MEDS Ed - Video library

This session of CareOregon Pharmacy’s MEDS Ed program highlights harm reduction strategies, how to talk about drug user health, as well as overdose reversal training.

Key Session Takeaways

(click the link to view a clip):

• There are two different ways we talk about harm reduction: policies that advance social justice for people who use drugs, and the clinical practice that supports reducing substance use related harm to improve quality of life. Part 1 – 5:06
• While there has been a reduction in prescription opioid use, this has been accompanied by increases in deaths from heroin and fentanyl. Part 1 – 9:30
• Healthcare providers need to embrace Naloxone kits, sometimes reducing community overdoses by over 45%. Part 1 – 18:07

• It’s important to understand what harm reduction grew out of. Part 2 – 05:46
• Harm reduction is a tool akin to seatbelts or a bike helmet. Part 2 – 22:24
• What are some examples of harm reduction in practice? Part 2 – 25:29
• How do you talk to patients/clients about Naloxone and safer use? Part 2 – 41:45
• Examples of how language matters. Part 2 –  1:00:33

• Insight on the increasing need for harm reduction services within Multnomah County. Part 3 – 08:10
• Visualizing the sheer volume of syringes and supplies. Part 3 – 18:24
• Barriers and strategies. Part 3 – 20:42
• What you can do today. Part 3 – 34:01

• What are peer mentors? Part 4 – 1:43
• What makes peers different? Part 4 – 14:13
• How peers instill hope. Part 4 – 17:25

• Introducing Team HOW. Part 5 – 2:04
• What can peer outreach offer? Part 5 – 5:21
• What peer outreach does. Part 5 – 10:00

• Who are candidates for Naloxone co-prescribing? Part 6 – 3:19
• Prescribing call to action and Naloxone. Part 6 – 9:05
• Social Stigma. Part 6 – 11:21
• Barriers, concerns, and resources. Part 6 – 14:50

• Overdose basics. Part 7 – 1:51
• Recognizing and overdose. Part 7 – 3:43
• How to respond to an overdose. Part 7 – 4:48
• Preventing an overdose. Part 7 – 16:40

This session of CareOregon Pharmacy’s MEDS Ed program explores weaving cultural competence into our behaviors and policies, improving our cultural effectiveness and the lives of our patients.

Key Session Takeaways

(click the link to view a clip):

• Don’t be afraid to establish ground rules when having difficult conversations about diversity; tailor them to your personality. Part 1 – 7:04
• Bias comes into play when providing care or identifying/hiring talent; these biases are most often implicit or unconscious. Part 1 – 14:30
• Don’t be afraid to assess bias. One can identify current strengths, and areas where improvements can be made. Part 1 – 16:07
• Develop a value base for EDI; ultimately construe it in the clinician’s best interest, but with mutual benefits. We are doing it as much for us as for them. Part 1 – 20:17
• Focus on equity as a way of tailoring or individualizing care and understanding the patient context. Part 1 – 23:47
• Develop your own talking points and identify with whom specific arguments might resonate. Part 1 – 25:02
• Try to understand the patient in terms of their internal and external health determinants. See within-group differences, understand the categories or how we label people can inadvertently cause us to invoke new stereotypes otherwise. Part 3 – 5:29
• See diversity when you see people, not just certain people. Part 3 – 9:00
• We are all diverse and unique. Part 3 – 10:55
• Show yourself and others grace.  This is a developmental process; we all start at different point; compare yourself to yourself over time. Part 3 – 48:22
• As with any body of knowledge, understand you’ll never exhaust the need to learn about diversity; cultures and contexts change over time and knowledge is always being developed. Part 3 – 49:26

This session of CareOregon Pharmacy’s MEDS Ed program explores the tremendous benefits and resources Community Health Workers can provide for both primary care clinicians and patients.

Key Session Takeaways

(click the link to view a clip):

• Understanding some of the roles and competencies for Community Health Workers. Part 1 – 20:17
• The role of Community Health Worker has been evolving since the 1950s. Part 1 – 25:38
• How systems benefit from working with Community Health Workers. Part 1 – 36:08
• A moving example of what can draw someone into becoming a Community Health Worker. Part 2 – 7:20
• How Community Health Workers are referred to patients who need them. Part 2 – 16:35
• Community Health Workers can help in many ways, including getting healthy produce to clients. Part 2 – 20:00
• Evolution of the Community Supported Agriculture program. Part 2 – 24:36
• What do relationships between Community Health Workers and other team members look like? Part 2 – 36:58
• Understanding Mobile Integrated Healthcare. Part 3 – 5:01
• Making an impact with behavioral health and substance use disorders. Part 3 – 10:51
• Examples that demonstrate success. Part 3 – 17:50          
• Examples of a strong collaboration with pharmacists. Part 3 – 21:51
• What kind of CHW support do the CCOs provide? Part 4 – 2:30
• How does the role of the Traditional Health Worker Liaison support CHW work? Part 4 – 6:00

This session of CareOregon Pharmacy’s MEDS Ed program focuses on managing the complexities of Alcohol Use Disorder, including strategies for removing the fear and lack of comfort around AUD treatment; assessment, and treatment-based competencies; the importance and under-utilization of medications in the treatment of AUD; engagement with behavioral health and community resources to assist with AUD treatment in a primary care setting.
Recorded on June 18th as a remote web-cast in Portland, OR.

