Archive for the ‘Medication Management’ Category

Infographic: Connected Technology Improves Medication Adherence

June 10th, 2016 by Melanie Matthews

The use of a connected medication dispensing technology can greatly benefit patients with chronic conditions, helping them better comply with long-term therapy, according to a new study from Philips. Over the span of one year, user data from more than 1,300 patients in the Netherlands was analyzed, showing 96 percent of patients using Philips Medido, a connected medication dispensing solution, were adherent to their medication schedule.

A new infographic by Philips looks at the impact of medication non-adherence, demographic data of the study's patients and the impact on medication adherence and cost savings from the intervention.

What's the cost of medication non-adherence? As high as $290 billion annually, according to one frequently cited estimate. An equally bitter pill to swallow is the dismal C+ grade in medication adherence earned in 2013 by Americans with chronic medical conditions, according to the first National Report Card on Adherence from the National Community Pharmacists Association (NCPA).

Fortunately, the healthcare industry is striving to improve performance in this area. 42 Metrics for Improving Medication Adherence: Interventions, Impacts and Technologies provides convincing evidence of the impact of nine key interventions on medication non-adherence—from the presence of pharmacists in patient-centered medical homes to medication reconciliation conducted during home visits.

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Novant Health Pharmacists Dispense Healthcare Value in the Discharge Space

February 25th, 2016 by Patricia Donovan

Novant Health's team of 12 clinical pharmacists supports medication management across the care continuum.

It's a statistic healthcare organizations know well: 20 percent of Medicare beneficiaries are readmitted to the hospital within 30 days.

Factor adverse drug events (ADEs) into this trend, and the picture becomes more dire.

Enlisting pharmacists to reduce the number of ADEs in the Medicare population is just one goal in a five-point program by Novant Health to deliver healthcare value through medication management services.

"We've focused on adverse drug events because we feel they are an opportunity," explained Rebecca Bean, Novant Health's director of population health pharmacy. "Many ADEs are potentially preventable, and we know they are a contributor to hospitalizations. We believe pharmacists have a role in reducing risk for ADEs."

The list of ADE risks is extensive. By the end of Ms. Bean's February 2016 presentation on Medication Management: Using Clinical Pharmacists To Complete Comprehensive Drug Therapy Management Post Discharge in High-Risk Patients, now available for replay, she had identified more than 25 different factors that can complicate medication management— everything from a patient's affordability issues, even among the insured, to fear of a drug's side effects to potential dangers from high-risk medications or health conditions.

In the Novant Health model, an RN care coordinator risk-stratifies the newly discharged, combing real-time hospital discharge notifications for red flags, such as patients taking high-risk medications or having high-risk conditions, signaling the need for a pharmacist referral.

Once referred, pharmacists conduct a comprehensive drug therapy review, keeping an eye out for adverse effects, newly prescribed medications and polypharmacy as well as general medication adherence issues.

"There could be financial barriers to getting their medications. There could be health literacy issues. Those are the sorts of things we want to make sure we're directing pharmacist resources toward," noted Ms. Bean.

Aware its providers have limited time to spend with patients, the integrated health system layers its pharmacists as an additional resource to improve quality performance, to incorporate protocols and evidence-based guidelines such as the all-important medication reconciliation. In an era of electronic health record use, the medication list has become dynamic, with many providers editing the list, Ms. Bean notes.

"We're also utilizing our pharmacy team both on the inpatient and outpatient sides to gather that best possible medication history, and then teach other clinical team members how to best reconcile medications."

Ms. Bean shared seven ways Novant Health pharmacists impact comprehensive medication management services, including the dozen benefits of incorporating these clinicians into its patient-centered medical homes (PCMH).

Encouraged by early financial gains from pharmacist interventions, particularly in the areas of medication reconciliation, therapeutic monitoring and warfarin review, Novant Health is committed to staff development to further its medication management program, exploring certification programs and even pharmacy resident programs.

"We feel it's really valuable in the discharge space to be able to get a pharmacist involved with taking care of patients," Ms. Bean concluded.

Listen to an interview with Rebecca Bean in which she offers ideas to improve the accuracy of medication lists.

Infographic: Medication Management

December 28th, 2015 by Melanie Matthews

Serious medication errors occur in 3.8 million inpatient admissions each year, according to a new infographic by Sentri7.

The infographic reviews how medication errors and adverse drug events affect patients and hospitals.

A clinical pharmacist-driven medication management effort at Novant Health identifies patients at high-risk for readmissions or ED visits related to adverse drug events. Using a combination of medication reconciliation, pharmacotherapy review, and patient education, Novant Health's clinical pharmacists are working to reduce preventable readmissions by optimizing medication regimens and removing barriers to adherence among these high-risk patients.

