The Rate Limiting Step to Scalability of Pharmacist Services is Lack of Interoperable Clinical Data & Payer Interaction within Workflow

The Pharmacy Sector transacts billions of prescription fill claims every year.  Those transactions are low cost and efficient, and would not be possible without  the use of the NCPDP Standard.  Services provided by pharmacists (and others) to optimize the use of medications are being choked by lack of interoperability between service providers and payers.   The growth and sustainability of services like Medication Therapy Management (MTM) and Comprehensive Medication Management (CMM) will remain inhibited from realizing their potential and their expression of value without the ubiquitous use of an interoperable standard that addresses both payment and the sharing of clinical data. Both are required for efficient service deployment and value-based payment models.

Example Payer Sheet

Example Payer Sheet v1.0 PeCP.png
  • Patient Demographics
  • Composition Author (Practitioner)
  • Encounter Participant
  • Encounter Location
  • Encoutner Type
  • Encounter Reason
  • Composition Custodian (Practice)
  • Composition Detail
  • Plan Coverage
  • Medication List
  • Procedure Detail
  • Communication Detail
  • Referral Detail
  • Patient Goals Detail
  • Outcomes

 

Click here to download example payer sheet.

Questions or Feedback?
Shelly Spiro - shelly@pharmacyhit.org