medical and surgical services to 200,000 patients through free clinics, primary care and
134
make use of innovative products developed by others. Two underlying premises provide the keys to the program's success: (1) project participants should not have to reinvent the wheel, and (2) people learn best from their peers. Through a series of commissioned field reports, resource tips, manuals, software packages, and other materials, VIH provides information on and assistance with fundraising, recruiting volunteers, organizing referral networks, tracking patients, liability, and other essential issues and tasks. These materials reflect the experiences of and solutions developed by individuals who grapple daily with the difficulties of providing medical, dental, and pharmaceutical care to uninsured
in health care
pants can learn how others have put their projects together and solved problems. To foster such a dialogue, in 1997 the Robert Wood Johnson Foundation funded VIH as a national resource center for information and technical assistance to local health care initiatives that rely on volunteer practitioners.
Resources for Volunteer Initiatives Drawing on a national database of more than 2,500 projects, VIH links volunteer projects and services around the country so that participants can share lessons learned and
Journal of the American Pharmaceutical Association
patients. Although the VIR Web site (www.volunteersinhealthcare.org) is the primary means of dissemination, oneon-one, customized technical assistance is available through the staff. Finally, the program provides seed grants to enhance the capabilities of volunteer projects. VIH will soon make available a series of field reports describing five different pharmaceutical access programs. The reports will discuss in detail how the programs began, how they operate, and how they acquire pharmaceuticals. That series will be followed by a Primer on Phar-
maceutical Access, which will present guidance on starting a pharmaceutical access program, sample formularies, and brief descriptions of programs across the country. Few would assert that volunteer projects are the entire solution to the national problem of caring for the uninsured, but they do serve as a vital component of the safety net in many communities. In the absence of a comprehensive solution, communities are faced with the challenge of caring for uninsured patients who show up at physician offices, clinics, pharmacies, and hospitals every day. Projects using volunteers and resources such as pharmaceutical patient assistance programs can relieve some of those pressures and make an immediate difference to the health and well-being of thousands of people .
RxAssist: Navigating Patient Assistance Programs RxAssist grew out of the earlier Reach Out demonstration program. Recognizing that access to pharmaceuticals
Pharmacists can find models, materials, and lessons learned through voluntary projects for the uninsured at www. volunteersinhealthcare.org or through a link at ww.w.RxAssist.org. Program staff are available for information and technical assistance at 1-877-8448442 (toll-free).
January/February 2001
Vol. 41, No.1
INTERDISCIPLINARY COLLABORATION
was a critical issue, health care providers in free clinics, referral networks, and other volunteer projects funded by "Reach Out" tried to use patient assistance programs but found that in general they were not user-friendly. Many of the programs have not been widely publicized, and even those who know about them can find it difficult to discover which drugs are available, determine the eligibility requirements, and obtain and fill out the application forms. RxAssist brings patient pharmaceutical assistance information together into an easily searchable Internet database, at no cost to the user. Infonnation is available on nearly 100 programs, covering about 700 medications. The RxAssist Web site allows the pharmacist or physician to search for covered drugs by company, brand name, generic name, or drug class. Eligibility requirements are listed. Users can download application forms for about 30 programs and learn how to obtain forms for the others. VIH staff update the material continually and post comments and tips from past users to ease the way for first-timers.
Larger Role for Pharmacists RxAssist is one tool pharmacists can use in collaborating with physicians to secure free or reduced-price medications for low-income uninsured patients. Pharmacists are in a strong position to identify patients who have financial difficulty obtaining prescription drugs. Pharmacists can search RxAssist to determine whether
Vol. 41,
No.1
January/February 2001
the drug is covered by a patient assistance prograIll---{)r suggest to the physician office, which may not be aware of the program, that they do so. If the drug is covered, this teamwork with the physician (application forms generally require a physician signature) can secure free or affordable medications for the patient who might otherwise face financial hardship or choose not to fill the prescription. VIH staff can provide information on successful efforts to secure charitable funding for medication expenses for the uninsured, for example, through local health care foundations. Some of these local foundations were established through the recent conversion of nonprofit hospitals or insurance companies to for-profit status. Pharmacists may want to explore these possibilities with community leaders as a means of helping support the provision of medications to uninsured patients. Finally, pharmacists familiar with voluntary efforts to provide medications for the uninsured are encouraged to communicate that information to VIR, so that those models can be incorporated into the database and shared with others. H. Denman Scott, MD, MPH, FACP, is program director, Volunteers in Health Care, and associate dean, School of Medicine, Brown University, Providence, R.I.
Reference 1. Scott H D, Bell J, Geller S, Thomas M. Caring for the uninsured and underinsured. JAMA. 2000;283:99-104.