Click here to view the whole session

Key session takeaways

• Defining binge-drinking & heavy alcohol use for both women and men. Part 1 – 24:19
• Alcohol Use Disorder is highly prevalent and often goes untreated (1 in 11). Part 1 – 27:52
• 5 Oregonians die from alcohol use every day – twice as many as opioid deaths. Part 1 – 29:18
• Gray Area Drinking – drinking among women has skyrocketed. Part 1 – 31:10
• Naltrexone and other medications for treatment – oral Naltrexone should be used much more often in your practice! Part 1 – 35:55

• Treatment engagement tends to be higher in a behavioral health setting. Part 2 – 4:08
• Oregon is drinking its way through the coronavirus crisis. Part 2 – 9:10
• Review of the DSM-5 criteria for AUD. Part 2 – 14:00
• Clinical Practice Guidelines on Alcohol Withdrawal Management. Part 2 – 39:37
• What you can incorporate into your practice today. Part 2 – 50:52

• Alarming facts about Alcohol Use Disorder. Part 3 – 6:00
• Patients are far more willing to enter treatment within a primary care setting than within a specialty treatment center. Part 3 – 10:35
• Tips on using a Trauma-Informed Care approach, including the importance of using affirming language. Part 3 – 38:00
• Tips on helping patients reduce drinking – and remembering to check your biases. Part 3 – 47:15
• Information about project ANTECEDENT as a free resource to support all primary care clinics! Part 3 – 58:54

• How your CCO can support the work you’re doing around Alcohol Use Disorder. Part 4 – 00:44

• Additional assistance, technical support, and next steps. Part 4 – 6:59

This session of CareOregon Pharmacy’s MEDS Ed program explores how issues of racial and social disparities and environmental stress impact maternal health and conception; mental health/SUD-related concerns during pregnancy; how maternal health is affected by pre-conception care; potentially harmful medications; social/emotional health for newborns and new mothers.



Click here to view the whole session

Key session takeaways

(click the link to view a clip):

• Virginia Garcia clinics serve 1 in every 13 residents of Washington and Yamhill counties – more than 50,000 patients. Part 1 – 7:50
• Virginia Garcia has prioritized hiring bilingual & bicultural staff, using data analysis, and integrating behavioral health into primary care. Part 1 – 14:15 
• Implementing the CenteringPregnancy® program has resulted in outstanding obstetrics outcomes. Part 1 – 24:53

• Dental care for the pregnant patient, and family members, is an upstream approach to address the transmissible and preventable chronic disease of early childhood caries. Part 2 – 17:31
• Important oral health recommendations during pregnancy for patients: Part 2 – 31:44
• Pregnant patients to complete a dental visit if
• they have not seen a dentist during their pregnancy  
• oral health problems were identified during the assessment
• Encourage good oral hygiene and associate oral health with other healthy habits
• nutrition
• tobacco cessation
• Inform patients that dentistry is safe during pregnancy and recommended for the health of both the patient and developing baby – that dentistry is safe during all three trimesters.
• Dental care request tool for any Health Share of Oregon, Jackson Care Connect or Columbia Pacific CCO patient. All OHP/Medicaid patients have comprehensive dental benefits. This tool helps connect your patient to their OHP dental plan for care coordination, simplifying the process for both you and your patient. Tool is accessible through the CareOregon Connect provider portal or OneHealthPort. Part 2 – 35:16

• The U.S. has the worst overall maternal and infant mortality rate and outcomes of the developed nations Part 3 – 21:13
• Black maternal mortality three times higher than white
• Native/Indigenous maternal mortality is more than twice as high as white

• There is a need for more skilled birth advocates for underserved and marginalized communities. Part 3 – 30:48
• The Community Doula Alliance was created to promote sustainable utilization and share resources. Part 3 – 53:12

This session provides an overview Motivational Interviewing principles, suited for either the beginner or for those looking for a refresher and fresh perspective. CareOregon Training & Development Specialist Paul Carson will convene the session to highlight ways that MI is an effective communication tool, and in particular for patients with a background of trauma.

Key Session Takeaways

(click the link to view a clip):

• The ACE (Adverse Childhood Experiences) study established a strong relationship between abuse and traumatic experiences during childhood and later-life adult health, well-being, and death.  Part 1 – 19:09
• Medication Trauma is medication complexity and lack of coordination that overwhelms the patient, caregivers and provider’s resources, creating fear, confusion and error, which leads to poor adherence, compliance and outcomes. Part 1 – 36:10
• Change is a process, not an event. Part 2 – 05:26
• Motivational Interviewing is made up of four core skills or “OARS.” Part 2 – 17:05
• Reflective Listening is the most important MI skill. Part 2 – 25:00
• Three parts of your MI “toolkit” you can still practice even when you don’t have a lot of time. Part 2 – 51:36
• A review of No-Lose Conflict Resolution. Part 3 – 06:45
• The difference between patient-owned problems and provider-owned problems. Part 3 – 11:40
• Recent Practical Case Examples – Part 3 – 37:17 

This session of CareOregon Pharmacy’s MEDS Ed program focuses on managing children’s complex health conditions, including the impact of parental trauma, behavioral health integration, high-risk medications, improving family engagement and follow-through, and population data highlighting high-risk children.
Recorded on May 21st as a remote web-cast in Portland, OR.

Click here to view the whole session

Key session takeaways (click the link to view a clip):

• Parental Trauma can have an impact on a child’s developmental delays and social-emotional risk. Part 1 – 2:38
• Parents have new brain growth in the first six months after their child’s birth…UNLESS they are experiencing stress, which impairs frontal cortex development. Part 1 – 9:33
• A child whose parent has a high ACE score will have increased odds for behavioral and emotional problems. Part 1 – 22:45
• Positive relationships with providers help build resilience. Part 1 – 31:50

• Providers only see a small glimpse of the greater social complexity that creates barriers to engagement.  Part 2 – 12:40
• The context of social determinants of health, inequities, and bad experiences with the healthcare system must be kept in mind when engaging with families, along with the perceptions and assumptions we have as providers. Part 2 – 55:52
• The top questionsto ask to help improve family follow-through and engagement.  Part 2 – 1:04:35

• Patients and families often feel more comfortable and trusting of primary care providers, which can help reduce stigma. Part 3 – 2:00
• Which disorders cause PCPs to contact child psychiatric resources? Part 3 – 7:00
• What are the criteria for improving clinical practice? Part 3 – 27:45

This session of CareOregon Pharmacy’s MEDS Ed program focuses on the intersection between psychological trauma and substance use disorders. Lydia Bartholow (DNP, PMHNP, CARN-AP) lays out the scope of the issues, highlights the most effective and lasting forms of engagement and treatment, and provides and in-depth review of the importance of trauma-informed care and patient-centered systems when engaging people experiencing substance use disorders.

