PQA is a non-profit organization with 250 diverse members across healthcare. Our members include community and specialty pharmacy organizations, pharmacists and other healthcare providers, pharmacies, health plans, pharmacy benefit managers, life sciences, technology vendors, government agencies, health information technology partners, researchers, accrediting organizations and academia.

New organizations regularly join PQA throughout the year. This blog recognizes eight organizations that have joined PQA since July:

The PQA Quality Forum Webinar is a regular, recurring series on healthcare quality topics with a focus on medication use and medication services. It is a forum for educating and engaging with PQA members and quality-focused healthcare professionals.

On March 12, 2020, Lucas Schulz, PharmD, BCIDP, an Infectious Diseases Clinical Coordinator at UW Health in Madison, Wisc., discussed the Antimicrobial Stewardship Program at University of Wisconsin Health.

PQA, the UNC Eshelman School of Pharmacy and Janssen Scientific Affairs have collaborated to jointly host a "Postdoctoral Fellowship in Real World Evidence, Population Health, and Quality Research." The two-year fellowship aims to prepare an individual for a career in healthcare quality-related outcomes research.

The inaugural fellow is Sabree Burbage, PharmD, MPH, a University of North Carolina at Chapel Hill dual-degree graduate. She began her fellowship at UNC earlier this year. 

The PQA Healthcare Quality Innovation Challenge (HQIC) is an annual national collegiate competition where student teams present technology-enabled solutions to improve healthcare quality. With the support of a faculty or pharmacy professional mentor, participating student teams develop a business summary proposal for their solution to one of three prompts provided by PQA. The prompts for the 2020-21 academic year are focused on pandemics, mental health and the social determinants of health.

Jeff Newell, CEO of Pharmacy Quality Solutions (PQS), participated in a Q&A with PQA about HQIC on August 20. He shared his insights on the competition, what makes it special and some tips this year’s students may want to consider as they develop their proposals. PQS has sponsored HQIC since its creation in 2017.

Our nation’s universities and academic institutions educate and train the healthcare quality workforce. More than 40 colleges and schools of pharmacy are PQA members and they are important partners in our work to advance medication use quality, especially in education.

I want to highlight three important opportunities for our academic members to be engaged with PQA and take advantage of our member benefits as the 2020-21 academic year gets underway.

PQA is developing a set of standard pharmacy performance measures that would be appropriate for pharmacy accountability. This work began in early 2019 in response to interest from our members and policymakers in standard measures to evaluate the quality of pharmacies and assess pharmacist-provided care and pharmacy-based services.

The focus of PQA’s current work is the Pharmacy Measure Development Action Plan. The draft plan was released August 6 and outlines steps for developing measure concepts that have been prioritized based on their feasibility and usability. PQA seeks comment on the plan now through August 28. The plan builds on work that resulted in three PQA-endorsed pharmacy performance measures.

This blog provides:

• some history on the impetus for PQA’s work to develop pharmacy measures,  
• information on the draft plan and how you can provide comments, and
• what comes next in building out a pharmacy measure set.

PQA Member and Policymaker Interest in Pharmacy Measures

PQA offers a new online continuing education and certificate program on Medication Use Quality. The program provides advanced training on quality measurement and strategies to improve medication safety, adherence and appropriate use. Pharmacists, pharmacy technicians, nurses and physicians can earn 15 accredited continuing education hours through the program.  

The program empowers healthcare professionals to lead quality improvement programs throughout our care system. Whether you’re focused on internal quality improvement or value-based payment models, you’ll gain valuable insights for delivering better results.

PQA with support from Pharmacy Quality Solutions is hosting the fourth annual Healthcare Quality Innovation Challenge, or HQIC. This competition encourages student pharmacists to work with fellow students from pharmacy, other health professions and business to develop innovative technology solutions to address the challenges facing pharmacy today.

For this year’s competition, PQA has developed three prompts to address pressing issues that have been exacerbated by the COVID-19 crisis:

The PQA Quality Forum Webinar is a regular, recurring series on healthcare quality topics with a focus on medication use and medication services. It is a forum for educating and engaging with PQA members and quality-focused healthcare professionals.

