Telepharmacists Reduce Hospital Readmissions

Transcription

1 Telepharmacists Reduce Hospital Readmissions

2 Casondra Kleven, PharmD PGY1 Pharmacy Resident University of Cincinnati/ Medication Managers, LLC Brad Hein, BS, PharmD, BCPS Associate Dean for Professional Education & Assessment James L. Winkle College of Pharmacy University of Cincinnati Josh Postolski, PharmD Clinical Consultant Pharmacist Medication Managers, LLC Craig Stiens, BS, PharmD Executive Vice President of Pharmacist Operations Medication Managers, LLC Bethanne Brown, PharmD, BCACP, TTS Associate Professor James L. Winkle College of Pharmacy University of Cincinnati

3 Background The Baby Boomers Large shift of population into the over 65 year old age group. Largest consumer of Health Care. 1 Transitions 41 Billion dollar problem 78% of admissions are preventable 2 66% of readmissions 3 are med related Medications 13% of the population consumes 34% of the medications 4

4 Care Gap Lack of proven systematic transition of care approach for vulnerable populations as they move between levels of care

5 Solution Pharmacist led virtual medication reconciliation Medication Expert The pharmacist is best positioned to provide actionable counseling Critical Juncture Discharge is a critical transition for a patient and last opportunity for intervention before the patient is back home Geriatric Focus Most vulnerable and fastest growing segment of the population

6 How It Works Nurse Pharmacist Patient

7 Patient Portal View

8 Service Aims Improve patient care Reduce discharge time Optimize medication regimen Increase patient adherence Reduce hospital readmission rates

9 Aim Based Service Assessment Average Discharge Consultation Time Patient Adherence (MMAS-4) Hospital Readmission Rates Patient Satisfaction (Likert Scale)

10 Assessment Demographics Experimental Group (n= 196) Control Group (n=100) Average Age Age (SD) 77.2 (9.8) 74.8 (13.3) Gender Female 79% 64% Average Charleston Comorbidity Index (CCI) CCI (SD) 6.0 (2.6) 5.6 (2.2) Average Number of Medications Medications (SD) 15.5 (6.2) 14.0 (4.8)

11 Average Consultation Time Minutes YEAR 1 YEAR 2 (YTD)

12 Patient Reported Medication Adherence Morisky Medication Adherence Scale-4 Scores* YEAR 1 YEAR 2 (YTD)

13 30-day Hospital Readmission Rates P-value= % 17.8% 15.0% 10.0% 13.0% 9.6% 10.9% 5.0% 0.0% NATIONAL AVERAGE PRE-STUDY YEAR 1 YEAR 2 (YTD)

14 Patient Satisfaction Ratings (Likert) YEAR 1 YEAR 2 (YTD)

15 Financial Justification Patients No direct cost to patient Healthcare Organizations Facility based contract pricing per discharge

16 Future Directions

17 References 1. National Health Expenditure Data. Cmsgov Available at: Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/index.html. 2. Unroe KT, Nazir A, Holtz LR et al. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care Approach: Preliminary data from the implementation of a Centers for Medicare and Medicaid Services Nursing Facility Demonstration project. J Am Geriatr Soc 2015;63: Carnahan, J., Unroe, K., Torke, A. Hospital Readmission Penalties: Coming Soon to a Nursing Home Near You. J Am Geriatr Soc. 64: , The Joint Commission. Sentinel Event Alert; Using Medication Reconciliation to Prevent Errors. The Joint Commission. January 25, PAMA Regulations. Cmsgov Available at: Service-Payment/PAMA-Regulations.html. 6. Hospital Readmissions Reduction Program. ahaorg Available at: 7. Nursing Home Compare. Medicaregov Available at: 8. Consultant Pharmacists Guiding Medication Therapy. Medication Managers Available at: 9. Virtual Pharmacist Led Medication Reconciliation. RxConcile Available at: