The hospital pharmacy typically accounts for up to 15% of a hospital's annual operating costs, but is an often-overlooked resource for improving financial performance, increasing patient safety and satisfaction and reducing readmissions. The hospital pharmacist can be an effective yet usually under-leveraged asset who can add value all along that continuum of care.
They can make a substantial and measurable difference, but they need help.
Empowered by innovative technology and augmented by modernized telepharmacy services that can seamlessly assume responsibility for processes that do not require the involvement of an on-site professional can free the hospital pharmacist to become a more integral and valuable contributor to the interdisciplinary healthcare team's ability to deliver an even higher level of patient-centric care.
The advantages of a fully integrated hospital pharmacy – and pharmacist – are clear. Medication management issues are among the top contributors to unnecessary readmissions post-discharge. Involving the hospital pharmacist at intake and throughout the continuum of care decreases the chance of an adverse medication event while the patient is in the hospital and later at home. For instance, effective medication management during transitions of care, particularly during discharge and at home, can reduce costs and unnecessary readmissions by up to 50%, improve the patient experience and satisfaction, and ultimately outcomes.
Hospitals need the right technology tools in place to power the kind of pharmacy operation that can achieve real, sustainable results. Leading hospitals throughout the country are focusing on four key technology tools as the mainstays for a pharmacy operation that can have a material impact on overall hospital performance:
1. Tablet Technology: In the emergency room, real-time access to inpatient, mail order and retail prescription claim data available to pharmacists and accessible through tablet technology ensures physicians are aware of all medication regimens the patient may be taking, and can factor that information into the diagnosis and treatment. At discharge, face-to-face coaching by a hospital pharmacist eliminates medication redundancies, allows for the discontinuation of medications no longer necessary and is the opportunity for the patient and caregiver to receive critical education on the drug regimen to be followed at home.
2. Video conferencing capabilities, whether by using hand-held devices, smart phones, tablets or a computer, expand the reach of the pharmacist and allow for greater patient access to pharmacy services. Face-to-face video consultations with patients who have returned home to recover can be easily scheduled within 48-72 hours of the patient being discharged, heading off medication management issues before they result in an adverse event and maintaining touch-points with the patient during the critical 30 day post-discharge period.
3. Complex Software Platforms have allowed for the seamless integration of hospital software with that of a remote pharmacy, creating a cost-effective means of augmenting existing staff or expanding pharmacy operations to 24/7/365. The remote pharmacy's software operations mirror and function identically to that of the hospital's pharmacy, ensuring continuity of care, patient safety, HIPAA compliance and quality monitoring for peer-to-peer interaction. With on-demand access to remotely located certified pharmacists, a hospital is better prepared to meet higher patient volume, emergencies or to staff during vacations. Additionally, the remote pharmacist can assume responsibility for orders and medication reconciliation, freeing the on-site pharmacist for rounding with the medical team, consultations with patients prior to discharge and to facilitate in-hospital patient transitions.
4.Mobile Applications: Newly emerging mobile apps are putting up-to-the-minute and on-the-go information into hands of hospital leadership. This increased visibility into pharmacy operations and performance empower hospital executives with the actionable, relevant, timely information they need to make decisions on staffing and drug purchases on a just-in-time basis, improving costs and helping to maintain a high level of patient care and safety.
Evolving to a 21st century in-hospital pharmacy involves more than updating processes, procedures and software to meet the higher level of quality, accountability, reporting and compliance that is expected post-healthcare reform. Integrating technology and telepharmacy services into a pharmacy's operations will fully optimize the hospital pharmacy's performance and better position it to meet the needs of a patient-centric care model.
1The Impact of Follow-up Telephone Calls to Patients After Hospitalization,Dudas, Bookwalter, Kerr, Pantilat; Am J Med. 2001; 111(9B):26S-30S.
Jeff Lackman has over 30 years of pharmacy management experience, in retail, hospital and hospital systems. He joined CPS 13 years ago. In 2012 he was promoted to Division Vice President over CPS' telepharmacy resources, Rx Remote Solutions. That group has quadrupled in that time.