Closing Gaps in Care Through Medication Refill Technology

CHALLENGE

One of the goals of the St. Joseph Heritage Healthcare (Heritage) Contact Center is to offload tasks from the clinics so that staff can operate at the top of their license and focus on the patients in front of them. Leadership at Heritage asked the Heritage Contact Center to extend its medication refill processing services to a broader group of physicians in multiple regions and specialties. Additionally, the team was tasked with providing more detailed reporting and analytics to quantify the Center’s activities. The end goal was to centralize the refill service and to delegate routine, repeatable tasks to non-clinical technicians. However, the Heritage team did not have additional funds to hire new FTEs. To accomplish the goal, the team sought a technology solution that would enable existing staff to be more efficient and increase capacity.

SOLUTION

Heritage团队在Allscripts TouchWorks®EHR中每月例行处理37000次药物补充请求。Heritage选择利用健康催化剂嵌入式填充应用程序，以方便世界杯葡萄牙vs加纳即时走地与TouchWorks集成。该项目仅在12周内完成，最终支持了200名初级保健医生。

In addition to the technical implementation, the rollout included organizational process and staffing changes. According to Renee Voll, Executive Director of Patient Experience and Contact Center at Heritage, “To fully operationalize a centralized refill service, it was imperative that we adopt a standardized set of refill protocols for all primary care physicians to follow. Through a consensus process with clinical leadership, our medical director ultimately signed off on the set of protocols now followed across the organization.” To support this process, the Health Catalyst customer success team provided guidance and identified opportunities for approving an even greater number of refills on behalf of the medical staff.

With standardized protocols for office visits and labs in place, Heritage began delegating routine refill tasks to non-clinical technicians. Requests originating from Surescripts, FollowMyHealth, and incoming faxes appear as Rx Renewal tasks in physicians’ task buckets that technicians continuously monitor. The Embedded Refills application presents relevant information in the tasks such as last appointment with the managing provider, appropriate refill amount, last time the medication was ordered, and associated labs required for the medication. Embedded Refills also flags out-of-range values, when the next office visit and labs are due, and the status of the medication. Previously, these items were all manually reviewed. With Embedded Refills, the staff no longer needs to scour patient charts, effectively automating the chart review process.

Each request is categorized as In Protocol, Duplicate, Out of Protocol, or Controlled. Based on the pre-populated information, technicians can easily act on In Protocol requests and delete Duplicates. Providers are only involved with Out of Protocol or Controlled requests.

RESULTS

“如今，超过65%的再填充请求由非临床再填充技术人员处理，而在使用嵌入式再填充之前，这一比例为50%。技术人员将其效率提高了三倍，现在每8小时轮班可处理200次以上的补充。这大大减轻了我们的供应商在白天和晚上的负担，”Voll说。另一个好处是病人满意度的提高。以前，重新填充请求的周转时间可能超过72小时。现在，申请最快可以在12小时内完成。

Embedded Refills also enables technicians to take a more proactive role in closing care gaps associated with medication refills. When a refill request is being processed, staff members holistically review each patient’s full medication list, identifying labs, visits and procedures that need to be completed in the next 90 days. Outstanding items are then scheduled with the patient. With care gaps addressed, upcoming refill requests to be categorized as In Protocol and processed immediately.

Physician satisfaction has also increased on multiple fronts. Because the Embedded Refills application helps staff identify missing visits, physicians are now seeing patients more frequently as opposed to simply autorenewing prescriptions, as had been done in the past. Additionally, incoming refill tasks received over the weekend no longer loom for physicians to process during off hours.

这些请求被从医生的储存桶中取出，交由遗产管理团队在周一上午处理。

GROWTH WITH EMBEDDED REFILLS

在听说成功使用了嵌入式填充应用程序后，Heritage的其他几个组现在正在寻求呼叫中心的支持。根据Voll的说法，“我们正在与我们的北加州初级保健领导团队和圣犹大内分泌科医生讨论，所有这些都可以得到嵌入式Refills协议的支持，而无需增加额外的fte。”