Anita Thomas, Pharm.D, is the Centers for Medicare & Medicaid Services’ (CMS) Quality Improvement Organization (QIO) Program’s Patient Safety program team lead and Medication Safety Subject Matter Expert. She supports work on improving coordination of care, reducing health care-acquired conditions (HACs) in nursing homes, and improving medication safety across care settings. Dr. Thomas is a clinical pharmacist specializing in pharmacoeconomics and outcomes research, and was part of the CMS team that helped implement the Medicare Drug benefit. She also has worked in the areas of data analysis, program-wide performance and strategy at CMS, as well as in clinical patient care in the private sector. She is dedicated to improving health care quality and patient safety.
Q: How does the current opioid epidemic fit in with your overall work to reduce adverse events?
The QIO Program’s Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) are focused on making improvements to reduce adverse events and improve health outcomes related to opioid use. QIN-QIOs lead change by providing data, education and technical assistance to help identify and implement local and national solutions to this epidemic. QIN-QIOs are working across communities, with beneficiaries, providers and stakeholders, coordinating with local and state efforts, and really supporting the provider-patient relationship to take appropriate steps to address adverse health outcomes associated with opioid use.
Some examples of QIN-QIO work in this area include providing technical assistance and education on the use of prescription drug monitoring program data for both providers and pharmacists, providing education and interventions on the use of naloxone, helping to implement or enhance medication reconciliation at care transitions, and sharing the Centers for Disease Control and Prevention (CDC) guidelines for opioid prescribing with clinicians. They also support clinicians by providing advanced data analysis and reports on the health outcomes of Medicare beneficiaries at risk for an opioid-related adverse drug event.
One of the QIN-QIOs started a multi-state coalition in New York, Washington, D.C. and South Carolina to improve pain management and enable clinicians and stakeholders across the states to come together and help identify best practices that support local needs.
Another example from a QIN-QIO is the implementation of an opioid assessment tool in partnership with multiple surgical centers in Massachusetts and Vermont to help identify beneficiaries who are in need of more information or follow-up. This QIN-QIO is also working alongside state efforts to reduce opioid harm and has now partnered with a large network of independently owned community pharmacies to provide education, screening and resources to individuals who take opioid medications.
Q: Do you include person and family engagement in the planning and/or implementation of your work on patient safety? If so, how?
Beneficiaries are the central part of our work. We have beneficiary advisors who provide input and feedback. We also just launched phase two of our Person and Family Engagement program for medication safety: the Campaign for Meds Management (CMM).
The CMM is a national effort that aims to learn from beneficiaries and their experiences, and that shares person-centered resources and information to help achieve better health care outcomes and reduced adverse drug events. Having beneficiaries as a central part of our work keeps us focused and motivated to make meaningful impacts on health care quality. This initiative also has national learning events that feature beneficiaries, beneficiary advocates and caregivers who want to share their experiences and health care journeys so that others can learn and be inspired to do more.
Q: How can providers and partners collaborate with a QIN-QIO to improve outcomes for Medicare beneficiaries and others?
QIN-QIOs are working in every state and are open to working and collaborating with stakeholders, partners and providers. You can reach out to your local QIN-QIO to learn more about ways to collaborate.
Q: What tools and/or resources are you working on that our readers can expect in the near future?
The CMM is identifying and cataloging resources for our three high priority drug classes: opioids, anticoagulants and diabetic medications.
Q: Anything else you want readers to know?
Together, I think we can support clinicians, beneficiaries, caregivers and other stakeholders to really make a positive change in both pain management and the prevention of adverse health outcomes related to opioids.