Interdisciplinary Collaboration: A Message to JAPhA Readers William M. Ellis
If ~hannacists are to assume a,greater role as primary care prov1ders, we must work toward an enhanced public understanding of the profession's evolving role in patient care. As pharmacists work to improve patient outcomes, we need to find ways to collaborate with other health care providers-in our own communities and at the state and national level-who are stakeholders in medication-related issues. Medication use is the central focus for a number of important public and private efforts throughout the United States. These e!forts includ~ assisting underserved populations, improving health care quality, enhancing patient safety, meeting public health needs, and developing health care policy. Many of these ongoing or planned health-r~lated initiatives have little or no pharm~cy input or involvement. This is unfortunate for both the profession and those initiatives. The intent of the Interdisciplinary Collaboration column, a new addition to JAPhA, i~ to help move ph~acists to become more directly involved with those groups that make decisions and design programs related to medication use. To this end, . we plan to provide information and describe options for pharmacists who wish to become involved with organizations focusing in whole or in part on medication use. We also hope to foster grassroots collaboration between pharmacists and other health care providers through those agency or organizational initiatives. In each issue of the Journal, the Interdisciplinary Collaboration column will highlight an organization that is active in some aspect of health care that has medication use as a key component. To encourage collaboratiqn, each organization profiled in the column will: • Describe their activities. • Highlight areas where they need or would be interested in pharmacy involvement. • Outline ways in which pharmacists can become involved with their efforts. This month's inaugural column highlights Volunteers in Health Care. Upcoming columns will discuss collaborative opportunities with the National Quality Forum and the American Heart Association. If you have been involved with an organization at the local, state, or national level that you believe would benefit from pharmacist involvement, I would like to hear about your experiences. William M. Ellis, MS, is executive director, American Pharmaceutical Association Foundation and contributing editor for the Interdisciplinary Collaboration column. He can be reached by email at [email protected].
Journal of the American Phannaceutical Association
135
Volunteers in Health Care: Helping Patients in Need H. Denman Scott
Working together, pharmacists and physicians can use a new Web site, RxAssist.org, to help uninsured low-income patients secure free or reduced-price medications from pharmaceutical companies' patient assistance pro,grams. RxAssist is one component of Volunteers in Health Care (VIH), a nonprofit national resource center whose purpose is to promote voluntary efforts to care for uninsured and medically underserved patients.
specialist referral networks, insurance plans, hospitalphysician practice partnerships, and physician-public health department collaboration. I One of many lessons learned from "Reach Out" was that volunteer-led projects have a great need for peer-topeer interaction so that partici-
•(1(( volunteers ~
Background In the absence of legislative solutions to the lack of universal health care coverage in the United States, the Robert Wood Johnson Foundation initiated a demonstration program in 1993 to encourage physician leadership of community efforts to care for uninsured and underserved patients. Under this program, which was titled "Reach Out: Physicians' Initiative to Expand Care to Underserved Americans," 39 physician-led projects recruited some 11,000 physicians. Over its 4-year life, "Reach Out" provided medical and surgical services to 200,000 patients through free clinics, primary care and
134
make use of innovative products developed by others. Two underlying premises provide the keys to the program's success: (1) project participants should not have to reinvent the wheel, and (2) people learn best from their peers. Through a series of commissioned field reports, resource tips, manuals, software packages, and other materials, VIH provides information on and assistance with fundraising, recruiting volunteers, organizing referral networks, tracking patients, liability, and other essential issues and tasks. These materials reflect the experiences of and solutions developed by individuals who grapple daily with the difficulties of providing medical, dental, and pharmaceutical care to uninsured
in health care
pants can learn how others have put their projects together and solved problems. To foster such a dialogue, in 1997 the Robert Wood Johnson Foundation funded VIH as a national resource center for information and technical assistance to local health care initiatives that rely on volunteer practitioners.
Resources for Volunteer Initiatives Drawing on a national database of more than 2,500 projects, VIH links volunteer projects and services around the country so that participants can share lessons learned and
Journal of the American Pharmaceutical Association
patients. Although the VIR Web site (www.volunteersinhealthcare.org) is the primary means of dissemination, oneon-one, customized technical assistance is available through the staff. Finally, the program provides seed grants to enhance the capabilities of volunteer projects. VIH will soon make available a series of field reports describing five different pharmaceutical access programs. The reports will discuss in detail how the programs began, how they operate, and how they acquire pharmaceuticals. That series will be followed by a Primer on Phar-
maceutical Access, which will present guidance on starting a pharmaceutical access program, sample formularies, and brief descriptions of programs across the country. Few would assert that volunteer projects are the entire solution to the national problem of caring for the uninsured, but they do serve as a vital component of the safety net in many communities. In the absence of a comprehensive solution, communities are faced with the challenge of caring for uninsured patients who show up at physician offices, clinics, pharmacies, and hospitals every day. Projects using volunteers and resources such as pharmaceutical patient assistance programs can relieve some of those pressures and make an immediate difference to the health and well-being of thousands of people .
