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QuickMAR president and co-founder Stan Turner talks with ComputerTalk’s Will Lockwood about how electronic medication administration records (eMARs) are supporting care collaboration. Hear how the technology is helping pharmacies and facilities gain an edge in patient care by creating new and better data flows that help track improved performance.
ComputerTalk: Let’s start with a little bit of background first.
Stan Turner: My background is in long-term care. And when I first got into the industry it was very clear to me that there had to be a better way of managing medications and taking better care of the residents from a medication standpoint. And so, at the company I worked with at the time, we developed our own internal solution to help manage medications. Then later, about 2007, we opted to commercialize that, and that’s how QuickMAR got started. Our purpose really was to do all we could to improve patient safety and improve efficiencies.
That’s kind of how we got started in the system. We have grown tremendously, and we’ve been really well received in the market.
CT: Let’s talk specifically about how eMARs are contributing in the new world of pharmacy, where there’s a lot of emphasis on collaboration and on plans measuring performance.
Turner: First of all, for pharmacies that use our product, it gives them a whole new level of visibility into their client base. I mean, before this, they would maybe have a medication profile in their system, but once they printed out the paper MARs [medication administration record], they lost a lot of that. If a drug was added that the family provided or some other pharmacy provided, then that printed MAR didn’t show the whole picture. With our software, they can actually get the full picture of exactly what’s happening in the building, with a specific patient. They can view their complete profile and see not just what their medication profile looks like at the moment, but they can track changes as well. They can see if medications aren’t being taken, for example if the patient is refusing them. There’s just an entirely different level of visibility. And the pharmacy can use that to whatever degree it wants.
We have some clients that exercise a small degree of oversight based on the eMAR information, and some that are very, very engaged in keeping track, watching changes, and looking for any issues that might surface. With the increased visibility comes more opportunity to have a positive impact on the patient.
CT: Have you found that the current emphasis on measuring performance has encouraged people to look at eMARs in a different way, to use them in a different way, to look at expanding the features they use?
Turner: Information that was kind of hidden before or very difficult to find is now really at your fingertips, whether it’s missed medications, all new orders, or all changes, or whether you want to see if somebody changed their med pass time from 7 a.m. to 8 a.m. Those are things that you would only see if you actually had the paper MARs in front of you before. Now our pharmacy partners have a dashboard within the eMAR where they can view the important information that they need. For example, in the scenario I just gave, the med pass time changes from 7 a.m. to 8 a.m. For a pharmacy that offers packaging, it’s crucial that they know about that change to ensure that the packaging is correctly labeled.
CT: How does this access to timely data impact reporting and metrics that can be important?
Turner: One good example here is when a facility can run a report that shows meds that are about to expire, which is something that they never had visibility into before. Or when a surveyor is coming out to a home, there are reports that they can run to make sure all the documentation is up to date and accurate.
From the pharmacy standpoint, there are just a variety of reports — it kind of depends on what’s important to them or what their issues have been. We have some great re-order reports, for instance, or expiring-orders reports. Pharmacies can see what kind of medication turnover a patient is experiencing, and then ask, “Why is this profile changing so much? Is there something we need to do to maybe stabilize things there?” There are also quality reports that they can run on a specific home to see certain key performance indicators. Is there a lot of manual entry as opposed to automated entry? Are they seeing overrides?
For those pharmacies that truly try to be a partner with their homes, this can make a huge difference. They can be involved and say, “Hey, what are some things we can do to help you guys improve your performance and improve the safety of the residents?”
CT: That’s got to be a great way to make sure that the pharmacy-facility relationship stays solid.
Turner: Right, it is. I want to talk about reimbursement briefly, and how that can be put at risk during surveys and audits. We have some tools that help. For example, we have the ability to attach digitized documents to a specific order. So if the surveyor wants to see this doctor’s order, they just go in and pull it up. They can see the actual order, as opposed to going back through files to try to find that order. This also helps the pharmacies when they are going through audits. They have got to produce documentation, too.
CT: What role are eMARs playing as a competitive differentiator now?
Turner: I see two types of pharmacies that partner with us. There’s the ones that are reactionary. They are the ones who come to us and say, “Hey, I’ve got a couple of homes that have said they want an electronic MAR. If I don’t help them find one, they are going leave and go to a different pharmacy.” They are very much reactive. They provide the eMAR and that’s about it. They aren’t extremely engaged. They don’t promote it to the rest of their clients.
Then we have quite a number of our pharmacy partners who have a vision. They are taking the lead and they understand what electronic MARS can do for them and their clients. They go out and promote it. They explain how it makes economic sense and how it makes sense from a safety standpoint. These are our clients that go out and experience tremendous growth in their bed counts because they are offering superior service. We have clients that, within about a year and a half, have tripled their business and largely because of offering an eMAR as part of their great service. It’s a real impetus for them to grow very fast. I wish I could get more of these pharmacies to where they actually catch the vision and realize, wow, we can really revolutionize the way that things are happening.
CT: There is this drive to connect pharmacy to the overall healthcare system. How do you see eMARs tying in?
Turner: With our software, the direction we are continuously moving in is to try to take this amazing data that we have — all the meds, all the administration records, the PRNs, etc. — and try to connect that with the overall condition of the patient. Are there falls? Is there an increasing amount of confusion? Whatever they might be experiencing, can we relate that to their medication profile? That’s the direction we are heading. We have got some tools in place. We have got some great data. We think we are sitting on a great opportunity, and we are trying to take advantage of that to really create the link between the medication profile and administration record and outcomes.
There’s clearly a benefit for the homes and for the patients. And I believe this could help pharmacies as well, because they could be involved in coming up with a solution if they see some correlation, some causation there, because of the data they have access to. They could be involved with the doctor and figure out what they can do to improve outcomes for a patient. CT