Why a connected clinical pharmacy team is key to better chronic condition care

Why a connected clinical pharmacy team is key to better chronic condition care

Caring for and growing with southern Colorado

A chronic condition is a disease or health condition that lasts one year or more, requires ongoing medical care, and impacts daily living.1 The most common chronic conditions are diabetes, heart disease, stroke, and cancer.1


Six in 10 Americans have been diagnosed with one chronic health condition, and 4 out of 10 live with two or more.2 People with chronic and mental health conditions make up 90% of the nation’s $4.1 trillion in annual health care expenditures.


Highly coordinated, multidisciplinary care is critical for managing the complex medical needs of patients with chronic conditions and reducing health care costs. Medication management is one component of complex care management. This is a process where a clinical pharmacist — a pharmacist with advanced training or board certification, who works in a health care facility and provides patient care — assists with consulting, developing, implementing, monitoring, and modifying medication regimens.


At Kaiser Permanente, one of America’s leading health care providers and nonprofit3 health plans, clinical pharmacists are connected to doctors and patients through a shared electronic health record. Our Clinical Pharmacy Services team serves as a highly skilled voice for Kaiser Permanente doctors, clinicians, and members when making drug therapy decisions. 


With over 100 clinical pharmacists working with over 70,000 members annually in Colorado, the Kaiser Permanente Clinical Pharmacy Services team provides comprehensive medication management that helps members achieve positive medication results. 


Evidence-based care programs that are built-in, not opt-in 


Kaiser Permanente provides health care and coverage together. In our integrated health system, patients with chronic conditions are automatically enrolled in evidenced-based care programs, which include clinical pharmacy care. These no-cost programs are managed by Kaiser Permanente clinicians, not outsourced to other vendors.


Through our electronic health record, members diagnosed with common chronic conditions like diabetes or heart disease and those taking high-risk medications are automatically assigned a clinical pharmacist to their care team to follow their care and optimize medications. Individual consultations with clinical pharmacists are also available to every Kaiser Permanente member, no matter their diagnosis.


New members are initially connected to Clinical Pharmacy Services when they transition their care to Kaiser Permanente. Based on the health history information they give to our New Member Connect team or input electronically on kp.org, members will be enrolled in the program.


Once enrolled, our team of clinical pharmacy specialists, pharmacists, and technicians help care for members across health plans and specialty areas including Medicare Medication Therapy Management and medication adherence programs for Medicare members, anticoagulation care (blood thinners), diabetes, and oncology. Their ongoing support includes:


  • Reviewing medications and making recommendations to adjust or change prescriptions
  • Developing and implementing medication plans
  • Educating patients about side effects and medication interactions
  • Coordinating medication plans between departments and specialties
  • Revising plans for medical procedures or when new prescriptions are added


Proven benefits for our members 


Kaiser Permanente’s commitment to providing top-notch clinical pharmacy care keeps our Colorado members at their healthiest. The proof is in our results:


  • More than 90% of Kaiser Permanente Medicare members adhere to diabetes, blood pressure, and cholesterol medications resulting in improved disease outcomes.4
  • Comprehensive management by our clinical pharmacists reduced the risk of dangerous side effects, including bleeding, stroke, and death, by over 30% among patients taking blood thinners.5


Our connected care model focuses on quality of care, not on the volume of care (tests, procedures, etc.) provided. It fosters collaboration, enabling doctors and clinical pharmacists to work with members diagnosed with complex health conditions and those with ongoing drug therapy needs to optimize medications. Because of the integration of clinical pharmacy services, Kaiser Permanente members are more likely to take their medications as directed, less likely to spend time in the hospital, and better able to achieve their health goals.


Learn more about how Kaiser Permanente’s clinical pharmacists combine skill and experience to help members live longer and healthier.


1. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention. July 2022. 
2. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention. December 2022. Chronic Diseases in America. cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
3. In the Colorado market Kaiser Permanente Colorado is composed of the nonprofit Kaiser Foundation Health Plan of Colorado and the for-profit Colorado Permanente Medical Group, P.C.
4. 2024. CMS.gov. Part C and D Performance Data.
5. Elise Phelps, et al., “Effect of increased time in the therapeutic range on atrial fibrillation outcomes within a centralized anticoagulation service,” Thrombosis Research, March 2018.