RxAssist: Navigating Patient Assistance Programs RxAssist grew out of the earlier Reach Out demonstration program. Recognizing that access to pharmaceuticals
Pharmacists can find models, materials, and lessons learned through voluntary projects for the uninsured at www. volunteersinhealthcare.org or through a link at ww.w.RxAssist.org. Program staff are available for information and technical assistance at 1-877-8448442 (toll-free).
January/February 2001
Vol. 41, No.1
INTERDISCIPLINARY COLLABORATION
was a critical issue, health care providers in free clinics, referral networks, and other volunteer projects funded by "Reach Out" tried to use patient assistance programs but found that in general they were not user-friendly. Many of the programs have not been widely publicized, and even those who know about them can find it difficult to discover which drugs are available, determine the eligibility requirements, and obtain and fill out the application forms. RxAssist brings patient pharmaceutical assistance information together into an easily searchable Internet database, at no cost to the user. Infonnation is available on nearly 100 programs, covering about 700 medications. The RxAssist Web site allows the pharmacist or physician to search for covered drugs by company, brand name, generic name, or drug class. Eligibility requirements are listed. Users can download application forms for about 30 programs and learn how to obtain forms for the others. VIH staff update the material continually and post comments and tips from past users to ease the way for first-timers.
Larger Role for Pharmacists RxAssist is one tool pharmacists can use in collaborating with physicians to secure free or reduced-price medications for low-income uninsured patients. Pharmacists are in a strong position to identify patients who have financial difficulty obtaining prescription drugs. Pharmacists can search RxAssist to determine whether
Vol. 41,
No.1
January/February 2001
the drug is covered by a patient assistance prograIll---{)r suggest to the physician office, which may not be aware of the program, that they do so. If the drug is covered, this teamwork with the physician (application forms generally require a physician signature) can secure free or affordable medications for the patient who might otherwise face financial hardship or choose not to fill the prescription. VIH staff can provide information on successful efforts to secure charitable funding for medication expenses for the uninsured, for example, through local health care foundations. Some of these local foundations were established through the recent conversion of nonprofit hospitals or insurance companies to for-profit status. Pharmacists may want to explore these possibilities with community leaders as a means of helping support the provision of medications to uninsured patients. Finally, pharmacists familiar with voluntary efforts to provide medications for the uninsured are encouraged to communicate that information to VIR, so that those models can be incorporated into the database and shared with others. H. Denman Scott, MD, MPH, FACP, is program director, Volunteers in Health Care, and associate dean, School of Medicine, Brown University, Providence, R.I.
Reference 1. Scott H D, Bell J, Geller S, Thomas M. Caring for the uninsured and underinsured. JAMA. 2000;283:99-104.
Interdisciplinary Collaboration: A Message to JAPhA Readers William M. Ellis
If ~hannacists are to assume a,greater role as primary care prov1ders, we must work toward an enhanced public understanding of the profession's evolving role in patient care. As pharmacists work to improve patient outcomes, we need to find ways to collaborate with other health care providers-in our own communities and at the state and national level-who are stakeholders in medication-related issues. Medication use is the central focus for a number of important public and private efforts throughout the United States. These e!forts includ~ assisting underserved populations, improving health care quality, enhancing patient safety, meeting public health needs, and developing health care policy. Many of these ongoing or planned health-r~lated initiatives have little or no pharm~cy input or involvement. This is unfortunate for both the profession and those initiatives. The intent of the Interdisciplinary Collaboration column, a new addition to JAPhA, i~ to help move ph~acists to become more directly involved with those groups that make decisions and design programs related to medication use. To this end, . we plan to provide information and describe options for pharmacists who wish to become involved with organizations focusing in whole or in part on medication use. We also hope to foster grassroots collaboration between pharmacists and other health care providers through those agency or organizational initiatives. In each issue of the Journal, the Interdisciplinary Collaboration column will highlight an organization that is active in some aspect of health care that has medication use as a key component. To encourage collaboratiqn, each organization profiled in the column will: • Describe their activities. • Highlight areas where they need or would be interested in pharmacy involvement. • Outline ways in which pharmacists can become involved with their efforts. This month's inaugural column highlights Volunteers in Health Care. Upcoming columns will discuss collaborative opportunities with the National Quality Forum and the American Heart Association. If you have been involved with an organization at the local, state, or national level that you believe would benefit from pharmacist involvement, I would like to hear about your experiences. William M. Ellis, MS, is executive director, American Pharmaceutical Association Foundation and contributing editor for the Interdisciplinary Collaboration column. He can be reached by email at [email protected].
Journal of the American Phannaceutical Association
135