LEARNING AND ACTION COLLABORATIVE STORIES
Real Health Systems.
Real Results.
LAC SUCCESS STORY
Legacy Health
Legacy Health is a non-profit, six-hospital health system in the Portland-Vancouver and mid-Willamette Valley areas of Oregon. They have 14,000 employees, nearly 3,000 healthcare providers and touch the lives of 2.5 million people.
BOLD AIM
To identify and resolve 1700 CKD-related medication therapy problems (MTPs) by October 31, 2025
Our mission is good health for our people, our patients, our communities and our world. Above all, we will do the right thing.
RESULTS
2,700
Total MTPs Documented
1,422
Distinct Patients
490
CKD-Related MTPs Identified
216
Distinct Patients with a CKD-related MTP
PATIENT DEMOGRAPHICS
69
Average Age
28-98
Age Range
45mL/min/1.73m
2
Baseline eGFR Avg
79mg/g
Baseline UACR Avg
CKD-RELATED MTPs
CKD-RELATED GDMT OPTIMIZATION
BIGGEST WINS
Establishing a care pathway for CKD, including development of a CPA, to fully leverage the pharmacist’s clinical expertise
Successfully utilize EHR functionality to systematically document MTPs and track their resolution
Partnered with informatics to build reporting that captures clinical and financial outcomes from pharmacists intervention
Collaboration with informatics to build reporting that captures MTPs and provides a visual representation of the accomplishments/work done by pharmacists
LAC SUCCESS STORY
Intermountain Health
Intermountain Health, the largest nonprofit health system in the Intermountain West, includes 34 hospitals and 400 clinics. They are “dedicated to creating healthier communities and helping our patients thrive” by partnering with patients and communities to support health, wellness, and quality of life.
BOLD AIM
To increase SGLT2i utilization by 10% in patients seen by a single nurse practitioner at the Intermountain Medical Center Kidney Clinic from November 2024 to September 2025.
ACTIONS
Created a new clinical pharmacist CMM service with the pharmacist present in the clinic one day per week and focused on patients seen by one nurse practitioner.
RESULTS
9%
SGLT2i prescribing increased
142
Patient CMM Visits
360
Total MTPs identified
61% related to indication (37% related to GDMT)
28% related to safety
132 GDMT RECOMMENDATIONS
BIGGEST WINS
Clinic leadership requested to increase pharmacist allocation to 1.0 FTE
Received approval to transition to CPA based workflow to allow pharmacist to implement changes directly with the patient.
Built pharmacist schedule independent of nurse practitioner schedule
LAC SUCCESS STORY
Sentara
Sentara Health, is a leading not-for-profit integrated healthcare delivery system serving Virginia, North Carolina, and Florida. The organization includes 12 hospitals, more than 400 sites of care, approximately 1 million health plan members, and 34,700+ employees, all working toward Sentara's mission to improve health every day.
BOLD AIM
Population Health Pharmacists will Improve the Kidney Health Evaluation for Patients with Diabetes (KED) HEDIS measure among commercial members by 20% by leveraging the Population Health Pharmacy Team. To meet the KED measure, a patient must receive both an estimated glomerular filtration rate (eGFR) and a urine albumin-to-creatinine ratio (UACR) in one measurement year.
ACTIONS
Expand existing CMM services to patients with CKD to optimize medication therapy, support guideline-directed care, and improve clinical outcomes.
RESULTS
BIGGEST WINS
Doubled the percent of persons screened for CKD with both eGFR and UACR
Improved medication safety and efficacy by identifying medications that needed dose adjustments based on kidney function
Developed CKD smart phrases to streamline documentation, improve adherence to guideline-directed medication therapy, and improve provider communication
Plans to extend pharmacist services into primary care practices, leveraging the demonstrated outcomes and success of the population health pharmacy model