Recorded on December 13, 2019 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Key session takeaways (click the link to view a clip):

• Long-term consequences of cortisol end up becoming the biggest chronic conditions that impact our life expectancy. Part 2 - 25:50
• Much of what we know about the connection between trauma and substance use disorders is based on the ACEs study. Part 3 - 6:07
• A central nervous system that has experienced trauma will look for outside sources to soothe. Part 3 - 13:55
• The brain that has experienced trauma has lower dopamine levels, looking for things to engage with that help overcome perceived threats to survival. Part 3 - 19:07
• Physiological withdrawal symptoms can mirror the neuro-hormonal landscape of revisiting a traumatic experience. Part 3 - 37:41
• Key elements of trauma-informed care are promoting safety and control. Part 4 - 00:28

This session of CareOregon Pharmacy’s MEDS Ed program touches on the positive impact that focusing on goals of care can make on patient outcomes, successful strategies for deprescribing pill burdens and potentially inappropriate medications, and how leveraging the model of care shared by Housecall Providers and CareOregon can improve health outcomes and increase patient well-being, while reducing health care costs.

Recorded on November 21, 2019 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Key session takeaways (click the link to view a clip):

• Palliative care patients are typically younger, in their 50s or 60s. In Oregon, if you have serious persistent mental illness, or if you’re experiencing homelessness, you die 20 years earlier than someone who doesn’t. Part 1 - 10:55
• Without relationships and security to help process trauma, people are left fragmented and held captive. Trusting relationships are the foundation of palliative work and most important therapeutic intervention. Part 1 - 15:53
• Focusing on positive aspects of a person’s past experiences and not just their past trauma can help strengthen engagement around goals of care. Part 2 - 24:30
• Pharmacist Leah Goeres shares her preferred method for deprescribing. Part 3 - 25:26
• Why is deprescribing so difficult? Part 3 - 33:05
• A guided tour of CareOregon’s Regional Care Teams structure. Part 4 - 24:50

This session of CareOregon Pharmacy’s MEDS Ed program focuses on clarifying sleep disorder screening and diagnosis, how to help patients through the challenges of CPAP usage and adherence and which medications pose greater risk for obstructive sleep apnea patients.

Recorded on July 26, 2019 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Key session takeaways (click the link to view a clip):

• Prevalence is huge: 12% of the CareOregon population is impacted by sleep apnea. Part 1 - 11:40-12:15
• OSA treatment with CPAP has a major beneficial impact on comorbidities, quality of life and health outcomes, but to do so requires regular use (minimum four hours per night). Part 1 - 12:12-14:19 
• It can be very difficult for patients to adjust to using and maintaining sleep equipment (e.g., CPAP). Strong patient support exists. Without that support, patients are likely to closet their machines and give up. Part 2 - 33:58-35:23
• Drowsy driving is a significant public health concern — 4% of drivers are drowsy behind the wheel every day. 36% admit to falling asleep behind the wheel of a moving vehicle. Part 3 - 26:13 – 29:25
• Due to the significant numbers of people affected, specialists need to collaborate with primary care clinical champions on DME support to better address this epidemic together. Part 2 - 47:35 - 48:48

This session of CareOregon Pharmacy’s MEDS Ed program focuses on new simplified medication guidelines for treatment of COPD, effective demonstration of inhalers and DME supplies and insight into the role of the specialist and pulmonology referral in coordinating treatment.

Recorded on March 1, 2019 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Key session takeaways:

• CareOregon has a new COPD treatment pathway that simplifies effective treatment based on the GOLD guidelines and covered formulary agents.
• Smoking cessation is an important component of long-term strategies for COPD. Use your teams, including behavioral health clinicians, to help with this (using trauma-informed approaches).
• Inhaler technique needs to be assessed regularly. Watch the video for inhaler demos and links to education videos to share with patients.
• Pulmonary rehabilitation programs are a covered non-pharmacological benefit that are effective in patients with COPD.
• There is a template to help guide when to refer a patient to a pulmonology specialist. Also, please contact our metro primary care innovation team if you are interested in help with implementation of templated referral workflows within your EMR and primary care teams.

This session of CareOregon Pharmacy’s MEDS Ed program focuses on the science and use of medications as best practice for the treatment of opioid and alcohol use disorders, distinguishing the barriers and myths about recovery treatment from evidence and effective treatment, Understanding the guidelines for effectively navigating high-risk patient referrals with a special focus on coordination between behavioral health and primary care and planning next steps to support further implementation and improved access of MAT in our network.

Click here to watch the seminar

Featured speakers:

• Paul Lewis, MD, MPH: Multnomah County Health Officer
• Andrew Mendenhall, MD, DABAM, DABFM: Senior Medical Director, Substance Use Disorder Services, Central City Concern
• Alison Noice, MA, CADC III: Deputy Director, CODA
• Amy Jo Cook: Community Paramedic, Clackamas Fire District #1
• Dan Hall: Community Paramedic, AMR
• Anthony Cheng, MD: OHSU South Waterfront
• Stacie Andoniadis: Primary Care Innovations Specialist, CareOregon
• Tanya Kapka, MD, MPH: Metro Medical Director, Network and Clinical Support, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program features interactive discussions on diagnosis, assessment and management of chronic liver disease from the physician and nurse perspectives, as well as a review of medications used to treat hepatitis C and manage complications of cirrhosis.

Click here to watch the seminar

Featured speakers:

• Atif Zaman, MD, MPH: Professor of Medicine, Oregon Health & Science University
• Karista Peabody RN, BS CMSRN: Hepatology Patient Care Coordinator, OHSU Hepatology
• Maddie Fry, PharmD: Post-graduate year 2 Pharmacist Resident, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program focuses on recent discoveries and lessons learned across transitional care environments, including hospital discharge, skilled nursing and Meds-to-Beds.

Click here to watch the seminar

Featured speakers:

• Jane Duck, RN, BSN: High Risk Populations Program Manager, CareOregon
• Mariah Alford, PharmD, BCPS: Pharmacy Clinical Supervisor, CareOregon 
• Mai Tran, PharmD, BCACP, BCGP: CareOregon
• Anthony Neises, PharmD: Legacy Health
• Nate Semm, CSWA: Legacy Health
• Elizabeth Decker: RN Case Manager, Legacy Health
• Carlo De Gregorio: Health Assistant, Pioneers Care Team, Central City Concern
• Meryl Manley, RN, PCCN: Post-Acute Care Manager, Prestige Care
• Elizabeth Whitworth, MPH: PreManage Project Manager, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program on pain management for health care professionals goes beyond pharmacological guidelines to examine the neurophysiology and language of pain as well as trauma-informed perspectives on challenging patient conversations.

