Scientific Poster Session II - Original Research

Original Research
  Sunday, November 12, 2023
  12:45 PM–02:15 PM

Abstract

Introduction: Health disparities and housing insecurity contribute to poor health outcomes in people experiencing homelessness (PEH). Clinical pharmacists operating under a collaborative practice agreement can improve health outcomes across outpatient settings. Community health workers (CHWs) can also help improve health outcomes. Research Question or Hypothesis: What were the: (1) patient outcomes (symptomatology, function, satisfaction) and (2) implementation outcomes (acceptability, adoption, appropriateness, costs, feasibility, fidelity) from a new collaborative clinical pharmacist-CHW service implemented in a federally qualified health center (FQHC) serving PEH. Study Design: We carried out an evaluation of the new service. Methods: Electronic health record data (e.g., blood pressure, social determinants of health) was collected from all patient participants (n = 96) to assess symptomatology; 15- to 30-minute semi-structured interviews were conducted with select patients (n = 9) to assess symptomatology, function, and satisfaction. Additionally, 15- to 30-minute semi-structured interviews were conducted with FQHC staff (n = 11) to assess implementation outcomes. Medicaid reimbursement rates for CHW services were calculated for costs. Results: Reimbursement data indicated the CHW conducted 249 billable visits, at a rate of $9.70, totaling $2,415.30. Qualitative data revealed that most patients and staff were satisfied with the clinical pharmacist-CHW service. Contributors included the CHW’s positive disposition, relatability, and rapport with patients; detractors included changes in the CHW’s availability; clinical outcomes data are pending. Staff felt the service fit well into the FQHC, filled a gap in patient care, and appreciated the flexible and high-touch care. Identified areas of improvement included inconsistency in the CHW’s schedule, a lack of clarity on the role of a CHW, and more structured coordination between the clinical pharmacist and the CHW. The FQHC hired the CHW into a full-time position. Conclusion: Findings indicate the clinical pharmacist-CHW service positively impacted patients and revealed areas for improvement and Medicaid billing opportunities for CHW services in the FQHC.

Presenting Author

Carly Kimiecik MSW
Purdue University

Authors

Shelby Albertson PharmD
Eskenazi Health

Jasmine Gonzalvo PharmD, BC-ADM, CDCES, FADCES
Purdue University

Chavon Harris CHW
Eskenazi Health

Molly Nichols PharmD, MATS
Purdue University