Embed, Measure, Sustain: A Model for Heart Failure Pharmacy Care

In an interview with Pharmacy Times, Cody Parsons, APh, PharmD, BCCCP, director of clinical operations in the division of cardiovascular health at Stanford Health Care, discussed the quality measures that best capture pharmacists' impact on heart failure care and how other health systems can launch similar programs. The discussion took place ahead of his presentation at the American Heart Association Scientific Sessions 2026, taking place November 6–9 in Chicago, Illinois.

Parsons said discharge prescribing gets patients started, but persistence is what keeps them protected long-term. At Stanford, pharmacists directly influence inpatient, discharge, and outpatient prescribing, as well as the optimal medical therapy score for patients empaneled in the cardiometabolic clinic. That score reflects which pillars of therapy a patient is on and how close each is to target dosing. Parsons noted that landmark trials show getting patients on these therapies at target doses reduces morbidity, mortality, and admissions and readmissions.

Nationally, IMPLEMENT-EF tracks medication metrics through the Get With The Guidelines–Heart Failure registry. Inpatient measures look at whether patients are discharged on angiotensin receptor blockers, angiotensin receptor-neprilysin inhibitors, sodium-glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists (MRAs), and nonsteroidal MRAs, along with health-related social needs assessments. Post-acute measures examine whether patients remain on therapy 30 days and 6 months after discharge, which Parsons said matters a lot to him as a clinician.

For other health systems, Parsons recommended an "embed, measure, and sustain" approach: place pharmacists where medication management is hardest; track prescribing, therapy scores, and admissions and readmissions; and bill for services when possible. Stanford's cardiometabolic clinic bills incident to physicians, which Parsons said is not always common, and the team has tracked ejection fraction improvement that he said has shown benefit over standard cardiology care. He added that IMPLEMENT-EF offers free resources, including webinars and a tip sheet on adding evidence-based therapies to hospital formularies, at heart.org/implementef.