Identity and insight: How the evolving pharmacist role includes risk mitigation
Craig Ford, LexisNexis Risk Solutions
The pharmacy industry has worked tirelessly on strategies and solutions that minimize dispensing errors. But this is merely one component of pharmacists’ increasingly complex role in the delivery of healthcare services.
Patients view their pharmacists as the most accessible members of their care team, available for “walk-in” consultations on a moment’s notice. Physicians, too, rely on pharmacists to assist with patient and medication management in achieving positive outcomes. Consider the burdens of HIPAA challenges, the opioid crisis, medical fraud, and record matching errors, and the neighborhood pharmacists have a lot on their shoulders.
The right technology and analytics can go a long way to help pharmacists better serve an engaged community on the path to improved health. Maintaining a secure and accurate system for managing patient records is vital. Understanding who the patients are and how to best serve them are the next pieces of the puzzle that must be solved across the industry.
Entering information into the wrong patient record (having multiple patient records open, side by side, or overlaying patient records);
Untangling (i.e., separating) co-mingled patient information; and
Mistakenly creating duplicate charts.
In pharmacy specifically, on average, seven wrong-patient errors happen each month at every location in the U.S. These errors can happen anywhere along the chain of care and can impact any number of record components, jeopardizing the safety of pharmacy services. Errors lead to unintended consequences of wrong patient, wrong medication, drug interactions, confidentiality breaches, serious health conditions left untreated, or worse.
To serve a community of patients, the pharmacy must be confident it is dispensing the correct medication to the right patient. The simple first step is maintaining a complete, accurate, and up-to-date patient record so that patient health is not in jeopardy. This is accomplished by resolving, matching and managing patient identities through advanced linking technology and a large referential database comprised of multiple sources of information. Such level of verification not only improves the safety and security of pharmacy care, it also enables reduced operational costs and streamlined processes surrounding the patient experience.
Engagement through understanding
Once the pharmacist dispenses the right prescription to the right patient, the next step is to confirm the patient understands the regimen and is committed to adhering to it. Solving this conundrum is now part of the pharmacist’s changing role. Personally knowing the life history and treatment details of each and every patient is, unfortunately, not practical. But personal attributes based on social determinants of health can provide pharmacists with information that impacts health, engagement and outcomes.
Medication adherence continues to be a major drain on the healthcare system, impacting patient health outcomes significantly. Between $100 and $300 billion of avoidable health care costs have been attributed to medication nonadherence every year,3 representing 3 to 10 percent of total U.S. healthcare costs in increased service utilization, preventable hospitalization, and development of comorbidities.
Moreover, the proportion of people taking five or more prescription medications doubled from 2000 to 2012, and currently about half of patients with chronic diseases don’t take their medication as prescribed.
Pharmacists’ growing role in managing patients—especially those with complex conditions—is one of care consultant, and with this responsibility comes a need for understanding risk drivers. Patients are impacted by the social, economic and environmental factors of their day-to-day lives. Education, literacy, finances, and a person’s degree of social isolation—to name a few—all impact health outcomes.
Making this information available at the point of care within the pharmacist’s workflow could be transformative. Imagine if a pharmacist knew that a patient recently declared bankruptcy and was undergoing financial hardship. She could inquire about low-cost options with the provider, and discuss challenges of adherence with the patient. If there were transportation problems, she could suggest mail-in prescriptions or help educate the patient on ride-sharing or public transportation. The pharmacist could also simply be alerted that a particular patient had a low adherence score, responding by giving a few extra minutes of medication counseling to the patient.
As the pharmacist’s role evolves in the era of value-based care, they need to zero in on patients who specifically need help. The socioeconomic factors present real barriers for patients, and the industry should embrace the technology that can address them: the stakes are too high to ignore them.
As key collaborators on the patient care team, pharmacists can improve health outcomes and help contain costs. But most importantly, they can enhance their patient relationships and grow trust their communities already place in them. By achieving and maintaining a greater understanding of the population served, pharmacists can mitigate risks with the right data at their fingertips.