Content from Pharmacy Resident Cassandra Miller from CareOregon explains current trends in opioid utilization, benefit criteria and non-opioid alternatives.

Content from Nora Stern, from the Providence Persistent Pain Project, focuses on the relationship between pain and trauma, how pain changes the nervous system and how education can act as a treatment intervention.

Content from Lydia Anne M Bartholow, from Central City Concern’s Old Town Clinic, reviews trauma-informed care, care plans, patient and provider challenges when discussing pain, as well as techniques to improve these difficult conversations.

Click here to watch the seminar

Featured speakers:

• Lydia Anne M Bartholow, DNP, PMHNP, CARN-AP: Old Town Clinic, Central City Concern
• Nora Stern, MSPT: Providence Persistent Pain Project
• Cassandra Miller, PharmD, MS PGY-1: Managed Care Pharmacy Resident, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program for health care professionals focuses on treating hypertension, providing a multidisciplinary approach to effectively treating this complex disease state.

Content from Jose Rueda, from OHSU's Comprehensive Hypertension Center, reviews hypertension treatment trials and evidence-based guidelines, as well as causes of secondary hypertension.

Content from Pharmacist Christopher Blem, from Legacy Health Systems, focuses on medications and how they work, as well as ways to improve adherence.

Content from Dietician Julia Hanfling, from 3 Peaches Nutrition and Diabetes Coaching, explores who is at risk for hypertension, the role of sodium in high blood pressure, three main dietary recommendations and the importance of lifestyle factors.

Click here to watch the seminar

Featured speakers:

• Jose Rueda, MD: Director Comprehensive Hypertension Clinic, Division of Nephrology and Hypertension, OHSU
• Chris Blem, PharmD, BCACP: Legacy Medical Group, Emanuel
• Julia Hanfling, RD, CDE: 3 Peaches Nutrition and Diabetes Coaching

This session of CareOregon Pharmacy’s MEDS Ed program for health care professionals introduces the new diabetes treatment pathway, a more effective approach to diabetes management created in partnership with area diabetes experts.

Content from Dr. Andrew Ahmann focuses on advancing therapy in Type 2 Diabetes to reduce A1C and improve complications. Use of GLP-1 agonists is featured in this segment.

Content from Dr. Leonard Bertheau examines managing complicated patient cases using new, impactful guidelines for this challenging disease state.

Content from Pharmacy Resident Sierra Fung dives into practical tips for navigating diabetic supplies and prescription coverage.

Recorded on September 20, 2017 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Featured speakers:

• Andrew Ahmann, MD: Director of OHSU's Harold Schnitzer Diabetes Health Center
• Leonard Bertheau, DO: Diabetes and Endocrine Center, Adventist Health
• Sierra Fung, PharmD: Pharmacy Managed Care Resident, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program for health care professionals focuses on heart failure, a disease of epidemic proportions. Approximately 5.7 million Americans are currently living with heart failure, with approximately one million hospitalized each year.

Content from Jayne Mitchell include types of heart failure, signs and symptoms, self-care and disease progression.

Recorded on April 20, 2017 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Featured speakers:

• Jayne Mitchell, ANP-BC, CHFN: OHSU Heart Failure Program
• Pamela Chukwuleta, PharmD: Pharmacy Resident, CareOregon
• Kelly Hayes, AIC RN: CareOregon
• Laura Macias, RN-CHPN: Clinical Manager OPPC, Adventist Health Homecare Services

An interprofessional speaker panel — CareOregon Training and Development Specialist Paul Carson and Adventist Health Nurse Care Manager Erin Lemon lead an interactive workshop on the fundamentals of motivational interviewing (MI). Attendees learned how to effectively incorporate MI techniques into a nurse’s busy workflow, while gaining an understanding of MI’s effectiveness in eliciting behavior change and improving communication with patients who experience a background of trauma.

Click here to watch the seminar

Featured speakers:

• Paul Carson, BA: Training and Development Specialist, CareOregon
• Erin Lemon, BSN, RN, CCDS: Adventist Health

Clinicians discuss treating chronic pain and ways to talk with patients about their pain management regimens. They describe how to screen, recognize and triage high-risk symptoms associated with pain medications.

Click here to watch the seminar

Featured speakers:

• Dr. Rachel Solotaroff: Medical Director, Central City Concern Chair, CareOregon Metro Chronic Pain/Chemical Dependency Task Force
• Tara Berkson, PharmD: MEDS Ed Coordinator, CareOregon
• Nadejda Razi-Robertson, LCSW: Behavioral Health Consultant

Psychiatrist John K. Bischof, MD, discusses the disease and therapy options for patients coping with depression. We get the patient perspective from David Lee Greenlee, and Bridget Bradley from Pacific University School of Pharmacy gives a medication review.

Click here to watch the seminar

Featured speakers:

• John K. Bischof, MD: Psychiatric Medical Director, Old Town Recovery Center, Central City Concern
• David Lee Greenlee
• Bridget Bradley, PharmD, BCPP: Pacific University School of Pharmacy, Virginia Garcia Memorial Health Center

An interprofessional speaker panel — Adventist Health Diabetologist Dr. Leonard Bertheau and Tara Berkson, PharmD lead interactive discussions on navigating the latest best practices when caring for complex and high-risk patients with diabetes. Certified Diabetes Educator and RN Cheryl Ortner shares her insights on educating patients about lifestyle modifications and medication use.

Click here to watch the seminar

Featured speakers:

• Leonard Bertheau, DO: Diabetes and Endocrine Center, Adventist Health
• Tara Berkson, PharmD: MEDS Ed Coordinator, CareOregon
• Cheryl Ortner, RN, MSN, CDE: Diabetes and Endocrine Center, Adventist Health

This session of CareOregon Pharmacy’s MEDS Ed program highlights harm reduction strategies, how to talk about drug user health, as well as overdose reversal training.

