Healthcare’s Shift to Value-Based Care
The days of fee-for-service care are quickly fading from the rearview mirror. Instead, healthcare organizations are staring into the headlights of value-based care.
The transition to a quality-based model is neither quick nor easy for most organizations as physicians struggle to see more patients, deliver better care—and comply with an ever-increasing number of governmental regulations. Yet the hourglass has finally run out. Eligible physicians are now facing penalties from CMS for non-compliance with its quality reporting and Meaningful Use initiatives, as well as with its Value-Based Payment Modifier program.
The good news is that there have been significant technology enhancements in recent years—such as mobile medication management—that can empower physicians with the knowledge, access and ability to comply with government requirements while achieving the end goal of optimal care at lower costs.
Present Day Challenge: You’re Mobile, But Your Technology Isn’t
Let’s examine a typical day in the life of the overtaxed physician who is responsible for providing care for patients while being impeded by administrative demands. During hospital rounds, the doctor receives a patient request on her mobile phone for an urgent prescription renewal, causing her to pause her rounds, call the office, ask a nurse to write the electronic prescription and send it to the pharmacy. How much easier would it be to just write and send the renewal from the same phone? Instead, in the current scenario, the pharmacy may receive the prescription the first time it’s called or faxed in—or it may take two or even three attempts. This all-too-familiar scene poses three issues, all of which can impact patient care:
• Doctor spends precious time calling in, waiting for a nurse to respond and communicating the information, taking her away from direct patient care delivery during that time.
• Transcription mistakes can occur easily, leading to medication errors.
• Patient may experience delayed care, with the risk of impacting long-term health.
Taking It to the Streets—or at Least Beyond the Hospital’s Four Walls
Regardless of location, with mobile medication management technology, doctors can leave labor-intensive prescribing processes in the dust. Now, with technology literally at their fingertips, physicians can electronically and quickly prescribe the desired prescription, securely transmitting it directly to the pharmacy.
Additionally, with seamless integration between mobile medication management solutions and a hospital’s or practice’s EHR, the physician benefits from automated population of patient demographic information into the script, decreasing the risk of human error. Further, this EHR integration produces even greater efficiencies by allowing the physician to stay within her normal workflow.
The ability to sync with an EHR also enables a mobile medication management solution to keep the medication list on a doctor’s mobile device up to date and supply drug/allergy alerts, both of which contribute to enhanced patient safety and clinical decision making at the point of care.
Bringing Drug Price Transparency to the Point of Care
A key element of successful medication management is medication adherence. The number one reason for non-adherence is high out-of-pocket prescription costs, a fact underscored by the recent Truven Health Analytics-NPR Health Poll. This study found that 67 percent of respondents who did not fill their prescriptions cited cost.
With the latest mobile medication management technologies, clinical prescribers can verify in real-time—at the point of care—the patient’s specific insurance coverage and out-of-pocket cost for a given prescription at various in-network pharmacies, as well as identify cost-effective therapeutic equivalent drugs.
Embracing this newfound price transparency, providers and patients are beginning to collaborate in creating more realistic, affordable and relevant patient care plans, resulting in expanded patient engagement, medication adherence and overall outcomes.
Technology To Help Identify & Prevent Opioid Addiction
Mobile medication management can also be useful in preventing opioid addiction in several ways. First, the recent and rapidly growing integration of state prescription drug monitoring programs (PDMPs) into mobile medication management technology offers providers critical insight into a patient’s prescribing history, prior to determining the appropriate medication—and potentially helping to identify a patient at risk of addiction, or one currently in need of “medication-assisted treatment” and related counseling.
Second, the ease of prescribing controlled substances and other drugs in a single electronic workflow makes prescribing more efficient, supporting the trend of prescribing smaller volumes of opioid drugs for acute scenarios, such as post-surgery. With the recent CMS proposal that, beginning in 2019, initial opioid prescriptions for acute pain be limited to seven days, physicians will be looking for convenient, mobile medication management technology that accommodates their busy schedules and supports both the initial fill and the potential for refills should the pain become chronic.
On the Horizon: A Sustainable Care Model
Although the healthcare industry’s transformation from fee-for-service to value-based care will not be without obstacles, it’s clear that aligning the stakeholders along the axes of more patient- and physician-friendly, efficient care and lower costs will, eventually, yield a sustainable care model. One of the ways to best support this value-based care journey is for healthcare organizations to embrace technologies such as mobile medication management so that clinicians gain the tools, data and access to vital patient information, enabling them to deliver the best—and most cost-effective—care possible for each patient, every day.
Tom Sullivan, MD, is a board-certified cardiologist and internal medicine specialist with over 40 years of clinical practice. He is chief strategy officer for e-prescribing and medication management solutions company DrFirst.