LIFE St. Mary, a hospital in the Trinity Health Mid-Atlantic health system, had a manual process to request medication refills and fill pillboxes.

THE PROBLEM

The pharmacy was not integrated with the electronic health record and it did not have full bidirectional electronic prescribing.

Medication lists were not accurate and there was no ability to confirm the last refill date or patient compliance. The health system had medication errors that led to emergency room visits as well as general adherence concerns that were hard to identify.

PROPOSAL

“Tabula Rasa HealthCare has a sophisticated pharmacy IT platform that upgraded the manual processes as well as adding in patient safety features,” said Dan Drake, president of continuing care at the Trinity Health Mid-Atlantic health system based in Philadelphia, Pennsylvania.

The health system partners with Moorestown, New Jersey-based Tabula Rasa HealthCare, using its technologies to benefit the health system.

"For LIFE St. Mary, at the corporate level we have been satisfied that we replaced manual process and gained cost savings early on after implementation, and at the patient level we have been satisfied with the simple adherence packing and the seamless refill process."

Dan Drake, Trinity Health Mid-Atlantic

For example, each medication is dispensed electronically into adherence packing so LIFE St. Mary was able to replace the tedious, labor-intensive process that was prone to human error with an electronic filling process with an error rate of .006%, Drake explained.

In addition, the provider organization decreased nursing costs, dramatically improved staff and patient satisfaction, and decreased medication errors to below 1% in the first year, he added.

“The IT implementation team was very experienced, and the transition was well managed over a short time period,” he said.

MARKETPLACE

There are many vendors of pharmacy information systems on the market today. Some of these vendors include Allscripts, Cerner, CPSI, Epic, Healthcare Management Systems, Horizon Meds Manager, Meditech, Mediware, Netsmart and Siemens.

MEETING THE CHALLENGE

Previously, medication lists were accessed by a few clinical staff members at the time of a face-to-face encounter. The IT cloud-based pharmacy platform dramatically changed access to all staff.

“Training was simple and clinical staff had access to real-time medication lists 24 hours a day,” Drake said. “The system accessibility has been a major advancement in providing care safely across the continuum of care, communicating with emergency rooms, hospitals, caregivers, and patients after hours and on the weekend.”

One additional technology added was the e-messaging capabilities that allow a prescriber to message the pharmacy team live. This bidirectional concurrent communication addresses immediate concerns, such as urgent community fills, or drug-drug interactions.

“The state-of-the-art e-messaging system with the pharmacist is not only quick and efficient, so the total prescribing and processing time is minimized, but also it adds an extra superior level of patient safety,” said Dr. Donna Raziano, medical director at LIFE ST. Mary, and a board-certified geriatrician.

RESULTS

The hospital has decreased emergency room utilization by 16% and decreased total hospitalization rates by 27%.

“This has been attributed to improved patient medication adherence and improved oversight by all levels of clinical staff,” Drake explained. “In addition, there has been an improvement in unnecessary medication refills due to the IT capabilities to minimize waste.”

ADVICE FOR OTHERS

An IT platform should have exceptional ease of functionality, improve care delivery, decrease FTE costs, improve patient safety, and have level-of-prescriber engagement, Drake advised.

“For LIFE St. Mary, at the corporate level we have been satisfied that we replaced manual process and gained cost savings early on after implementation, and at the patient level we have been satisfied with the simple adherence packing and the seamless refill process,” he added. “Tabula Rasa HealthCare has added tremendous value to our organization.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com
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