Key Session Takeaways

(click the link to view a clip):

• There are two different ways we talk about harm reduction: policies that advance social justice for people who use drugs, and the clinical practice that supports reducing substance use related harm to improve quality of life. Part 1 – 5:06
• While there has been a reduction in prescription opioid use, this has been accompanied by increases in deaths from heroin and fentanyl. Part 1 – 9:30
• Healthcare providers need to embrace Naloxone kits, sometimes reducing community overdoses by over 45%. Part 1 – 18:07

• It’s important to understand what harm reduction grew out of. Part 2 – 05:46
• Harm reduction is a tool akin to seatbelts or a bike helmet. Part 2 – 22:24
• What are some examples of harm reduction in practice? Part 2 – 25:29
• How do you talk to patients/clients about Naloxone and safer use? Part 2 – 41:45
• Examples of how language matters. Part 2 –  1:00:33

• Insight on the increasing need for harm reduction services within Multnomah County. Part 3 – 08:10
• Visualizing the sheer volume of syringes and supplies. Part 3 – 18:24
• Barriers and strategies. Part 3 – 20:42
• What you can do today. Part 3 – 34:01

• What are peer mentors? Part 4 – 1:43
• What makes peers different? Part 4 – 14:13
• How peers instill hope. Part 4 – 17:25

• Introducing Team HOW. Part 5 – 2:04
• What can peer outreach offer? Part 5 – 5:21
• What peer outreach does. Part 5 – 10:00

• Who are candidates for Naloxone co-prescribing? Part 6 – 3:19
• Prescribing call to action and Naloxone. Part 6 – 9:05
• Social Stigma. Part 6 – 11:21
• Barriers, concerns, and resources. Part 6 – 14:50

• Overdose basics. Part 7 – 1:51
• Recognizing and overdose. Part 7 – 3:43
• How to respond to an overdose. Part 7 – 4:48
• Preventing an overdose. Part 7 – 16:40

This session of CareOregon Pharmacy’s MEDS Ed program focuses on managing the complexities of Alcohol Use Disorder, including strategies for removing the fear and lack of comfort around AUD treatment; assessment, and treatment-based competencies; the importance and under-utilization of medications in the treatment of AUD; engagement with behavioral health and community resources to assist with AUD treatment in a primary care setting.
Recorded on June 18th as a remote web-cast in Portland, OR.

Click here to view the whole session

Key session takeaways

• Defining binge-drinking & heavy alcohol use for both women and men. Part 1 – 24:19
• Alcohol Use Disorder is highly prevalent and often goes untreated (1 in 11). Part 1 – 27:52
• 5 Oregonians die from alcohol use every day – twice as many as opioid deaths. Part 1 – 29:18
• Gray Area Drinking – drinking among women has skyrocketed. Part 1 – 31:10
• Naltrexone and other medications for treatment – oral Naltrexone should be used much more often in your practice! Part 1 – 35:55

• Treatment engagement tends to be higher in a behavioral health setting. Part 2 – 4:08
• Oregon is drinking its way through the coronavirus crisis. Part 2 – 9:10
• Review of the DSM-5 criteria for AUD. Part 2 – 14:00
• Clinical Practice Guidelines on Alcohol Withdrawal Management. Part 2 – 39:37
• What you can incorporate into your practice today. Part 2 – 50:52

• Alarming facts about Alcohol Use Disorder. Part 3 – 6:00
• Patients are far more willing to enter treatment within a primary care setting than within a specialty treatment center. Part 3 – 10:35
• Tips on using a Trauma-Informed Care approach, including the importance of using affirming language. Part 3 – 38:00
• Tips on helping patients reduce drinking – and remembering to check your biases. Part 3 – 47:15
• Information about project ANTECEDENT as a free resource to support all primary care clinics! Part 3 – 58:54

• How your CCO can support the work you’re doing around Alcohol Use Disorder. Part 4 – 00:44

• Additional assistance, technical support, and next steps. Part 4 – 6:59

This session provides an overview Motivational Interviewing principles, suited for either the beginner or for those looking for a refresher and fresh perspective. CareOregon Training & Development Specialist Paul Carson will convene the session to highlight ways that MI is an effective communication tool, and in particular for patients with a background of trauma.

Key Session Takeaways

(click the link to view a clip):

• The ACE (Adverse Childhood Experiences) study established a strong relationship between abuse and traumatic experiences during childhood and later-life adult health, well-being, and death.  Part 1 – 19:09
• Medication Trauma is medication complexity and lack of coordination that overwhelms the patient, caregivers and provider’s resources, creating fear, confusion and error, which leads to poor adherence, compliance and outcomes. Part 1 – 36:10
• Change is a process, not an event. Part 2 – 05:26
• Motivational Interviewing is made up of four core skills or “OARS.” Part 2 – 17:05
• Reflective Listening is the most important MI skill. Part 2 – 25:00
• Three parts of your MI “toolkit” you can still practice even when you don’t have a lot of time. Part 2 – 51:36
• A review of No-Lose Conflict Resolution. Part 3 – 06:45
• The difference between patient-owned problems and provider-owned problems. Part 3 – 11:40
• Recent Practical Case Examples – Part 3 – 37:17 

This session of CareOregon Pharmacy’s MEDS Ed program focuses on the intersection between psychological trauma and substance use disorders. Lydia Bartholow (DNP, PMHNP, CARN-AP) lays out the scope of the issues, highlights the most effective and lasting forms of engagement and treatment, and provides and in-depth review of the importance of trauma-informed care and patient-centered systems when engaging people experiencing substance use disorders.

