Independent Medical Reviews
July 03, 2014
What our vision statement means to me...
Mornings for me begin with the same routine almost every day of the year. I wake up, start the coffee maker, sign on to my computer for work, and catch up on emails. Although I treat my mornings the same, I am inspired to treat every case I process at work individually and carefully because I believe every patient deserves quality healthcare.
At Advanced Medical Reviews, I am a review specialist for Pharmacy Benefit Management reviews. I work directly with reviewers and our medical director through the QA process to ensure high quality for each and every patient. These reviews focus on optimizing medication treatment and assisting providers with patient care options. To me, these reviews symbolize the concept that every patient deserves quality healthcare. Each case focuses on an individual patient whose care has been escalated to AMR to review for a specific reason. When I begin to read a report, I do a brief overview of the case. I look at the name of the patient, their complaints, their past treatments, and what medications they are currently prescribed. By getting acquainted with the case details, it makes me feel like I am getting acquainted with the patient.
When I begin to read the report from the physician reviewer, I feel more connected with the patient and strive to create the highest quality product. Through this process, I am able to focus on the belief that every patient deserves quality healthcare. For each of these cases, I try to put myself in the patient’s shoes. I try to think about what it would feel like to be taking multiple medications for chronic pain on a daily basis or how it would feel to not be able to participate in regular activities because I was incapacitated by my pain. Other times, I think about how these patients could be a relative of mine and how I would want to see my loved ones receive the best care possible—and the reviews we do at AMR are part of the process to provide high quality care for every patient.
Pharmacy Benefit Management reviews exemplify the concept of delivering quality healthcare to every individual. We receive these cases if there is something identified in a patient’s care that has the opportunity to be maximized. Some of these patients have been on high doses of pain killers for years, others are struggling with high pill burdens, and others may not be seeing optimal relief. By providing another opinion, we are able to help providers manage care for these patients and provide insight on how to improve each patient’s healthcare. Sometimes, we are able to recommend alternative medications that could replace multiple pills or reduce adverse side effects. Reviewers also provide non-pharmaceutical alternatives to treat pain, insomnia, and other conditions. With suggestions like physical therapy, massage, or sleep hygiene therapy, patients may be able to reduce issues related to pain and return to regular activities they used to enjoy.
In every case I process—Pharmacy Benefit Management and beyond—the belief that every patient deserves quality healthcare is present in each step I take. Checking clinical information provided, reading and editing the written report, and communicating with our clients are more than just basic steps I take to pass the time throughout the work day. Remembering that each case we process is for an individual and crucial to their healthcare motivates me to strive for the highest quality possible so that each and every patient receives the best healthcare possible.
Written by ELLEN BUBAK, Medical Review Specialist
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