Supercharging Pop Health Programs with a Strong Dose of Medication Data
The following is an interview with Weston Blakeslee, PhD, VP Population Health at DrFirst
Tell us a little bit about yourself and DrFirst.
I’m VP of Population Health at DrFirst, a leading healthcare technology vendor. We improve efficiency and patient care by streamlining medication management workflows and helping patients start and stay on therapy. I also lead the company’s Applied Clinical Research initiative, which measures the value of DrFirst solutions through customer improvements in clinician productivity and clinical outcomes.
How big of a problem is patients not filling their prescriptions? What are some of the financial and care impacts?
Prescription abandonment is a huge problem, with studies showing that up to 25% of new prescriptions are never picked up.
This can have a severe financial impact on the U.S. healthcare system, with approximately $100 billion spent annually due to hospitalizations, emergency room visits, and treatments that could have been avoided. From a patient care perspective, non-adherence to medications can result in poor health outcomes, including more complications and preventable hospital readmissions. For patients with chronic conditions such as heart disease or diabetes who don’t take their medications as prescribed, there is a higher risk of adverse events, which can make their condition worse.
What are some of the main reasons that patients aren’t filling their prescriptions?
Patients fail to fill their prescriptions for several reasons. First, the cost of medication is a significant barrier; many patients face “sticker shock” at the pharmacy counter, leading to prescription abandonment when out-of-pocket costs are unaffordable. Second, logistical issues such as lack of transportation or difficulty getting to the pharmacy during business hours can get in the way of patients picking up their medications. Third, patients often don’t realize the importance of taking their medications and the consequences of not following their doctors’ instructions. The complexity of medication regimens, including the number of pills and frequency of doses, also can overwhelm patients, leading to non-adherence. These challenges make it clear that healthcare providers need solutions that address both financial and logistical barriers to ensure patients follow through with their prescribed treatments. Last but not least, patients don’t fill their medications because they simply forget to do so.
What are some ways that a full medication history can be used to improve patient care?
When hospitals and health systems have access to more complete and accurate prescription fill information, their staff doesn’t have to manually gather and type that data into the electronic health record (EHR).
Unfortunately, the standard medication history data feed is often missing information. And because their EHR and the systems used by pharmacies, payers, and health information exchanges often don’t speak the same language, it can be difficult to assemble a complete medication history for each patient. That means clinical staff must search for missing information by making phone calls to medical practices and pharmacies, and then manually enter the information. These time-consuming tasks can delay care and increase the chance of manual entry errors.
To optimize the process, the DrFirst medication history solution gathers more information from multiple sources, including local pharmacies. Then our patented, clinical-grade AI safely translates more than 90% of incoming prescription instructions (known as “sigs”). The payoff lies in clinicians’ ability to avoid keyboard errors, save time, and meet medication reconciliation initiatives.
Can’t we just get medication history from claims or dispense history from big box pharmacies?
The traditional medication history data feed pulls from claims data, which is based on financial transactions. This can be unreliable because medication sometimes gets reshelved or is paid for with cash or coupons rather than through insurance. Also, financial transaction records don’t include the sig, which tells the clinician how the patient is supposed to take the medication, such as, “Take 1 tablet by mouth twice a day.”
Another challenge is due to claims data from payer attribution files arriving one to six months after the transaction, which delays medication adherence interventions with patients who may not be filling their prescriptions regularly.
DrFirst gathers financial data from the traditional feed and then augments that information with other sources. We connect hospitals and health systems to local and independent pharmacies, and we include information about when a drug went out the door—no matter how it was paid for.
What can be done to ensure you have augmented medication data and insights that are clean and can be trusted?
One key is to be sure you are using medication fill data rather than data from medication lists that have not been reconciled. DrFirst gathers more comprehensive, accurate fill history, then leverages clinical-grade AI to translate free text and safely infer missing sig data for clinician review before importing it into the EHR. Our customers find that this streamlines medication workflows in a way that frees their clinicians from burdensome data entry tasks.
We define “AI” as “augmented intelligence” because our solutions support clinicians’ decision-making rather than replace it. Our clinical-grade AI is trained on high-quality healthcare data, validated by a team of clinical pharmacists, and complies with strict requirements for data security. Most generative AI engines aren’t smart enough to know what they don’t know. They give an answer for every query, even if it’s flat-out wrong.
That’s not acceptable in healthcare, where patient safety is paramount. The guiding principle for our clinical-grade AI is that it’s better to provide no answer than to deliver a wrong answer. It infers missing data only when it’s safe to do so. If there’s any doubt about the clinical meaning, the AI flags it for a clinician to make the call.
How does that translate to population health initiatives?
For population health programs, DrFirst provides a single source of structured, complete data that’s delivered within 24 hours. We automate this process so hospitals and health systems, accountable care organizations, and technology vendors can replace manual workflows, which is crucial to relieving burnout and keeping clinicians focused on patient care.
By making data accessible more quickly, our population health management solution helps care teams consolidate patient rosters and identify at-risk patients based on adherence scores. In addition to the positive health outcomes for patients, better adherence is vital to value-based care initiatives that aim to reduce the use of healthcare resources and earn higher reimbursements for healthcare providers.
Can you share a story or two where medication data was used to improve population health efforts?
Absolutely. As I mentioned earlier, our Applied Clinical Research team works with our customers to measure the value of DrFirst solutions. Here are a couple of projects that have successfully used our medication data as part of their population health initiatives:
Magnolia Regional Health Center in Mississippi partnered with DrFirst to get access to clinically actionable medication history for patients with congestive heart failure (CHF) in near-real time via a user interface that measures gaps in adherence at the population level. The health system created a Nurse Navigator program using prescription fill data from DrFirst to identify and prioritize patients who need intervention to stay on their medications. Nurse Navigators give patients and their families counseling at discharge and between clinic visits to help them cope with this complex, long-term illness. To optimize medication management for the patient, it’s vital that the nurse has the patient’s most up-to-date medication history, as well as the notes from the Hospitalist during transitions of care. Early results from 361 patients over a seven-month study period indicate that prescription fill rates have increased by double-digits across all four guideline-directed medical therapies for congestive heart failure.
The University of Maryland Medical System faced similar challenges in ensuring medication adherence among patients with CHF and chronic obstructive pulmonary disease (COPD). Partnering with DrFirst, they used our population health management solution to track and analyze prescription fill patterns, enabling mobile caregivers and pharmacists to intervene with those who weren’t adhering to their medication regimens. This data-driven approach resulted in a nearly 20% increase in first-fill rates for CHF patients and a 25% increase for COPD patients.
Where can people go to learn more about DrFirst’s population health solutions?
Our website is a great place to start. You can also watch one of our webinars on population health, where we demonstrate how our population health solutions work.
By John Lynn, Article Link
DrFirst is a proud sponsor of Healthcare Scene.