Recorded on December 13, 2019 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Key session takeaways (click the link to view a clip):

• Long-term consequences of cortisol end up becoming the biggest chronic conditions that impact our life expectancy. Part 2 - 25:50
• Much of what we know about the connection between trauma and substance use disorders is based on the ACEs study. Part 3 - 6:07
• A central nervous system that has experienced trauma will look for outside sources to soothe. Part 3 - 13:55
• The brain that has experienced trauma has lower dopamine levels, looking for things to engage with that help overcome perceived threats to survival. Part 3 - 19:07
• Physiological withdrawal symptoms can mirror the neuro-hormonal landscape of revisiting a traumatic experience. Part 3 - 37:41
• Key elements of trauma-informed care are promoting safety and control. Part 4 - 00:28

This session of CareOregon Pharmacy’s MEDS Ed program focuses on the science and use of medications as best practice for the treatment of opioid and alcohol use disorders, distinguishing the barriers and myths about recovery treatment from evidence and effective treatment, Understanding the guidelines for effectively navigating high-risk patient referrals with a special focus on coordination between behavioral health and primary care and planning next steps to support further implementation and improved access of MAT in our network.

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Featured speakers:

• Paul Lewis, MD, MPH: Multnomah County Health Officer
• Andrew Mendenhall, MD, DABAM, DABFM: Senior Medical Director, Substance Use Disorder Services, Central City Concern
• Alison Noice, MA, CADC III: Deputy Director, CODA
• Amy Jo Cook: Community Paramedic, Clackamas Fire District #1
• Dan Hall: Community Paramedic, AMR
• Anthony Cheng, MD: OHSU South Waterfront
• Stacie Andoniadis: Primary Care Innovations Specialist, CareOregon
• Tanya Kapka, MD, MPH: Metro Medical Director, Network and Clinical Support, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program on pain management for health care professionals goes beyond pharmacological guidelines to examine the neurophysiology and language of pain as well as trauma-informed perspectives on challenging patient conversations.

Content from Pharmacy Resident Cassandra Miller from CareOregon explains current trends in opioid utilization, benefit criteria and non-opioid alternatives.

Content from Nora Stern, from the Providence Persistent Pain Project, focuses on the relationship between pain and trauma, how pain changes the nervous system and how education can act as a treatment intervention.

Content from Lydia Anne M Bartholow, from Central City Concern’s Old Town Clinic, reviews trauma-informed care, care plans, patient and provider challenges when discussing pain, as well as techniques to improve these difficult conversations.

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Featured speakers:

• Lydia Anne M Bartholow, DNP, PMHNP, CARN-AP: Old Town Clinic, Central City Concern
• Nora Stern, MSPT: Providence Persistent Pain Project
• Cassandra Miller, PharmD, MS PGY-1: Managed Care Pharmacy Resident, CareOregon

An interprofessional speaker panel — CareOregon Training and Development Specialist Paul Carson and Adventist Health Nurse Care Manager Erin Lemon lead an interactive workshop on the fundamentals of motivational interviewing (MI). Attendees learned how to effectively incorporate MI techniques into a nurse’s busy workflow, while gaining an understanding of MI’s effectiveness in eliciting behavior change and improving communication with patients who experience a background of trauma.

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Featured speakers:

• Paul Carson, BA: Training and Development Specialist, CareOregon
• Erin Lemon, BSN, RN, CCDS: Adventist Health

Clinicians discuss treating chronic pain and ways to talk with patients about their pain management regimens. They describe how to screen, recognize and triage high-risk symptoms associated with pain medications.

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Featured speakers:

• Dr. Rachel Solotaroff: Medical Director, Central City Concern Chair, CareOregon Metro Chronic Pain/Chemical Dependency Task Force
• Tara Berkson, PharmD: MEDS Ed Coordinator, CareOregon
• Nadejda Razi-Robertson, LCSW: Behavioral Health Consultant

Psychiatrist John K. Bischof, MD, discusses the disease and therapy options for patients coping with depression. We get the patient perspective from David Lee Greenlee, and Bridget Bradley from Pacific University School of Pharmacy gives a medication review.

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Featured speakers:

• John K. Bischof, MD: Psychiatric Medical Director, Old Town Recovery Center, Central City Concern
• David Lee Greenlee
• Bridget Bradley, PharmD, BCPP: Pacific University School of Pharmacy, Virginia Garcia Memorial Health Center

This session of CareOregon Pharmacy’s MEDS Ed program explores weaving cultural competence into our behaviors and policies, improving our cultural effectiveness and the lives of our patients.

Key Session Takeaways

(click the link to view a clip):

• Don’t be afraid to establish ground rules when having difficult conversations about diversity; tailor them to your personality. Part 1 – 7:04
• Bias comes into play when providing care or identifying/hiring talent; these biases are most often implicit or unconscious. Part 1 – 14:30
• Don’t be afraid to assess bias. One can identify current strengths, and areas where improvements can be made. Part 1 – 16:07
• Develop a value base for EDI; ultimately construe it in the clinician’s best interest, but with mutual benefits. We are doing it as much for us as for them. Part 1 – 20:17
• Focus on equity as a way of tailoring or individualizing care and understanding the patient context. Part 1 – 23:47
• Develop your own talking points and identify with whom specific arguments might resonate. Part 1 – 25:02
• Try to understand the patient in terms of their internal and external health determinants. See within-group differences, understand the categories or how we label people can inadvertently cause us to invoke new stereotypes otherwise. Part 3 – 5:29
• See diversity when you see people, not just certain people. Part 3 – 9:00
• We are all diverse and unique. Part 3 – 10:55
• Show yourself and others grace.  This is a developmental process; we all start at different point; compare yourself to yourself over time. Part 3 – 48:22
• As with any body of knowledge, understand you’ll never exhaust the need to learn about diversity; cultures and contexts change over time and knowledge is always being developed. Part 3 – 49:26

This session of CareOregon Pharmacy’s MEDS Ed program explores the tremendous benefits and resources Community Health Workers can provide for both primary care clinicians and patients.