Interest in telehealth has skyrocketed with the COVID-19 and many advocates hope it will become a regular part of standard care, as social distancing orders continue and patients need to receive care where they are.

Adam Chesler, the director of Regulatory Affairs at Cardinal Health, was our presenter for the April 16, 2020, PQA Quality Forum Webinar. He provided an overview of telehealth with an emphasis on telepharmacy. The adoption of telepharmacy has varied from state to state, and Adam shared examples of effective pharmacy practice models that are leveraging technology to provide remote clinical services.

Telehealth originated in the late 1870s, with the use of telephones to reduce office visits. With the pandemic, it is expanding faster than ever. It is used for live video consultations and remote patient monitoring in primary care, specialty care (mental health, dermatology, cardiology, radiology, etc.) and specific disease states. Chesler believes the growing adoption of telehealth will be one of the biggest paradigm shifts in health care.

Chesler addressed telepharmacy, which is a subset of telehealth. The National Association of Boards of Pharmacy loosely defines telepharmacy as "the provision of pharmaceutical care through the use of telecommunications and information technologies to patients at a distance." Telepharmacy is just like traditional pharmacy in that it can be broken down to inpatient and outpatient settings. Inpatient telepharmacy includes remote order entry review and IV admixture, while outpatient includes retail pharmacy and remote counseling.

Chesler focused on retail telepharmacy, which is the most common model. Retail telepharmacy is provided through a brick-and-mortar location, just like any other pharmacy, but:

• A pharmacist is not on-site;
• Pharmacists verify prescriptions for the telepharmacy through software solutions that provide a live video feed and images; and
• Pharmacists counsel patients via a live video call

Telepharmacy is most common and most needed in underserved areas. In some states, people must drive 50 miles to the nearest pharmacy to obtain medications or receive counseling. With telepharmacy, patients can receive care where they are and medications via delivery or mail. Another benefit is that it allows pharmacists to work remotely and lower their COVID-19 exposure risk.

There are more than 200 telepharmacies nationwide with 24 states permitting retail telepharmacy, though regulations vary drastically. Some of the rules and regulations governing telepharmacy include:

Pharmacist-provided care, as a part of patient-centered team-based care, has an important role to play in improving access to care, patient experiences and health outcomes.

The COVID crisis has multiplied the importance and urgency of access to high-quality care, especially among vulnerable populations and individuals with hypertension, heart disease, diabetes and other chronic conditions. These patients are more likely to suffer severe COVID-19 illness. Even before the pandemic, these conditions were leading drivers of healthcare costs, hospitalizations, premature deaths, disability and lost productivity.

Chris Kotschevar is the 2020-21 PQA Executive Fellow. He is a PharmD graduate from South Dakota State University College of Pharmacy and Allied Health Professions. Kotschevar joined PQA in June and has hit the ground running, helping to finalize and launch projects such as PQA’s Medication Use Quality continuing education and certificate program and the Healthcare Quality Innovation Challenge.  

What drew you to PQA and the Executive Fellowship program?

Statement by PQA CEO Laura Cranston, RPh

“After 15 years of leading PQA from a start-up organization to the nation’s only organization solely dedicated to optimizing health by advancing the quality of medication use, I will step down as CEO by the end of the year. This is a planned transition that will ensure PQA’s work to optimize the safe and appropriate use of medications through the development and implementation of meaningful measures, research and cutting-edge educational initiatives continues its strong momentum.

“As an organization that CMS envisioned 15 years ago as a public-private partnership, it has been my privilege to serve as the founding CEO of PQA, an organization that has grown to 250 members. I continue to be inspired every day by PQA’s mission, and am grateful for the steadfast commitment and engagement of the PQA team, the board of directors and the strong volunteerism of the membership that helps to shape the work we are doing in helping to develop measures through a consensus-driven process that will enhance patient outcomes through appropriate medication management.

“PQA’s ambitious agenda is shaped by the strategic leaders on our board, combined by the strong clinical, measurement science, research skills, and business acumen of our multi-stakeholder membership base. PQA is poised to continue to shape the quality agenda for today’s healthcare system as we emerge from this pandemic. I have the strongest confidence in our leadership, and in the momentum of the organization, and look forward to passing the baton to a new executive leader by the end of 2020.

