Publisher's Window: March/April 2013

Patient Care

In reading the company profiles in this issue, I was impressed by the efforts of the system vendors to help pharmacists initiate programs that will encourage adherence to a person’s medication regimen and improve outcomes. This is being done in a number of ways. Using IVR systems to remind people of refills coming due is one approach, and reminding people via IVR that their prescriptions are ready for pickup is another. There is now access to software to implement synchronization programs so all refills come due on the same day. There are packaging systems designed to improve adherence, and pharmacists are finding that they can charge for this service. Even apps for mobile devices have been introduced to promote adherence.

There is plenty of evidence that pharmacist intervention can make a difference. And with the decline in the number of primary-care physicians, pharmacists have an opportunity to pick up the slack. Pharmacists certainly have the technology tools and knowledge to do so. Adherence programs fit nicely with medication therapy management (MTM).

That said, the American Society for Automation in Pharmacy (ASAP) developed a standard for MTM information exchange a few years ago. The purpose was to allow pharmacists to receive alerts directly into their pharmacy management systems for patients who qualify for MTM interventions. OutcomesMTM is now supporting this ASAP standard, and is reporting growing participation in MTM programs as a result. This is good example of how pharmacy management systems can be used to make a process more efficient. 

In addition to receiving the opportunity alerts in the pharmacy management system, we are seeing functionality built into the systems to document and bill for this type of service. 

System vendors respond to what their users are asking for. Apparently, the interest is there for MTM functionality. I see this as a positive development for pharmacy in positioning the profession to engage in health information exchanges. Will the next step be a pharmacy-specific electronic health record (EHR) that will interface with the pharmacy management system? Perhaps, but don’t expect incentive payments from the government to install such a system.

On the topic of incentive payments: There was a front-page article in The New York Times on Feb. 20 about the money being raked in by the companies selling electronic health record (EHR) systems. It appears that these companies did a full-court press on the White House and legislators in Washington to include incentive payments in the 2009 economic stimulus bill to encourage physicians and hospitals to install EHR systems. The pitch was how these systems could lead to more efficiency in healthcare delivery and better patient care through interoperability. As of February, CMS has given out over $12 billion in incentive payments to providers complying with the meaningful-use criteria established by the government. This is a significant price to pay to gain adoption of these systems when EHRs are getting mixed reviews by the users. What I have read is that EHRs add five to 10 minutes to a patient encounter, interoperability with other systems isn’t always the case, and they are difficult to use.

I will close on that note. CT

Bill Lockwood, chairman/publisher, can be reached at wal@computertalk.com.


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