Leslie Helou, PharmD, is the Vice President, Medication Strategies at MOBE. After starting her career as a clinical pharmacist, Helou held several leadership positions at Upsher-Smith Laboratories before joining MOBE.
“At MOBE, we're constantly trying to create innovative change,” says Leslie Helou, MOBE’s Vice President, Medication Strategies. “Our unique business setting—kind of sitting outside of the health care system—has allowed us to design a leading-edge clinical pharmacy approach. It gives us a unique opportunity to help individual patients find a way to get optimal results from their medicines and treatments.”
According to Helou, “During the last 30 years, we've had substantially more drugs come to market and we’re spending more on health care than ever before. But we’re not seeing better outcomes and our population is not healthier. In the same period, statistics show we’ve gone from 30-minute doctors’ appointments to 15-minute appointments to 12 minutes to eight minutes. One thing that hasn't changed is the percentage of people that walk out the door with a prescription drug. Medications are part of 80% of treatment plans.”
“In today’s environment, a health care provider can only spend maybe 30 seconds discussing a medication that a person might end up staying on for weeks, months, or years,” she explains. “Meanwhile, the majority of pharmacists are working in pharmacies, where their priority is processing prescriptions and dispensing meds. They can answer some questions, but in-depth conversations are not part of the business structure.”
“We need to step back and ask ourselves where medications might be contributing to some of the problems in the health care industry. We need to take the time to assess how to identify, resolve, or prevent medication problems,” she says.
When most health care professionals think about the objectives for pharmacy services, they generally think about driving down the cost of prescription drug use. For them, looking at utilization and removing or limiting the use of expensive drugs is necessary.
However, Helou says, “The key to actually optimizing people's medications is to assess whether they're even needed and if they're having a safe experience.”
“MOBE is focused on reducing medical utilization, not pharmacy utilization, and that is contrary to the majority of pharmacy-based programs,” she explains. “Our objectives focus more on optimizing medication use to reduce ER visits, hospital admissions, or negative outcomes. When we do that, we connect the dots between pharmaceutical or pharmacy use, and medical outcomes. Until recently, the system hadn't been comfortable applying pharmacy services to seeing a benefit in medical spending.”
The main difference in MOBE’s pharmacy model is that Pharmacists are allowed to spend a limitless amount of time with each participant. It's all based on individual needs. To get the best outcomes, Pharmacists need to not be restricted by an amount of time, artificially constrained by checklists, or the number of visits that they can have with somebody.
“Our Pharmacists can focus and give attention to individual participants,” says Helou. “They have time to review all of the participant’s meds across all of their providers and all of their conditions. We spend on average 45 minutes or more just on the initial assessment. Then we aim for at least two to three follow-ups with participants to ensure that they understand the recommendations that were made.”
She adds, “Our Pharmacists also take time to provide written materials for our participants, describing everything they talked about. During conversations with our Pharmacists, participants get a lot of information to take in. Having the information in writing is a good way to help people remember the details and take any recommended actions.”
As part of MOBE’s dedication to whole-person health, our Pharmacists cooperate with everyone who cares for our participants.
For example, Helou says, “After a Pharmacist’s assessment, we often follow up with the participant’s health care providers to provide suggestions and insights. We spend a lot of time ensuring we're providing evidence-based recommendations. We also acknowledge and admit where we have limitations. We've had positive receptivity across all different provider types.”
“And, of course, our Pharmacists work hand-in-hand with our MOBE Guides,” Helou continues. “For example, a Pharmacist might talk to a participant about their medications and find opportunities to optimize results. Then, while working with their Guide, they create a goal around moving more and eating differently. If we know that their medication doses are sensitive to their weight or what they eat, Pharmacists can help participants adjust. We don't want to cause a medication problem by helping them get healthier from a lifestyle perspective.”
Recently, the MOBE team had an opportunity with one of our clients to look at whether our service was generating the savings we expected for people who had one to three visits with our Pharmacists.
“We saw incremental reductions in ER visits, hospital admissions, and total cost of care in those scenarios,” Helou says. “It was a validation of the design of our program and supported our ability to grow and be able and expand the number of people that we’re able to serve.”
“I think I'm most proud of being able to build a flexible service that demonstrates the value we provide to our participants and clients. My hope is that our program can lead to the evolution of this type of service being adapted, embraced, and embedded in health care—available to everybody.”
Learn more about how MOBE is shifting expectations around pharmacy services. Contact us.