Key Session Takeaways

(click the link to view a clip):

• Understanding some of the roles and competencies for Community Health Workers. Part 1 – 20:17
• The role of Community Health Worker has been evolving since the 1950s. Part 1 – 25:38
• How systems benefit from working with Community Health Workers. Part 1 – 36:08
• A moving example of what can draw someone into becoming a Community Health Worker. Part 2 – 7:20
• How Community Health Workers are referred to patients who need them. Part 2 – 16:35
• Community Health Workers can help in many ways, including getting healthy produce to clients. Part 2 – 20:00
• Evolution of the Community Supported Agriculture program. Part 2 – 24:36
• What do relationships between Community Health Workers and other team members look like? Part 2 – 36:58
• Understanding Mobile Integrated Healthcare. Part 3 – 5:01
• Making an impact with behavioral health and substance use disorders. Part 3 – 10:51
• Examples that demonstrate success. Part 3 – 17:50          
• Examples of a strong collaboration with pharmacists. Part 3 – 21:51
• What kind of CHW support do the CCOs provide? Part 4 – 2:30
• How does the role of the Traditional Health Worker Liaison support CHW work? Part 4 – 6:00

This session of CareOregon Pharmacy’s MEDS Ed program explores how issues of racial and social disparities and environmental stress impact maternal health and conception; mental health/SUD-related concerns during pregnancy; how maternal health is affected by pre-conception care; potentially harmful medications; social/emotional health for newborns and new mothers.



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Key session takeaways

(click the link to view a clip):

• Virginia Garcia clinics serve 1 in every 13 residents of Washington and Yamhill counties – more than 50,000 patients. Part 1 – 7:50
• Virginia Garcia has prioritized hiring bilingual & bicultural staff, using data analysis, and integrating behavioral health into primary care. Part 1 – 14:15 
• Implementing the CenteringPregnancy® program has resulted in outstanding obstetrics outcomes. Part 1 – 24:53

• Dental care for the pregnant patient, and family members, is an upstream approach to address the transmissible and preventable chronic disease of early childhood caries. Part 2 – 17:31
• Important oral health recommendations during pregnancy for patients: Part 2 – 31:44
• Pregnant patients to complete a dental visit if
• they have not seen a dentist during their pregnancy  
• oral health problems were identified during the assessment
• Encourage good oral hygiene and associate oral health with other healthy habits
• nutrition
• tobacco cessation
• Inform patients that dentistry is safe during pregnancy and recommended for the health of both the patient and developing baby – that dentistry is safe during all three trimesters.
• Dental care request tool for any Health Share of Oregon, Jackson Care Connect or Columbia Pacific CCO patient. All OHP/Medicaid patients have comprehensive dental benefits. This tool helps connect your patient to their OHP dental plan for care coordination, simplifying the process for both you and your patient. Tool is accessible through the CareOregon Connect provider portal or OneHealthPort. Part 2 – 35:16

• The U.S. has the worst overall maternal and infant mortality rate and outcomes of the developed nations Part 3 – 21:13
• Black maternal mortality three times higher than white
• Native/Indigenous maternal mortality is more than twice as high as white

• There is a need for more skilled birth advocates for underserved and marginalized communities. Part 3 – 30:48
• The Community Doula Alliance was created to promote sustainable utilization and share resources. Part 3 – 53:12

This session of CareOregon Pharmacy’s MEDS Ed program focuses on managing children’s complex health conditions, including the impact of parental trauma, behavioral health integration, high-risk medications, improving family engagement and follow-through, and population data highlighting high-risk children.
Recorded on May 21st as a remote web-cast in Portland, OR.

Click here to view the whole session

Key session takeaways (click the link to view a clip):

• Parental Trauma can have an impact on a child’s developmental delays and social-emotional risk. Part 1 – 2:38
• Parents have new brain growth in the first six months after their child’s birth…UNLESS they are experiencing stress, which impairs frontal cortex development. Part 1 – 9:33
• A child whose parent has a high ACE score will have increased odds for behavioral and emotional problems. Part 1 – 22:45
• Positive relationships with providers help build resilience. Part 1 – 31:50

• Providers only see a small glimpse of the greater social complexity that creates barriers to engagement.  Part 2 – 12:40
• The context of social determinants of health, inequities, and bad experiences with the healthcare system must be kept in mind when engaging with families, along with the perceptions and assumptions we have as providers. Part 2 – 55:52
• The top questionsto ask to help improve family follow-through and engagement.  Part 2 – 1:04:35

• Patients and families often feel more comfortable and trusting of primary care providers, which can help reduce stigma. Part 3 – 2:00
• Which disorders cause PCPs to contact child psychiatric resources? Part 3 – 7:00
• What are the criteria for improving clinical practice? Part 3 – 27:45

This session of CareOregon Pharmacy’s MEDS Ed program touches on the positive impact that focusing on goals of care can make on patient outcomes, successful strategies for deprescribing pill burdens and potentially inappropriate medications, and how leveraging the model of care shared by Housecall Providers and CareOregon can improve health outcomes and increase patient well-being, while reducing health care costs.

Recorded on November 21, 2019 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Key session takeaways (click the link to view a clip):

• Palliative care patients are typically younger, in their 50s or 60s. In Oregon, if you have serious persistent mental illness, or if you’re experiencing homelessness, you die 20 years earlier than someone who doesn’t. Part 1 - 10:55
• Without relationships and security to help process trauma, people are left fragmented and held captive. Trusting relationships are the foundation of palliative work and most important therapeutic intervention. Part 1 - 15:53
• Focusing on positive aspects of a person’s past experiences and not just their past trauma can help strengthen engagement around goals of care. Part 2 - 24:30
• Pharmacist Leah Goeres shares her preferred method for deprescribing. Part 3 - 25:26
• Why is deprescribing so difficult? Part 3 - 33:05
• A guided tour of CareOregon’s Regional Care Teams structure. Part 4 - 24:50

This session of CareOregon Pharmacy’s MEDS Ed program focuses on clarifying sleep disorder screening and diagnosis, how to help patients through the challenges of CPAP usage and adherence and which medications pose greater risk for obstructive sleep apnea patients.

