INNOVATIVE PRACTICE FORM

Name LuAnn Porter, Pharm. D.

Address Talbert's Country Club Medical Center

Phone # 602-644-1010

FAX # 602-833-7281

E-mail/Information service

Briefly describe innovation

According to Dr. Porter, a large percentage of patients in Arizona are medicare patients; and most of them receive care through HMOs. She works at one of many "staff model centers" which originally were created as part of HCF, a California-based HMO. These staff model centers are being officially "spun off" from HCF to form a collective, separate company. Stated simply, Dr. Porter's innovation is preventive care. On a more complex level, Porter designs pharmaceutical ambulatory care services for a very specific patient population: anticoagulant therapy patients. Although other staff model centers are being readied in other areas such as asthma and hyperlipidemia, Porter seems to see the anticoag clinic as her ideal niche. The first anticoag clinic was set up in Tucson, and Porter's mission was to start up the first Phoenix clinic. Today, her clinic has 3.5 pharmacist FTEs. Along with seven other anticoag clinics, 600 anticoag patients are continuously, effectively and very economically monitored. In order for the staff model center system to come into being, survive and ultimately gain independence from its parent HMO, documentation of outcomes had to be presented to medical directors, physicians and the Director of Pharmacy Services. After overcoming that initial hurdleby utilizing the appropriate patient statistics, Porter and her colleagues had to contend with the possible discontinuation of face-to-face counseling. Telephone conferences with patients were seen by the still-influential parent HMO as more cost-effective, but Porter knew that her patients valued person-to-person contact. She cited this overwhelming preference to HCF and preserved the direct counseling format.

Method of Reimbursement

According to Porter, the clinics bill the State of Arizona medicare system directly. They utilize a form which also serves as an addendum to patient charts. Payor(s) Arizona medicare system

Reimbursement rate Porter's form and info are forthcoming.

Is documentation required? Yes, and Porter points out that the fact that they have full access to patient charts makes documentation much easier. Yes

Software/instrumentation required? Yes Porter says that DuPont' "CoumaCare" package is an integral part of patient record-keeping and care. They are very pleased with DuPont, which continues to modify its product as needs change.

Interviewed by: Lee Bullock