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    Toward Better Meds-to-Beds Programs

    Technology is creating a system to identify patients in need of medication help at discharge.


    New technology could help pharmacists identify patients at high risk for nonadherence before they leave the hospital.

    Nonadherence, particularly immediately after discharge, continues to be an obstacle for the health-care system and has been linked to higher readmission rates, greater costs, and worse health outcomes.

    However, by using new technology and intervention strategies, health systems can partner with on-site ambulatory care pharmacies to improve the success of meds-to-beds programs and plan specific targeted interventions that are focused on those patients who need it most.

    On-site ambulatory care pharmacists often have the skills and resources necessary to help position high-risk patients for success after discharge, but in many cases these pharmacists may not be used to their fullest ability.
    “[Health systems] have a tremendous resource of having a pharmacy on campus and yet, in many ways, this resource really isn’t being leveraged as a hub for med adherence,” says Neil Smiley, CEO of Loopback Analytics, a software service platform.

    Related article: Addressing unique medication adherence issues for patients with schizophrenia

    To help target patient interventions, Loopback Analytics uses data analytics to identify patients who are at high-risk for an adverse outcome. These data integrate hospital electronic medical records, information from prior hospitalization, discharge medications, and patient fills. They can then be used by pharmacists to identify patients within a hospital who may benefit most from extra attention or interventions before they are sent home.

    “You’ve got an opportunity now to engage with them and set them on the right course before they transition to their next care setting, wherever that might be,” Smiley says.

    On-site pharmacies typically don’t have the resources to provide extra counseling and support for every patient, but by targeting those who are at the greatest risk for nonadherence or other concerns, pharmacies can use their resources in the most effective manner.

    “Doing a meds-to-beds program, you’ve got a limited number of resources—obviously, they cost money. If you have a pharmacy tech who is rounding at bedside—if you use that resource indiscriminately, then you are not really going to be getting to the patients who are most in need,” Smiley says.

    Reducing readmissions

    Pharmacies that have used this more-targeted approach in their meds-to-beds program are already starting to see success.

    Related article: Medication adherence pays off for patients, payers, and community pharmacy

    The University of Tennessee Medical Center started a pilot program using the technology in mid-September as a strategy to improve their concierge service or bedside delivery program.

    Prior to the pilot, the medical center had a concierge program, but they weren’t identifying specific individuals and were relying on nurse referrals or patient knowledge of the program to foster participation.

    “We weren’t getting any huge buy-in and we weren’t really targeting anybody,” says Troy Rebert, DPh, Assistant Director of Pharmacy for the University of Tennessee Medical Center.

    Up next: How the program helped patients

    Jill Sederstrom
    Jill Sederstrom is a Contributing Editor


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