Recorded on July 26, 2019 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Key session takeaways (click the link to view a clip):

• Prevalence is huge: 12% of the CareOregon population is impacted by sleep apnea. Part 1 - 11:40-12:15
• OSA treatment with CPAP has a major beneficial impact on comorbidities, quality of life and health outcomes, but to do so requires regular use (minimum four hours per night). Part 1 - 12:12-14:19 
• It can be very difficult for patients to adjust to using and maintaining sleep equipment (e.g., CPAP). Strong patient support exists. Without that support, patients are likely to closet their machines and give up. Part 2 - 33:58-35:23
• Drowsy driving is a significant public health concern — 4% of drivers are drowsy behind the wheel every day. 36% admit to falling asleep behind the wheel of a moving vehicle. Part 3 - 26:13 – 29:25
• Due to the significant numbers of people affected, specialists need to collaborate with primary care clinical champions on DME support to better address this epidemic together. Part 2 - 47:35 - 48:48

This session of CareOregon Pharmacy’s MEDS Ed program focuses on new simplified medication guidelines for treatment of COPD, effective demonstration of inhalers and DME supplies and insight into the role of the specialist and pulmonology referral in coordinating treatment.

Recorded on March 1, 2019 at CareOregon (Portland, Oregon).

Click here to watch the seminar

Key session takeaways:

• CareOregon has a new COPD treatment pathway that simplifies effective treatment based on the GOLD guidelines and covered formulary agents.
• Smoking cessation is an important component of long-term strategies for COPD. Use your teams, including behavioral health clinicians, to help with this (using trauma-informed approaches).
• Inhaler technique needs to be assessed regularly. Watch the video for inhaler demos and links to education videos to share with patients.
• Pulmonary rehabilitation programs are a covered non-pharmacological benefit that are effective in patients with COPD.
• There is a template to help guide when to refer a patient to a pulmonology specialist. Also, please contact our metro primary care innovation team if you are interested in help with implementation of templated referral workflows within your EMR and primary care teams.

This session of CareOregon Pharmacy’s MEDS Ed program features interactive discussions on diagnosis, assessment and management of chronic liver disease from the physician and nurse perspectives, as well as a review of medications used to treat hepatitis C and manage complications of cirrhosis.

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Featured speakers:

• Atif Zaman, MD, MPH: Professor of Medicine, Oregon Health & Science University
• Karista Peabody RN, BS CMSRN: Hepatology Patient Care Coordinator, OHSU Hepatology
• Maddie Fry, PharmD: Post-graduate year 2 Pharmacist Resident, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program focuses on recent discoveries and lessons learned across transitional care environments, including hospital discharge, skilled nursing and Meds-to-Beds.

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Featured speakers:

• Jane Duck, RN, BSN: High Risk Populations Program Manager, CareOregon
• Mariah Alford, PharmD, BCPS: Pharmacy Clinical Supervisor, CareOregon 
• Mai Tran, PharmD, BCACP, BCGP: CareOregon
• Anthony Neises, PharmD: Legacy Health
• Nate Semm, CSWA: Legacy Health
• Elizabeth Decker: RN Case Manager, Legacy Health
• Carlo De Gregorio: Health Assistant, Pioneers Care Team, Central City Concern
• Meryl Manley, RN, PCCN: Post-Acute Care Manager, Prestige Care
• Elizabeth Whitworth, MPH: PreManage Project Manager, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program for health care professionals focuses on treating hypertension, providing a multidisciplinary approach to effectively treating this complex disease state.

Content from Jose Rueda, from OHSU's Comprehensive Hypertension Center, reviews hypertension treatment trials and evidence-based guidelines, as well as causes of secondary hypertension.

Content from Pharmacist Christopher Blem, from Legacy Health Systems, focuses on medications and how they work, as well as ways to improve adherence.

Content from Dietician Julia Hanfling, from 3 Peaches Nutrition and Diabetes Coaching, explores who is at risk for hypertension, the role of sodium in high blood pressure, three main dietary recommendations and the importance of lifestyle factors.

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Featured speakers:

• Jose Rueda, MD: Director Comprehensive Hypertension Clinic, Division of Nephrology and Hypertension, OHSU
• Chris Blem, PharmD, BCACP: Legacy Medical Group, Emanuel
• Julia Hanfling, RD, CDE: 3 Peaches Nutrition and Diabetes Coaching

This session of CareOregon Pharmacy’s MEDS Ed program for health care professionals introduces the new diabetes treatment pathway, a more effective approach to diabetes management created in partnership with area diabetes experts.

Content from Dr. Andrew Ahmann focuses on advancing therapy in Type 2 Diabetes to reduce A1C and improve complications. Use of GLP-1 agonists is featured in this segment.

Content from Dr. Leonard Bertheau examines managing complicated patient cases using new, impactful guidelines for this challenging disease state.

Content from Pharmacy Resident Sierra Fung dives into practical tips for navigating diabetic supplies and prescription coverage.

Recorded on September 20, 2017 at CareOregon (Portland, Oregon).

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Featured speakers:

• Andrew Ahmann, MD: Director of OHSU's Harold Schnitzer Diabetes Health Center
• Leonard Bertheau, DO: Diabetes and Endocrine Center, Adventist Health
• Sierra Fung, PharmD: Pharmacy Managed Care Resident, CareOregon

This session of CareOregon Pharmacy’s MEDS Ed program for health care professionals focuses on heart failure, a disease of epidemic proportions. Approximately 5.7 million Americans are currently living with heart failure, with approximately one million hospitalized each year.

Content from Jayne Mitchell include types of heart failure, signs and symptoms, self-care and disease progression.

Recorded on April 20, 2017 at CareOregon (Portland, Oregon).

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Featured speakers:

• Jayne Mitchell, ANP-BC, CHFN: OHSU Heart Failure Program
• Pamela Chukwuleta, PharmD: Pharmacy Resident, CareOregon
• Kelly Hayes, AIC RN: CareOregon
• Laura Macias, RN-CHPN: Clinical Manager OPPC, Adventist Health Homecare Services

An interprofessional speaker panel — Adventist Health Diabetologist Dr. Leonard Bertheau and Tara Berkson, PharmD lead interactive discussions on navigating the latest best practices when caring for complex and high-risk patients with diabetes. Certified Diabetes Educator and RN Cheryl Ortner shares her insights on educating patients about lifestyle modifications and medication use.

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Featured speakers:

• Leonard Bertheau, DO: Diabetes and Endocrine Center, Adventist Health
• Tara Berkson, PharmD: MEDS Ed Coordinator, CareOregon
• Cheryl Ortner, RN, MSN, CDE: Diabetes and Endocrine Center, Adventist Health