During Medication Management: Using Clinical Pharmacists To Complete Comprehensive Drug Therapy Management Post Discharge in High-Risk Patients, a 45-minute webinar on February 3rd at 1:30 p.m. Eastern, Rebecca Bean, director, population health pharmacy, Novant Health, will share her organization’s medication management approach and why a clinical pharmacist is key to the program's success.

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Infographic: mHealth Improves Medication Adherence, Lowers Costs

November 16th, 2015 by Melanie Matthews

Fifty percent of medications are not taken as prescribed, according to a new infographic by MediSafe.

The infographic also looks at the impact of three chronic conditions on the U.S. healthcare system and results from an IMS study on how MediSafe's medication management platform increased medication adherence.

mHealth Improves Medication Adherence, Lowers Costs

What's the cost of medication non-adherence? As high as $290 billion annually, according to one frequently cited estimate. An equally bitter pill to swallow is the dismal C+ grade in medication adherence earned in 2013 by Americans with chronic medical conditions, according to the first National Report Card on Adherence from the National Community Pharmacists Association (NCPA).

Fortunately, the healthcare industry is striving to improve performance in this area. 42 Metrics for Improving Medication Adherence: Interventions, Impacts and Technologies provides convincing evidence of the impact of nine key interventions on medication non-adherence—from the presence of pharmacists in patient-centered medical homes to medication reconciliation conducted during home visits.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you'd like featured on our site? Click here for submission guidelines.

Infographic: Curbing Healthcare Costs

July 17th, 2015 by Melanie Matthews

The U.S. healthcare system could save $213 billion annually if medicines were used properly, according to a 2013 study by IMS Institute for Healthcare Informatics. An article in Health Affairs echoed this sentiment and found that just an extra $1 spent on medicines for adherent patients with congestive heart failure, high blood pressure, diabetes and high cholesterol can generate $3 to $10 in savings on emergency room visits and inpatient hospitalizations.

A new infographic by PhRMA looks at the impact of medicine on healthcare costs.

Pharmacists and Medication Adherence: Brief Interventions, Motivational Interviewing and TelepharmacyThese three misconceptions are at the heart of medication non-adherence, says Janice Pringle, Ph.D., of the University of Pittsburgh School of Pharmacy — misconceptions that pharmacists can help to clear up.

Dr. Pringle, named as an Innovations Advisor by the Centers for Medicare and Medicaid Services, is one of three contributors to Pharmacists and Medication Adherence: Brief Interventions, Motivational Interviewing and Telepharmacy. This 50-page resource describes a number of interventions in which pharmacists help to guide patients and health plan members to higher levels of medication adherence — programs that take place in the pharmacy, in the physician practice, or virtually.

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Infographic: Medication Adherence

June 29th, 2015 by Melanie Matthews

Seventy-five percent of physician visits involve drug therapy, according to a new infographic by Anthem.

The infographic also looks at the percent of Americans taking prescription medications, the public health cost of medication non-adherence and how to improve adherence.

42 Metrics for Improving Medication Adherence: Interventions, Impacts and Technologies What's the cost of medication non-adherence? As high as $290 billion annually, according to one frequently cited estimate. An equally bitter pill to swallow is the dismal C+ grade in medication adherence earned in 2013 by Americans with chronic medical conditions, according to the first National Report Card on Adherence from the National Community Pharmacists Association (NCPA).

Fortunately, the healthcare industry is striving to improve performance in this area. 42 Metrics for Improving Medication Adherence: Interventions, Impacts and Technologies provides convincing evidence of the impact of nine key interventions on medication non-adherence—from the presence of pharmacists in patient-centered medical homes to medication reconciliation conducted during home visits.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you'd like featured on our site? Click here for submission guidelines.

ROI and 12 More Rewards from Stratifying High-Risk, High-Cost Patients

May 21st, 2015 by Patricia Donovan

Health risk stratification—for example, grouping diabetics in a single physician practice or drilling down to an ACO's subset of medication non-adherent diabetics with elevated HbA1cs—followed by risk-appropriate interventions can significantly enhance a healthcare organization's clinical and financial outlook.

For 9.4 percent of respondents to HIN's 2014 Health Risk Stratification Survey, risk stratification resulted in program ROI of between 3:1 and 4:1, while 6.3 said return on investment was greater than 5:1.

Stratification and targeted interventions also generated a healthy drop in healthcare cost, nursing home stays, ER utilization and time off work while boosting quality ratings, patient engagement levels and care plan adherence.

