Closing the Readmission Gap with a Virtual Pharmacist Solution

March 20, 2017 | Jeff Neasmith

Providing quality care and implementing strategies to reduce readmissions to hospitals has become a focus in the transition to value-based health care. This transition is reflective in the efforts healthcare facilities are making to reduce hospital readmission rates to both improve patient experience and avoid costly fines.

To address this issue, we’re outlining the breadth and impact that hospital readmissions have on the healthcare system as a whole, but specifically focused on preventable admissions as addressed through a telemedicine approach to medication management in long term care patients.

The problem facing the healthcare system is utilization control and finding cost effective solutions to ensure better patient outcomes. For long term care facilities in particular, addressing medication management as a significant contributor to hospital readmissions is essential.

The reality is that up to 75% of all readmissions are preventable1.

In looking at the contributing factors across the continuum of care, targeting medication management as a primary area of focus to reduce costs and system burdens while improving patient outcomes is achievable through the technology we have available.

This is particularly relevant for long term care where users in this demographic maintain high levels of prescription use and medication change throughout their care cycle.

The cost of preventable medication errors:

Preventable medication errors account for an estimated 66% of hospital readmissions that occur during transitions in care2. This means that 2/3 of patients, will be readmitted because of medication management issues alone, contributing to the $40 billion annual cost for Medicare patients3.

Chad Worz, a pharmacist and the CEO for RxConcile summarizes the landscape for this model of care stating, “As people age, health care consumption and medication consumption increases to manage disease processes and conditions. The most vulnerable within the older patient population often cannot go straight home and transition to a skilled nursing facility first to recover from an event that placed them in the hospital. These patients are characteristically suffering multiple comorbidities, on multiple medications and transitioning through a nursing facility for 2-3 weeks of rehab care before returning home.

Challenges for long term care:

Long term care facilities are no longer rest homes, but provide transitional care before releasing a patient home. The complex nature of medication management for these patients opens the door for errors that compromise patient care and add to increased hospital readmission rates.

Up to 30% of hospital admissions of older adults are drug-related4. When this happens, not only do the hospitals face fines from Medicare, but the long term care facility’s position with their major referring hospitals is placed at risk as well as their Five Star Quality ratings. The cost impact across the continuum of care is substantial.

Doctors and nurses are not afforded the time nor are they best positioned to manage the medication reconciliation or education process. Pharmacists are not deployed to be able to perform a live counseling session with each patient rehabbing in a skilled nursing facility. The current system does not support or offer a quality solution for working with patients on their medication management issues. In terms of medication additions and changes, often little is given in terms of patient consultation. Patients recovering from an acute event often find medication adherence confusing and their retention of prescribing instructions is compromised, feeding into high risks for errors and readmission potential.

When no pharmacist interaction is given, patient satisfaction rates decline by 25% influencing their choice of care facility and likelihood of referral5. When patients receive follow up one on one instruction readmission rates are reduced by 50%6. With long term care facilities depending on ratings and reputation for enhanced patient care for their referral stream, the cost effect compounds.

Hospital readmission reduction through medication reconciliation:

Providing personalized pharmacist consultations is cost prohibitive for healthcare facilities but technology can assist in delivering direct pharmacist care to patients at the point of discharge to mitigate readmissions throughout the transition of care.

RxConcile is a cost effective solution that delivers custom patient consultations with a pharmacist to provide medication education and management, while engaging the patient in the direction of their care.

The RxConcile app is integrated into the discharge process where a discharge coordinator will input prescription information and schedule a video call between a remote pharmacist and the patient. This delivery method allows for real time instruction and communication over medication use, side effects, and questions. The pharmacist can assess patient comprehension and answer any questions instantly. The session is recorded and accessible by the patient and the patient’s family through an internet-based HIPAA compliant patient portal for review.

“This allows for these high risk patients to adjust to what has been an overwhelming and often confusing sequence of health events and participate in understanding the management of the very medications that are intended to keep them healthy and out of the hospital.” says Worz.

The outcome is that hospitals and skilled nursing facilities avoid penalties associated with preventable readmissions and improve their Five-Star Quality ratings.

For long term care facilities specifically, Rxconcile has the ability to decrease financial liability, reduce patient re-admittance, improve Five-Star Quality ratings, increase referrals, and improve staff retention. Using this virtual pharmacist platform as a primary readmission prevention solution elevates the standard of care, improves patient satisfaction and prevents uneccesary hospitalizations.


ASA Conference Presentation

Reducing Hospital Re-Admissions with Telemedicine & Medication Reconciliation



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