Table 4 Prioritized readiness challenges and readiness building strategies

Operational integration

• Data process and systems

• Financial resources

• Patient information repository

• Referral process

• Workflow

• Staffing

Build data processes and systems to track and monitor

Build data management process and/or system to monitor patient progress and outcomes (e.g., integration with EPIC)

1, 2, 5, 8

Implementation

Develop reimbursement/financial plan

Develop a payment/billing methodology

6

Implementation

Develop a financial plan to sustain the initiative through meetings with leadership and by hiring staff

2

Sustainability

Develop and present a scalability plan showcasing pilot data to obtain additional financial resources through meetings with leadership

3

Scalability

Create a patient information repository

Develop a centralized repository for patient information by partnering with IT

8

Implementation

Develop a referral process

Develop a referral process for service by creating a referral form for primary care physicians

5

Implementation

Develop integrated workflow

Develop workflow for service (e.g., after reviewing current best practices for service, after completing driver diagram)

2, 4

Implementation

Create workflow to meet the capacity needed to reach a larger high-risk patient population

6

Scalability

Optimize staffing to maximize efficiencies

Optimize staffing to maximize efficiencies by transitioning roles and responsibilities to mitigate staff turnover

4

Implementation

Optimize staffing to maximize efficiencies by modifying roles and responsibilities to allow pharmacists to focus on billable services

5

Implementation

Stakeholder engagement and buy-in

Use pilot data

Use pilot data for gaining approval from partnering health plan for payment model

6

Implementation

Use of pilot data to increase buy-in from leadership for scaling service

3

Scalability

Market/create promotional messaging

Create and disseminate marketing materials through multiple avenues of communication (e.g., mailing lists, media outlets) to increase patient and provider engagement in the service

8

Implementation

Brainstorm promotional messaging for internal marketing materials with pharmacy managers to increase pharmacist engagement

6

Implementation

Deliver promotional messaging to pharmacists through program champions (i.e., pharmacists on board)

6

Implementation

Conduct trainings

Develop and conduct trainings for pharmacy residents and clinic staff (e.g., on workflows, data collection)

3, 4

Implementation

Provide education

Educate clinic staff on service and their role

1

Implementation

Team

Identify team members

Identify team members responsible for readiness and implementation

1

Implementation

Engage team members

Engage implementation team through online training and showcasing of positive patient stories to obtain buy-in for the selected service

4

Implementation

Champion

Identify champion

Identify champion to promote service through discussion with leadership

1

Implementation

Leverage champion

Leverage champion to develop a billing pathway and help prepare for implementation

1

Implementation

Priority alignment

Determine priority for service

Determine priority for service by reaching out to new leadership once identified (in midst of merger)

7

Sustainability

Demonstrate value

Continue to deliver pharmacy service and collect data to showcase value to new leadership once identified (in midst of merger)

7

Sustainability

Obtain feedback

Obtain feedback and support from leadership on priority for scalability of the service through meetings and presentation of pilot data

3

Scalability

Service fit

Clarify needs

Determine expectations for selecting a service through meetings with leadership

1

Implementation

Support

Access coaching

Engage coach to support readiness process

1

Implementation

Learn from peers

Communicate with peers outside of the organization to learn about billing pathways from providers implementing this service

1

Implementation