Survey respondents further quantified successes achieved from health risk stratification in their own words:

  • "„„Decreased readmissions and decreased skilled nursing facility (SNF) utilization."
  • "Improved treat-to-target for diabetes, blood pressure, and depression care."
  • "Reduction in readmissions by 20+ percent."
  • "Reducing heart failure, pneumonia, acute myocardial infarction (AMI) and chronic obstructive pulmonary disorder (COPD) Medicare readmissions."
  • "Patient compliance to care plan."
  • "Patient health outcomes, quality of life, and satisfaction with services."
  • "Member satisfaction."
  • "More referrals to patient-centered medical homes and fair retention with limited resources."
  • "Decreased primary care-sensitive ED visits and increased quality metrics."
  • "One-on-one interaction w/members to promote behavior change."
  • "A reduction of costs in the range of 6 to 8 percent of target spend."
  • "Lower readmission rates for those patients on AIM 2.0 program with home health and more compliance with meds. We meet with FQHCs every other month and discuss issues and case management."

Source: 2014 Healthcare Benchmarks: Stratifying High-Risk Patients

http://hin.3dcartstores.com/2014-Healthcare-Benchmarks-Stratifying-High-Risk-Patients_p_4963.html

2014 Healthcare Benchmarks: Stratifying High-Risk Patients captures the tools and practices employed by dozens of organizations in this prerequisite for care management and jumping-off point for population health improvement — data analytics that will ultimately enhance quality ratings and improve reimbursement in the industry's value-focused climate.

Home Health on Care Transitions Management: Focus on Post-Acute to Home Handoff

April 7th, 2015 by Patricia Donovan

With the hospital-to-home care transition deemed the most critical by half of healthcare organizations, home health sits on the front lines of care transitions management.

An overwhelming majority of home health organizations, which comprised approximately 10 percent of respondents to HIN's 2015 survey on Care Transitions Management, have a care transition management program in place: 80 percent versus 67 percent overall, and of those that don’t, 100 percent intend to implement one in the next 12 months, versus 56 percent overall.

Contrary to overall respondents, this sector considers the hospital to post-acute care transition key (50 percent versus 24 percent overall) as well as the post-acute care to home handoff (50 percent versus 9 percent overall).

Heart failure is the top health condition targeted by home health organizations (87 percent of respondents, versus 81 percent overall). This sector also targets acute myocardial infarction, or AMI (62 percent versus 51 percent overall), and the frail elderly, a top concern for 75 percent of this sector versus 44 percent overall.

Half of home health organizations surveyed self-developed care transitions programs (50 percent versus 34 percent overall). Similarly to most respondents, programs include medication reconciliation (87 percent versus 75 percent overall) and transition/handoff training (87 percent versus 39 percent overall). This sector also relied on telephonic follow-up (87 percent 79 percent overall) in their care transition programs.

Transition coaches were primarily responsible for coordinating care transitions, according to 37 percent of home health respondents, versus 25 percent overall.

Some ways home health organizations improved transitions of care included creation of community partnerships with acute care facilities, development of post-acute networks, and collaborations with all clinical and hospice providers.

Successful strategies for this sector included separating data input from hands-on patient discharge paperwork so clinicians doing the transition could focus more on the patient, and not typing. Also, maintaining open communication with all staff and following up on communication with the patient and/or caregiver to ensure they transitioned appropriately into the new setting helped them to identify any concerns in the hopes of avoiding an unnecessary hospitalization.

Provider engagement remains the biggest challenge to this sector’s transition management efforts, say 37 percent of home health organizations, versus 13 percent overall.

Source: 2015 Healthcare Benchmarks: Care Transitions Management

http://hin.3dcartstores.com/Chronic-Care-Management-Reimbursement-Compliance-Physician-Requirements-for-Value-Based-Revenue_p_5027.html

2015 Healthcare Benchmarks: Care Transitions Management HIN's fourth annual analysis of these cross-continuum initiatives examines programs, models, protocols and results associated with movement of patients from one care site to another, including the impact of care transitions management on quality metrics and delivery of value-based care.

12 Things to Know About Chronic Care Management

February 24th, 2015 by Cheryl Miller

Despite new CPT codes that reimburse physician practices for select chronic care management (CCM) services, almost half of healthcare organizations lack a formal CCM program, leaving critical reimbursement dollars on the table, according to 125 respondents to the Healthcare Intelligence Network’s (HIN) 2015 Chronic Care Management survey, conducted in January 2015.

However, 92 percent of respondents believe the Medicare CCM reimbursement codes that became effective January 1, 2015 will prompt equivalent quality overtures from private payors, underscoring care coordination’s importance in a value-based healthcare system.

We also asked respondents how they structured their CCM programs, and who had primary responsibility for CCM services. Following are their responses.

