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From Information to Knowledge: How Medication Learning Optimizes Patient Outcomes

August 23, 2016
by Anthony Donato, M.D., M.H.P.E., Gregory Hood, M.D., M.A.C.P.
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NEHI data suggests that inpatient, preventable medication errors cost the U.S. healthcare system more than $16.4 billion annually
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For many healthcare executives, patient experience and satisfaction is one of their top priorities, and this should come as no surprise, as the move from a fee-for-service to pay-for-performance model ties reimbursements directly to quality of care. In the hospital setting, the Centers for Medicare and Medicaid Services (CMS) measures “quality” using two metrics—patient satisfaction and patient outcomes.

The patient experience is the responsibility of the entire care team. From admission to discharge, everyone has the ability to impact quality of care and patient satisfaction, which includes prevention of errors. It probably goes without saying, but there is no faster way to create an unsatisfactory experience than through error. According to a study conducted by researchers at Johns Hopkins, medical errors are the third leading cause of death in America. Research from the Institute of Medicine of the National Academies shows specifically that medication errors impact at least 1.5 million people in this country each year. While death is a worse-case scenario, these figures prove that medical error can be costly on many levels.

Appropriate medication management is central to meeting CMS quality measures, which is used to determine reimbursement rates. This is particularly true with regard to the emphasis on avoiding unnecessary readmissions. Medication management also is central to managing healthcare costs. Data from the Network for Excellence in Health Innovation (NEHI) and Massachusetts Technology Collaborative suggests that inpatient, preventable medication errors cost the U.S. healthcare system more than $16.4 billion annually.

Medication learning tools may augment prescribers’ effectiveness, and are never more necessary with the explosion of new pharmaceutical options available. Tools that are concise, evidence-based and delivered at the point of care may be most effective to meet a provider’s educational needs. This could potentially result in improved patient outcomes that translate into higher CMS quality scores and higher reimbursement rates.

Staying Current with Medication Learning

Staying current with the latest changes in medicine is a daunting challenge. Many prescribers receive the newest drug information from pharmaceutical representatives who are incentivized to promote their products. This isn’t to say that the information is incorrect or harmful, but rather to illustrate that pharmaceutical company-generated information may be written and presented in a way that is biased towards the benefits of their specific medication and may not help prescribers choose among all options.

Because medication prescribing is not one-size-fits all, having an independent and unbiased source for medication information is important. Physicians and other prescribers need to be aware of the many different drug therapy options for different conditions, and how to best compare and contrast these medications in terms of efficacy. Pharmacists need to be current on important drug interactions, medication side effects, and dosing recommendations. Medication learning resources that are provided by independent, unbiased sources may also help facilitate appropriate medication use during transitions of care.

Given how often errors occur at transitions, an effective resource has the potential to improve efficiency, lower costs, and reduce errors, which could enhance overall patient care quality. Effective resources might be those edited together by pharmacists and prescribers, and delivered in a concise and easy to digest format. These relevant resources, written and edited together by a team of pharmacists, researchers and prescribers, might more effectively meet the needs of learners than those from non-clinical or non-practice environments.

Dr. Donato’s Medication Learning in Practice

In my clinical role as an inpatient academic hospitalist with Reading Health System, I am fortunate to regularly do my rounds with a pharmacist and a pharmacy student along with my ward team. We consistently rely on medication learning materials to help with patient care, which in many cases has had a significant impact on outcomes.

A recent example involves one of my patients who had developed wound sepsis nearly three weeks after a urological surgery. This patient was placed on a new SGLT-2 inhibitor preoperatively for diabetes control. Recalling information I had learned in my role as a volunteer editor with an independent medication learning provider, I was aware of the higher risk of urogenital infections due to the medication he had taken prior to surgery, despite the fact he had stopped taking the medication two days before this admission. After discussing his prior medication with him, I was able to determine that there may indeed have been a connection between his oral diabetes medication and this infection, which was then subsequently reported to the FDA and his urologist.

Dr. Hood’s Medication Learning in Practice