Technology That Helps You Implement Medication Adherence Services

America’s Other Drug Problem

Medication non-adherence has long been acknowledged as a serious problem for the American healthcare system, costing $106 billion annually and resulting in the premature death of an estimated 125,000 Americans each year.

Studies indicate that for every 100 prescriptions doctors write, only 50–65% are actually filled. Of those prescriptions that are filled, only 25–30% are taken by patients as directed and only 15–20% are refilled. According to The Express Scripts 2009 Drug Trend Report, procrastination is a primary factor in why 80–85% of prescriptions are never refilled by patients.

Pharmacists Are Part of the Solution

Increasingly, the healthcare industry is looking to pharmacists, particularly community pharmacists, to play a key role in solving the medication adherence problem.

New business models are emerging and reimbursement for medication therapy management (MTM) is getting more attention. A recent article in Drug Topics (“Is MTM Ready for Prime Time?” January 15, 2011) asserted that “Medication therapy management is looking like the next new career opportunity for pharmacists as the Patient Protection and Affordable Care Act, health plans, and employers press for its adoption.”

Pharmacists are interested in taking steps to improve medication adherence because doing so represents an opportunity to improve patient health outcomes, tap new revenue streams, and strengthen customer relationships.

Technology is a Prerequisite

Before pharmacists can implement medication compliance programs, they must find ways to replace their current daily tasks, reorganize their pharmacy, and implement technology that enables them to efficiently and profitably offer clinical services.

Ways that community pharmacists can use technology to improve medication adherence and increase revenues include:

• Implementing a pharmacy management system. Pharmacy management systems can decrease the amount of time spent on administrative tasks, freeing up a pharmacist to spend more time with patients and on value-added clinical services.
• Accessing electronic health records (EHRs). The Drug Topics article indicated that having organized patient information is an important prerequisite in a pharmacist’s MTM review, and is not something pharmacists want to invest significant time in. Pharmacists need to be able to quickly and efficiently access patient information and EHRs.

Pharmacy management systems that are HL7 enabled have the ability to support interoperability between pharmacies and other clinical systems. When pharmacists can electronically access their patients’ medical records, patients receive more holistic care from each member of their healthcare team.

• Automating refills. Today’s leading pharmacy management systems, like McKesson’s EnterpriseRx, simplify the refill process for both the pharmacy and the patient by tasking the system, rather than the patient, with initiating the refill.

In some systems, Enhanced Refill Processing (ERP) will automatically refill patient prescriptions for maintenance medications as they come due. If a patient is out of refills for a prescription, the system will electronically transmit or fax a refill authorization request to an eligible prescriber long before the medication is needed by the patient. Once the authorization is electronically sent back to the pharmacy, the software will automatically move the prescription back into workflow so a technician can proceed with dispensing. This automated process adds efficiency and saves time in the pharmacy. It also simplifies the process for the patient and improves compliance since it eliminates the need for the patient to request a refill or contact their doctor.

• Utilizing IVR. Outbound IVR calling is another technology that can enhance medication adherence. An adherence-focused IVR system will automatically phone a patient when a prescription is ready to be picked up. Some IVR systems will also automatically follow up with patients if they haven’t picked up their medication after a certain number of days. Pharmacies using these IVR features have seen a measurable decrease in the number of prescriptions not picked up by patients.

Each of these advances in technology helps pharmacists take the lead as medication adherence advisors to their patients. Yet, there is still plenty of work ahead in both technology development and operational changes behind the counter. As the role of the pharmacist continues to evolve, McKesson will focus on providing innovative technologies to help pharmacists serve more patients, offer more services, and drive better results.