  • Almost 45 percent of respondents to HIN’s 2015 CCM survey have yet to launch a CCM initiative, the survey determined.
  • A diagnosis of diabetes is the leading criterion for admission to a CCM initiative, said 89 percent of respondents with existing CCM programs.
  • A primary care physician or healthcare case manager most often bears primary responsibility for CCM, say 29 percent of survey respondents.
  • Just over one-third of respondents — 35 percent — are currently reimbursed for CCM-related activities.
  • Patient engagement is the most difficult challenge of CCM, according to one-third of survey respondents.
  • The majority of CCM tasks are conducted telephonically, say 88 percent of respondents.
  • Almost three-quarters of respondents — 72 percent — admit patients with hypertension to CCM programs, respondents said.
  • Healthcare claims are the most frequently mined source of risk-stratification data for CCM, say 72 percent of respondents.
  • More than half of respondents — 51 percent — include palliative care or management of advanced illness in CCM programs.
  • On average, each CCM patient is seen monthly, say 29 percent of respondents.

Source: 2015 Healthcare Benchmarks: Chronic Care Management

http://hin.3dcartstores.com/2015-Healthcare-Benchmarks-Chronic-Care-Management_p_5003.html

2015 Healthcare Benchmarks: Chronic Care Management captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease. This 40-page report, based on responses from 119 healthcare companies to HIN's industry survey on chronic care management, assembles a wealth of metrics on eligibility requirements, reimbursement trends, promising protocols, challenges and ROI.

Guest Post: 10 Medication Adherence Facts to Know in 2015

January 22nd, 2015 by Troy Hilsenroth

medication adherence

$105 billion of avoidable U.S. healthcare costs is due to medication non-adherence.

With 50 percent of Americans suffering from at least one chronic condition in their lifetime, medication management affects nearly everyone at some point. Whether an individual takes multiple medications or cares for a family member who is, the importance of taking medications as prescribed is highly undervalued. While missing a pill one day may seem insignificant, the effects of these habits can be highly detrimental and far-reaching, as guest blogger Troy Hilsenroth explains.

Not taking medication as prescribed, or medication non-adherence, can result in costly hospital bills, declines in patient wellness, and medical complications among other outcomes. Due to these very real risks, additional awareness about this serious public health issue is crucial moving into 2015.

Pharmacists already possess the patient care tools necessary to help with this problem. Patients need to access available tools to improve their medication adherence and educate themselves about their meds. The first step in reversing these trends is to promote education around the severity of medication non-adherence.

The following are ten medication adherence statistics to know in 2015:

  • In the United States, avoidable healthcare costs add up to $213 billion, of which $105 billion is due to medication non-adherence, according to the Express Scripts 2013 Drug Trend Report.
  • Non-adherence causes 30-50 percent of treatment failures and 125,000 deaths annually. 1
  • 64 percent of readmissions within 30 days are due to medication issues, according to HIN's 2010 Benchmarks in Improving Medication Adherence.
  • Medications are not continued as prescribed in about 50 percent of cases, according to a 2013 Centers for Disease Control and Prevention (CDC) presentation.
  • Nearly 50 percent of Americans have one or more chronic conditions that require prescription medications, according to the CDC.
  • Medication adherence is higher among patients who see the same healthcare provider each time they have a medical appointment. In this group, the average adherence is 81 percent, according to "Medication Adherence in America: A National Report Card," a recent report from the National Community Pharmacists Association.
  • Non-adherent patients are 17 percent more likely to be hospitalized than adherent patients, with a cost that exceeds that of an adherent patient by $3,575. 2
  • Generic medications have higher rates of adherence than name brand prescriptions, with 77 percent of patients adhering to generics as opposed to 71 percent with the name brand. 3
  • For some classes of medication, up to 30 percent of prescriptions are never filled by the patient, according to the Network for Excellence in Health Innovation (NEHI).
  • Patients receive 3.4 more refills per prescription in a 12-month period when their refills are synchronized, according to the National Community Pharmacists Association.

Medication non-adherence poses a very real risk for patients and their providers. A collaborative care team including physicians, pharmacists, and the patient is crucial to continuing education on this issue and establishing a medication management strategy to stay healthy and out of the hospital.

About the Author: Troy Hilsenroth has been with Omnicell for over six years, and currently serves as its vice president of the non-acute care division. In this role, he develops and delivers solutions to help organizations develop new and better ways of doing business and cultivates programs that change healthcare dynamics. Throughout his 22-year career in healthcare, his mission has been to deliver higher clinical quality at a lower cost. Prior to working at Omnicell, Troy served as a licensed clinical pharmacist for 14 years in a broad range of pharmacy environments, while also working as a firefighter and paramedic.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.


1. Smith D, Compliance Packaging; a patient education tool, American Pharmacy, Vol. NS29, No 2, February 1989.
2. A. Dragomir et al. (May 2010.). Impact of Adherence to Antihypertensive Agents on Clinical Outcomes and Hospitalization Costs. Medical Care, 48 (418-425). doi: 10.1097/MLR.0b013e3181d567bd
3. O’Riordan, Michael. (2014, September 15). Generics Beat Brand-Name Statins for Patient Adherence and Improving Outcomes. Medscape. Retrieved from http://www.medscape.com/viewarticle/831707