How medication adherence works
A new initiative from electronic prescribing network vendor Surescripts to offer physicians the medication histories of their patients is a big step toward improving medication adherence and patient outcomes.
That’s the view of Michael Mirro, MD, a cardiologist, informaticist and chief academic research officer at nine-hospital Parkview Health in Fort Wayne, Ind., which is serving as a pilot site.
Under the program, Surescripts will integrate histories into a provider’s patient panel through the provider’s electronic health record, population health management or analytics vendor. Providers, depending on their contracts, could be responsible for the costs that the vendor incurs.
Parkview Health has medication adherence programs for diabetics and other patients with chronic disease, most notably atrial fibrillation, which can cause blood clots or stroke, as well as heart failure.
Heart failure patients are particularly at risk if they are not adhering to their medication regime because they use an average of five different medications; if those patients don’t exactly follow the regimen, they are at risk of having a setback and being admitted to the hospital. That scenario also would put Parkview on the financial hook because of Medicare’s 30-day readmission payment policy.
These patients historically are tested monthly, but with new and more effective medications now available, they aren’t seen in the clinic as often as in years past, Mirro notes. Consequently, Parkview is looking for technology ways to keep medication adherence levels up.
That’s where the medication history becomes important, because it is easy to use data from EHRs or other systems to learn when refills are ordered and to be able to text or otherwise notify patients if they aren’t getting refills.
“The idea with medication history is to raise patient engagement,” Mirro says. “They think they are adhering well, but often have short lapses and with some drugs that can be disastrous.”
Surescripts’ new program is smart not just for provider and patients, but for the vendor itself, Mirro believes. “It’s a great business case from Surescripts’ view to keep patients out of the hospital. It’s a great tool to add to a HIT environment.”