Kevin Komoto ’08, PharmD, MBA, the chief operations officer for Komoto Healthcare in Bakersfield, recognizes the importance of transitions of care (TOC) to improve patient outcomes and prevent adverse medication-related events. Inspired by the death of a patient post-hospital discharge, Dr. Komoto launched a TOC service in his community pharmacy. He believes that a well-designed TOC program can reduce hospital readmission rates and health care costs — and ultimately save lives. 

“There are many aspects that contribute to the overall health of a patient, such as disease state, type of medications, housing and other social determinants of health,” Dr. Komoto said. “I believe his death was preventable.” 

Dr. Komoto’s team of TOC pharmacists focus on patient-centered interventions to improve medication management. Daily responsibilities involve conducting medication reviews, providing medication consultations and coordinating with other health care providers to provide seamless care. He envisions a future where hospital-based TOC service becomes standard practice.

Fellow alumni Navi Braich ’11, PharmD aims to accomplish this goal. After 10 years of working as a retail pharmacist, Dr. Braich accepted a transitions of care pharmacist role at Bakersfield Memorial Hospital, the only one in the region to offer a TOC program. Her team includes two pharmacists and four pharmacy technicians. 

“Our goal is to promote and advocate for medication-use safety and address medication-related issues to prevent delays in the patients’ hospital discharge. Drug therapies should be optimized at discharge to prevent readmittance to the hospital,” said Dr. Braich. “We want to be the bridge and resource for patients as they navigate their pharmacy care inside and outside the hospital.” 

To achieve this, pharmacists review hospital discharge summaries, educate the patients on changes in their drug therapy and connect with community pharmacists to ensure patients have access to any new medications. When using a TOC approach, it is also the pharmacist’s responsibility to provide alternatives to costly medications and request drug coverage approvals from insurance providers.

Diana Hang ’17, PharmD, APh was introduced to TOC as a doctor of pharmacy student at Pacific during an Advanced Pharmacy Practice Experience rotation. After graduation, she accepted a position with Komoto Healthcare helping health plans and medical groups reduce their 30-day hospital readmission rate. Dr. Hang is incorporating what she learned earlier in her career to help build the new admit-to-discharge program at Huntington Hospital in Pasadena. 

“We are medications experts and as pharmacists we can help address the gap in the transitions of care to provide the best care to all patients,” said Dr. Hang. “I want to build a stronger relationship with the health care team to help patients live healthier lives.” 

This approach to patient care has a positive, measurable impact. In 2017, Dr. Komoto and his research team found a TOC program reduced the risk of hospital readmission within six months by 32 percent. In the past year, Dr. Braich and her team contributed to a decrease in hospital readmission by 10 percent and discovered more than 150,000 medication discrepancies. These results have generated a high level of interest from surrounding hospitals who are requesting guidance and seeking collaborations.