Bridging the Gap Series : January 2022
Introduction by Vice Chancellor Steve Goldstein
Two dedicated UCI School of Pharmacy & Pharmaceutical Sciences clinical professors are fighting health care disparities in underserved areas across Santa Ana and Anaheim with a new program to foster high-quality care. Joyce Yu-Chia Lee, Pharm.D. and Sarah McBane, Pharm.D. launched the pilot program last Fall in both UCI Federally Qualified Health Centers (FQHCs) to better meet the needs of Orange County’s underserved populations.
This essay in the UCI Health Affairs “Bridging the Gap” series focuses on the role FQHCs and pharmacists play in addressing health disparities. FQHCs are a critical component of the healthcare safety net, where UCI partners with communities to ensure that all individuals have access to affordable, high quality health care. Here, Lee and McBane explore the beneficial impact of team-based services that include pharmacists in healthcare delivery and education in the community.
Lee and McBane launched the innovative program to embed pharmacists at the center of the primary care team in our FQHCs to serve as collaborative experts with attending physicians, their resident trainees, and patients. Expanding the pharmacist’s role improves safe and effective use of medications at each phase of the health journey. The role of the pharmacist is significantly more expansive then dispensing drugs, however, and includes the provision of frontline preventive care and chronic disease management to support wellness and improve disease outcomes. This program is a good demonstration of the UCI commitment to patient-centered, interprofessional, team-based education, research and care.
UCI is at the forefront of the digital health future that will offer precision care to individuals and communities. This includes the FQHCs where we are increasing access to digital care through telemedicine and remote monitoring. Pharmacists are essential to community health and expanding their role on the frontline is key to equitable care for the underserved.
FQHCs are community-based health care providers that are supported by federal funds and bear the responsibility to provide care in a service area without financial and social discrimination. UCI maintains two FQHCs, in Santa Ana and Anaheim, that deliver high quality primary medical care to the underserved, low-income population. The two UCI health centers are the oldest FQHCs in Orange County.
Our FQHCs provide the full spectrum of primary, urgent, dental, behavioral and preventive services for pediatric, adolescent and adult patients, inclusive of women’s healthcare, medical and surgical diagnostic consultations, geriatric services, and patient education classes.
Many communities in Orange County fall under the federal poverty level and lack access to critical services. Patients in these low-income communities often have chronic conditions, encounter cultural barriers when trying to access care, and work more than one job. Our FQHCs connect those in these vulnerable communities with UCI’s cutting-edge facilities and renowned healthcare providers. Both clinics are staffed by UCI faculty and medical residents and serve as innovative training sites for healthcare students. Since many patients in these communities do not have access to a vehicle, both clinic sites are located to ease access to care.
By: Joyce Yu-Chia Lee, Pharm.D
I currently provide care at the Anaheim clinic, which focuses on comprehensive medication and chronic condition management, while Dr. McBane leads medical resident pharmacotherapy education efforts for the Santa Ana clinic. Both clinical sites provide learning opportunities for residents to improve their prescribing habits that address the specific needs of many in these communities.
My vision for FQHC Anaheim is to provide comprehensive medication management for uncontrolled chronic conditions like diabetes, hypertension or heart failure. By connecting with the Anaheim community, I have learned that we cannot have a one-size-fits-all approach to care delivery. FQHC patients have their own set of needs. We need to take the time to get to know the patient population and deliver a personalized touch that makes all the difference.
My counterpart, Dr. McBane at the Santa Ana clinic, is training the next generation of medical residents to be better prescribers. She also works to ensure the effectiveness of the pharmacist’s role in proactively planning and looking through the patient file to address gaps in medication management.
Our role as pharmacists is critical to ensure that we take all the proper steps to address health disparities. Medical residents and healthcare professionals alike need to approach each patient holistically, taking social determinants into account to provide best-in-class, personalized care.
Incorporating pharmacists in team-based care increases patient awareness of the importance of medication adherence. Further, it encourages and supports behavioral changes and self-management so valuable to good outcomes with chronic illnesses. Our FQHCs are also at the lead of bringing the digital frontier to the underserved to ease access by telemedicine and remote patient monitoring. In my experience, it has been so rewarding to hear from patients the positive impact our role as pharmacists has played in their care.
Involving pharmacists in expanded roles helps achieve the “Triple Aim” of increasing the quality of care, improving patient outcomes by controlling disorders and illnesses, and reducing healthcare costs. The expanded role of pharmacists with care teams and those in training will allow them to have an even greater impact in the rapidly shifting landscape of health care to improve public health.
Regarding what comes next at the UCI FQHCs, we plan to expand telehealth services, add clinical sites, increase research opportunities and continue to advocate for health equity. It is important to note that despite the progress made towards addressing health disparities, there is more work to be done. Supporting local communities by increasing access to low-cost and high-quality care requires that healthcare providers are in place close to home. Bringing different clinical perspectives to the table allows us to advance research and medicine, deliver care, explore digital innovation, and empower the next generation of pharmacists. This delivers better outcomes, deeper community ties, and more excellent health for those most in need.
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