Katherine CappsMolly Ekstrand, BPharm, BCACP, AE-C
Pharmacists well understand that medication is part of the daily lives of many Americans. In fact, studies show nearly 75% of visits to physician offices and hospital outpatient clinics involve medication therapy, and almost 30% of adults take five or more medications. Unfortunately, suboptimal medication use leads to at least 275,000 deaths annually and costs more than $528 billion.
Recently, our organization, The Get the Medications Right (GTMRx) Institute, in Tysons Corner, Va., released a report outlining steps for medication management reform, including a call for comprehensive medication management, or CMM. This comprehensive management is an evidence-based process of care that personalizes the approach, resulting in better care, reduced costs, and improved patient satisfaction and provider work life.
The report, the GTMRx Blueprint for Change, includes recommendations outlining how each stakeholder can get involved to improve patient carefrom physicians to clinical pharmacists, health plan sponsors, providers, consumer groups, employers as health plan sponsors, and policymakers.Many things need to change, but technology and information technology (IT) capabilities are central in the challenge for reform.
Here, we outline four health IT categories to achieve medication optimization through CMM, enabling a broad practice adoption of a systematic approach to medication use throughout the continuum of care. Software supports the practice management systems developed around CMM workflows and thought processes, driving consistency of the CMM service. Within each of these categories, organizations will undergo a journey toward maturity. However, considerations in each of these categories are foundational.
1. Clinical Decision Support Tools (at the point of care): Access to diagnostic results, clinical notes, patient status and other clinical information allows care teams to fulfill important activities in the CMM process. This information offers insight into patients experiencing medication therapy problems, and it helps the clinicians determine whether or not the patient has achieved the clinical goals of therapy. Having the ability to evaluate actual use patterns of all medications (e.g., over the counter, supplements, prescribed drugs and biologics) also is important. This full view of information is essential for the medication expert to properly assess each medication for appropriateness, focusing on the achievement of the clinical goals for each therapy. Organization and interpretation of these data in a medication-centric workflow can improve the efficiency and efficacy of clinical decision making. A medication-related dashboard should have the ability to support anyone on the care team, allowing them to make simple, streamlined decisions about a patients medication therapy. This dashboard should include objective data that help clinicians decide whether a patient needs a higher level statin, the blood pressure medicine should be increased, or pharmacogenomic data are needed to assess the safety or efficacy of the medications.
2. Population Health and Risk Stratification Tools: Health care resources are finite. There are certain patient populations that benefit more from CMM services. Tools that integrate data from electronic health records (EHRs), pharmacies, health plans and other reliable sources can provide the foundation for deployment of comprehensive risk models. Risk modeling tools allow payor, provider or value-based networks to easily identify the patients who are at risk and will benefit most from CMM services. Health systems, pharmacies, payors and prescribers should also have the ability to proactively reach out and invite at-risk patients to participate in CMM services, effectively automating a process and decreasing administrative burden from the point-of-care clinician.
3. Patient Engagement and Care Coordination Tools: Health IT should enable and facilitate the exchange of information between the patient and care team. Patients gather information in various forms that can inform clinical decisions regarding medication therapy. The tools should have the ability to integrate the digital therapeutic health information from a patient with the pharmacogenomic data that clinicians currently receive as a separate, cumbersome report. These types of information would come together in an EHR in a usable fashion. Health IT can facilitate bidirectional communication between the pharmacist, clinician and patient. Clinicians should have the ability to effectively and efficiently communicate across the continuum of care. In many cases, the patients care team, including the pharmacist providing comprehensive medication management, are not colocated and do not share a single EHR platform. Its imperative that health IT has the ability to enable bidirectional, secure health-related data exchange to promote optimal medication use.
4. Health IT Supporting Economic, Clinical and Humanistic Outcomes: Purpose-built software can drive consistency and demonstrate the value of CMM practice. Software ensures the capture of compliance and regulatory reporting requirements unique to CMM services. The tools should have the ability to allow the team to identify medication therapy problems in a systematic way, with the ability to gather and analyze information across systems and care settings. The tools should have the ability to track participation, offer point-of-care insight to the clinician, and, in order to efficiently identify medication therapy problems, record the defined medication care plan and steps toward resolution.
CMM services can be correlated with broader changes in health status or health care utilization patterns, thus demonstrating contribution and value to the broader health care system. However, optimizing medication use through CMM in practice truly and wholly relies on having the right data, at the right time, at the point of care and available to the entire team.
Ms. Capps is the co-founder and executive director of the GTMRx Instituteusvuwtdtxr, a catalyst for change that brings critical stakeholders together, bound by the urgent need to get the medications right. Ms. Ekstrand is a distinguished fellow at GTMRx.
See original here:
The Formative Four: Top Health IT Capabilities That Will Improve Medication Management - Pharmacy Technology Report
Recommendation and review posted by G. Smith
