Ohio State primary care clinics team receives APhA Pinnacle Award for novel remote monitoring system
A team of practitioners, residents, residency directors and faculty members from The Ohio State University College of Pharmacy and within the Ohio State primary care clinics received an American Pharmacists Association (APhA) Foundation Pinnacle Award in September for their Remote Monitoring Hypertension Program.
For nearly 30 years, the annual APhA Pinnacle Awards program has celebrated significant contributions to the field of pharmacy that improve patient outcomes. Awardees have launched services that increase patient adherence, reduce adverse drug events, enhance communication among their care teams and improve the health care landscape.
The novel remote patient monitoring (RPM) program was launched following years of interprofessional work, illustrating the powerful partnership between the OSUWMC Division of General Internal Medicine and the College of Pharmacy.
Getting a hold on hypertension
The Remote Monitoring Hypertension Program was created in 2021 when Kelli Barnes, PharmD, BCACP, FAPhA, P3 IPPE administrator at the College of Pharmacy, and Neeraj Tayal, MD, clinical professor at the College of Medicine, identified a need for continuous and simple blood pressure monitoring services for OSUWMC primary care patients.
“Blood pressure is an important, value-based, quality indicator of a patient's overall health status, with hypertension—one of the most common chronic disease states—leading to increased risk of heart attacks and strokes,” Dr. Barnes said. “Combined with the number of patients who experience high blood pressure, this made it obvious that creating a RPM program for hypertension offered potential benefits to a huge portion of our patient population.”
The pilot program, then led and managed by Drs. Barnes and Tayal, loaned monitors to patients to track their blood pressure and automatically transmit their results into their medical record. Blood pressure results were monitored by a team of pharmacists who practice under collaborative agreements, allowing them to adjust medications for and empower patients to improve blood pressure in a timely manner.
During the pilot program, patients expressed satisfaction with having pharmacists manage this vital aspect of their health without having to regularly visit the clinic.
“Because the initial pilot was so successful, the Ohio State primary care team secured funding to expand the project to all of Ohio State general internal medicine (GIM), family medicine and primary care clinics,” said Jen Sabatino, PharmD, BCACP, current program manager and GIM clinical pharmacist. “This is where our residents and care teams really stepped up.”
"Ohio State has a history of similarly exciting programs and caring teams, and residents are continually attracted to the Ohio State residency experience."
Residents and providers team up
A shining light throughout the Ohio State primary care clinics where the program was implemented is a sense of collaboration among members of the care teams.
“One of the things that was most influential in spreading the program’s success was having our physician champions early on,” Dr. Sabatino reflected. “Dr. Tayal was of course an early advocate for the pilot, but the providers and practitioners at each family medicine and GIM clinic were early adopters of the program and connected patients to the new resource.”
Over the past four years, GIM pharmacy residents have partnered with these providers to grow enrollment and success of the Remote Monitoring Hypertension Program.
Cory Coffey, PharmD, MS ’24, BCACP, BCPP, lead clinical pharmacist and residency program director for the Ambulatory Care Pharmacy Residencies at GIM, guides the residency program’s day-to-day operations and supports the success of residents as they engage with innovative programs like the RPM initiative.
Under his leadership, GIM residents became essential to extending the monitoring program’s reach across eight primary care locations.
"Integrating residents into the monitoring program’s workflow and allowing them to take an active role has been a game-changer for its success,” Dr. Coffey said. “Not only do our residents become entrenched in this program’s functioning, but we use it to educate them on service development, scaling and aspects of reimbursement that must be considered for novel programming.”
Sarah Leupold, PharmD ’22, BCACP, clinical pharmacist and College of Pharmacy Integrated Patient Care Lab (IPCaL) instructor, was one of many GIM residents who provided critical support to the pharmacist-led Remote Monitoring Hypertension Program.
“One of the reasons that I chose to complete a residency at Ohio State was because of the innovation,” she said. “As a PharmD student, I could see that the role of a pharmacist was being expanded through the college and hospital system to optimize the level of patient care.”
On rotations at these practice sites, GIM residents met with primary care physicians to provide overviews and share the criteria for referring patients to the program.
“The reason that programs like this are so successful at Ohio State is because everybody on the care team is invested,” Dr. Barnes emphasized. “We're lucky to have this environment where primary care providers, pharmacists and other members of the health care team support one another's work to achieve the best patient care possible”
When physicians referred patients who were good matches, the pharmacy residents were often the team members called in to issue patients the proper equipment and orient them with the program.
“One of the highlights of my residency has been following patients throughout their entire remote monitoring journey,” reflected Sydney Robbins, PharmD ’24, BSPS ’20, PGY2 resident. “Starting with device setup, making medication adjustments along the way and ultimately celebrating with patients when they reach their blood pressure goals and ‘graduate’ from the program has been really special.”
The shared residency program between the primary care clinics and college ensures that innovative practice at Ohio State has plenty of room and resources to flourish.
“After being a part of the team that supported the program, I saw that it was a positive-feedback loop of sorts,” Dr. Leupold said. “With a team of competent and innovative residents, the program received the additional support it needed to get off the ground. Ohio State has a history of similarly exciting programs and caring teams, and residents are continually attracted to the Ohio State residency experience.”
The residents were instrumental in growing the Remote Monitoring Hypertension Program beyond the initial pilot. In turn, the program provided residents valuable experience with an interdisciplinary team and challenged them to engage with reimbursement and collaborative practice agreements.
“The longstanding shared residency program has a mission of developing practice change agents,” said Bella Mehta, PharmD ’97, BS Pharm ’95, clinical professor and chair of the Division of Pharmacy Practice and Science at the College of Pharmacy. “Our residents are encouraged to develop pharmacy services like this program that will improve access, medication adherence and patient outcomes for the communities we serve.”
Leading the way
The Remote Monitoring Hypertension Program’s implementation provided a greater level of patient care by enabling more detailed and timely insights into patient blood pressure trends. Data collected over a 3-year time period showed that 61% of patients reached their blood pressure goals.
“Remote physiologic monitoring has transformed hypertension management,” said Emily Vrontos, PharmD, CDE, specialty practice pharmacist in the College of Medicine Department of Family and Community Medicine. “By providing blood pressure devices that automatically transmit readings into the patient’s medical record, we have been able to bridge gaps in access, empower patients with real-time insights and enable clinicians to intervene earlier and more frequently than traditional office visits. This has resulted in more equitable care and significantly improved outcomes.”
The program also produced positive impacts on medication management, patient access to care and overall blood pressure control, and demonstrated that it can be fiscally sustainable with meaningful reimbursement for the pharmacists' time.
“The reach of the RPM for hypertension has expanded beyond the OSUWMC primary care clinics to other specialty clinics and has seen interest from other health systems and payors.” Dr. Mehta said. “It is a novel approach that will transform the role of the pharmacist in the care of patients with elevated blood pressure and other chronic conditions.”