Medication non-adherence is a national epidemic. A study by the New England Healthcare Institute reveals that medication non-adherence, sub-optimal prescribing, and improper drug administration costs the U.S over $300 billion annually. Additionally, over 20% of an employer’s healthcare costs are caused by non-adherence, and 50% of patients never take the medication as prescribed.
Poor medication management derives from the inability for providers to understand and utilize prescription usage data to improve outcomes. PrognoCIS has recently taken a step toward creating value-based outcomes with medication management for adherence technology from Surescripts.
What is Medication Management for Adherence?
Medication Management for Adherence is a type of population health analysis by Surescripts, integrated into PrognoCIS EHR. Surescripts analyzes prescription usage data from Pharmacy Benefit Managers (PBMs) and funnels the relevant information into PrognoCIS. Providers are given real-time messages about:
- Drugs that should be taken, but weren’t prescribed
- Medications that could cause adverse side effects
- Medication not being taken properly (non-adherence)
With Medication Management for Adherence, patients receive more informed care for better outcomes, and physicians are empowered with timely, targeted information to improve adherence.
How Medication Management for Adherence Works
PrognoCIS has integrated functionality of Medication Management with Physician workflow. With Medication Management for Adherence, prescription benefit managers report prescription usage data to Surescripts in form of messages, which are promptly reported to providers through the Surescripts Accelerator. The Surescripts Accelerator is a medium provided by Surescripts that has been integrated and implemented in PrognoCIS.
Surescripts Accelerator enables users to:
- View medication management messages.
- View the patient’s adherence summary, PDC ratio.
- Submit a response to a medication management message.
- Allow worklist tracking to manage tasks requiring attention.
Consider typical scenarios where Medical Management Adherence provides a solution:
Medication Adherence: Kara has been prescribed medication along with its refill, but she doesn’t finish her course and drops it mid-way. She does not bother to pick up her refill. When a Patient hasn’t followed the Prescription to the ‘T’ then the PBM updates Surescripts with such information and the Surescripts notifies the patient’s Provider by sending across a message through the Surescripts Accelerator.
High Risk Medication: Lane is a 73 year old elderly patient who has been prescribed a non-benzodiazepine hypnotic medication in his prescription. Long-term use of non-benzodiazepine hypnotic medication is not recommended as tolerance and addiction can occur. It should be specifically avoided in elderly patients. When medications that may turn out to be a high risk for patients, depending upon a Patient’s diagnoses, age and other factors is brought to the notice of the Prescriber through messages sent on Surescripts Accelerator.
Missing Medication: When a Patient has been prescribed with medications but a medication that is expected to be present based on a Patient’s diagnosis codes is missing in the Rx, or if there is existence of another drug. For example of the message displayed: “ABC Health Plan records indicate this patient may benefit from a statin. Please evaluate the use of a statin for a diabetic patient.”
PrognoCIS and Medication Management for Adherence
PrognoCIS implements Medication Management for Adherence with a Face Sheet that displays information coming from PBMs based on Patient’s active eligibility and plan. Based on the eligibility fetched for the patient, an alert is displayed on the Face Sheet. The popup displays the message for the provider and the Lowest Proportion of Days Covered (PDC) score. The Proportion of Days Covered Score is the percentage of adherence, how long the patient has been diagnosed, and how long the patient has been taking the drugs etc.
PrognoCIS and Surescripts Solving the Medication Non-Adherence Problem
Improper medication management must be tackled from multiple fronts. PMBs must create and be involved in programs which create and promote physician engagement, and EHRs need to work with physicians to improve the prescription-to-patient workflow. We must proactively provide information to both physician and patient about improper medication management for better outcomes.
Learn more about Medication Management for Adherence on the Surescripts website.