“I have been humbled by the opportunity to lead PQA, and I am proud of the organization we have built. Together, we have defined medication quality and positively impacted how healthcare is experienced and evaluated. PQA is in a great place today and I am ready for the next chapter in my career.”

Statement by Jamie Chan, PharmD, Chair, PQA Board of Directors

Every session from the 2020 PQA Annual Meeting is now available to be viewed on demand in PQA's new Education Center. Access to these recordings is available exclusively to individuals who registered to attend the meeting and PQA members.

If you registered to attend the meeting, check your email for details on how to access the recordings. If you are a PQA member, you can also obtain login details in our Member Resources Library.

The PQA Annual Meeting continues on May 28 with the first of five weekly one-hour online sessions. Each week features a new educational session and an innovation theater, which is a commercial showcase of an organization’s innovations, technology, services or research.

All sessions take place on the 2020 PQA Annual Meeting website. Use the same username and password you used to access the May 13-15 sessions. Log in to your meeting account or update your profile, if needed. If you have any trouble, please email [email protected].

You can still register for the meeting, if you have not previously registered. Below are the upcoming sessions. Visit the meeting's agenda page for updates. 

May 28, 1:00-2:00 p.m. ET

The 2020 PQA Annual Meeting starts in two weeks on Wednesday, May 13. If you haven't made plans to join us, register today! All of the meeting sessions you would experience at our in-person meeting will be delivered online. 

The meeting takes place May 13-15 through five 90-minute sessions. If you can't be online for the full meeting, all sessions will be recorded and available to registrants on demand after the meeting. There is no registration cost for PQA members. 

PQA announced on Monday that the National Quality Forum has endorsed three PQA risk-adjusted adherence measures. These measures are used in the Centers for Medicare & Medicaid Services (CMS) Medicare Part D Star Ratings Program, and they evaluate adherence to medications for diabetes, hypertension and cholesterol.

The updated measures include a valid risk adjustment methodology for sociodemographic status factors. Accounting for these factors may impact patient health outcomes is important for ensuring that quality measures are applied fairly.

NQF recommends that performance-based measures be risk-adjusted for sociodemographic factors if there is scientific evidence that such factors affect the quality outcome measured. That recommendation is detailed in the Measure Developer Guidebook for Submitting Measures to NQF (PDF), which was last updated in September 2019. NQF’s rationale is supported in part by an earlier technical report: Risk Adjustment for Socioeconomic Status or Other Sociodemographic Factors (PDF).

CMS addressed this in the Announcement of Calendar Year (CY) 2021 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, which was released April 6. On pages 97-98, CMS discussed PQA’s measures and noted NQF’s recent endorsement, saying:

The risk-adjusted adherence measures were endorsed by the National Quality Forum (NQF) in the 2019 Spring cycle (NQF endorsed #0541). CMS will consider implementation of the PQA recommendations in the future for these Star Ratings measures (i.e., for the 2022 measurement year or beyond). Substantive measure changes must be proposed and finalized through rulemaking.

As the nation's most accessible health care professionals — and through telehealth — pharmacists are being empowered to provide critical patient services; however, this work is not without risk, which also needs to be addressed. PQA members are advocating for and supporting pharmacists as our health system’s medication experts. They are:

• Recommending policies to: authorize test-treat-immunize; ease operational barriers to address workforce and workflow issues; address shortages and continuity of care; and reimburse for services and remove barriers
• Highlighting best practices to ensure the safety of pharmacists, while leveraging their experience and skills to meet the needs of patients
• Establishing guidelines to limit COVID exposures and protocols for pharmacists and pharmacy staff, who have had contact with infected patients

PQA Members in Action

Drug Shortages – and COVID-19

Early refills, drug substitutions, off-label use and supply chain interruptions may all contribute to drug shortages sparked by the COVID-19 crisis. PQA members are anticipating and responding to potential drug shortages. Here are some of the ways they’re taking action.

Access to Care 

Social distancing, unemployment and current or anticipated financial difficulties for millions of Americans are affecting access to care and access to medications. PQA members are taking steps to overcome and eliminate the barriers that reduce patient access to care during the COVID crisis. Those efforts include: