Pharmacies and Home Medical Equipment (HME) providers can gather patient data to improve patient medication adherence, set up synchronization programs and increase revenue. Analyzing dispensing and demographic information from pharmacy claims, medical records, patient-satisfaction surveys and online patient portals can also assist with identifying adherence outliers – patients who are not taking their medications on time or not changing out their supplies as often as prescribed. It can also help pharmacies bring patients into compliance with their medication regimens, which will not only improve their health outcomes but can increase a pharmacy’s Five-Star Ratings and reimbursements.
The concept of data collection is not new. A 2014 study in the Journal of the American Medical Informatics Association conducted research into “aggregating and displaying clinically relevant data that can identify problems with medication adherence and facilitate patient-provider communication about strategies to improve medication use.”1 In summary, the study found that medication adherence is a challenge that requires participation by the patient and provider and a connection between electronic health records, clinical support and patient-controlled technologies. The study concluded with the recommendation that “(f)uture research should focus on integrated strategies to provide patients and providers with the right combination of informatics tools to help them adequately address the challenge of adherence to complex medication therapies.”2
As the industry grapples with the best way to collect data and how to use it to improve patient health, pharmacies are being financially incentivized to have high adherence scores, leading them to purchase adherence services from vendors in an effort to ensure patients have the supplies and medications they need. Adherence results in higher ratings for pharmacies and an overall reduction in healthcare costs. Additionally, lab values and genetic information can be gathered to offer at-risk patients specialized attention.
While pharmacists and providers can’t force patients to use their supplies, or use them correctly, they can ensure patients have what they need to start, continue or complete therapies at the appropriate time. With QS/1’s integrated HME and pharmacy management systems, providers can collect patient data through International Classification of Diseases (ICD) 10 codes that classify diseases and other health problems. Patients who need equipment that requires additional supplies are ideal candidates for this type of data collection. Oxygen, continuous positive airway pressure (CPAP) therapy or wound-care patients are most likely to benefit since recurring supplies are needed to use the equipment properly. Patients who use crutches are not ideal, since they are typically only used once.
Reports that include patients who are not regularly picking up their supplies are a beneficial tool and provide valuable data. Comprehensive, flexible reporting provides the opportunity to not only spot patient trends but also opportunities for recurring revenue. Data can be used to determine how certain outcomes were achieved, and organizations can then identify and implement best practices.
Providers and their partners, if provided accurate information, can make a great team. In addition to identifying which patients are using particular equipment, reports can also identify opportunities to provide patients with supplies they need to use their equipment properly. For example, patients using CPAP machines would also need to purchase masks, tubing, etc. If patients understand the severity of their medical conditions, believe they are capable of taking their medications properly, can afford them and remember to refill them, they are more likely to adhere to their medication regimens.3 It is up to the healthcare industry and lawmakers to set them up for success.
1,2 Dixon, Brian E. “An Informatics Approach to Medication Adherence Assessment and Improvement Using Clinical, Billing, and Patient-centered Data.” NCBI. Journal of the American Medical Informatics Association, 27 Sept. 2013. Web. 23 Nov. 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3994862
3 Aslam, Imran, MD, and Steven R. Feldman, MD, Ph.D. “Practical Strategies to Improve Patient Adherence to Treatment Regimens.” Medscape. Southern Medical Journal, 2015. Web. 23 Nov. 2016. http://www.medscape.com/viewarticle/846427_2