Increasing patient safety and satisfaction, while maximizing pharmacy output is all part of the package with this comprehensive software system.
In 1992, the United States federal government created the 340B Drug Discount Program, which requires drug manufacturers to provide outpatient medications to eligible healthcare organizations, hospitals, and other nonprofit groups at discount prices. The program aims to reduce medication costs for low-income or uninsured patients and provide them with a broader range of health care. In official language, the 340B program enables covered entities “to stretch scarce federal resources as far as possible, reaching more eligible patients, and providing more comprehensive services.”
The 340B program is more than a pharmaceutical delivery system, however. To receive drug discounts, healthcare organizations must be able to show proof of established relationships with those patients served, including maintenance of health records. Patients must also receive care that goes beyond medication dispensing.
Keeping track of patients and their interactions is complicated and crucial to continued participation in the 340B discount program. Liberty Software specializes in pharmacy management software that simplifies workflow and auditing capability, while maximizing patient care for 340B compliance.
Josh Carzoli, PharmD, is Director of Operations at El Rio Health in Tucson, Arizona, a federally qualified health center comprising 11 locations and serving more than 105,000 individuals in that community. He joined El Rio in 2002 and has seen the pharmaceutical arm of the health center grow to span seven pharmacies that provide 600,000 prescriptions per year. Carzoli has a strong understanding of the 340B program, having trained as a peer-to-peer mentor and speaker.
In order to participate in 340B and continue receiving reimbursement, El Rio must meet a variety of exacting criteria and be recertified annually. “The two biggest requirements are meeting patient definitions and avoiding duplicate discounts,” Carzoli said. “We must have auditable records for every single medication we dispense to every patient, down to the tablet.
El Rio’s previous pharmacy management software system was rife with frequent filing mistakes involving sound-alike or spelled-alike patient and drug names. These mistakes resulted in potentially dangerous dispensing errors. “It was death by 1,000 paper cuts. We filed alphabetically, and the previous system did not let us know if we had multiple patients in the same bag or alert us to check the patient’s identity,” Carzoli said. “The vendor was unable to make adjustments to safeguard our patients.” In addition, El Rio’s volume was increasing. “The system we had simply could not keep up. We would have needed to continually add more staff.”
El Rio was also dealing with a manual prescription refill system that required a dedicated technician to spend an entire day listening to patients’ voice messages and typing prescriptions into the system. “Keeping our tech staff tied up with manual tasks like that meant that our most knowledgeable and expensive resources – our pharmacists – were spending time counting tablets and pouring liquids,” said Carzoli.
These needs for technological efficiency, increased safety, and improved patient satisfaction drove an exhaustive search for a better software solution. “We required more robust clinical checking and were looking for ways to improve our adherence and star rating,” Carzoli said. “We also wanted better messaging and education for our patients.”
El Rio’s information technology team was heavily involved in making the final decision, based strongly on their concerns around patient data safety and reliable functionality. “Liberty Software revolutionized our workflow. We love the layout, and we have seen a reduction or elimination of manual tasks.” Joshua Carzoli, PharmD, BCACP, 340B ACE, DPLA Director of Operations ~ El Rio Health CASE STUDY www.libertysoftware.com “We were really impressed by Liberty Software’s willingness to embrace all of our challenges and suggestions for change,” Carzoli said.
Switching to Liberty Software in 2015 improved El Rio’s efficiency, while providing more comprehensive patient care. “The same number of pharmacists now do more clinical review and have time to work directly with patients to identify their needs and improve their health care,” Carzoli said.
The new software included a custom bin management system that uses dates and slot numbers rather than patient names. “We went from having multiple wrong dispensations per year to a single one since using Liberty,” Carzoli said, “and that error only happened because a staff member overrode the safety system.”
Liberty Software was also willing and able to customize El Rio’s patient keypad, adding four prompt questions that patients must answer when receiving medication to verify their identity and the name of the drug. “This is another huge advancement in our technology that is responsible for dropping our safety events to virtually nothing,” Carzoli said.
In addition, the time wasting refill system has been replaced with an automated smart phone app and auto-refill features. “Now, patients enter an order and it goes directly into the system, to be safely processed right away.”
One of the tenets of participating in the 340B drug program is the requirement for healthcare entities to provide patients with continuity of care. Every step, however, must be documented. “With Liberty Software, we can now access and review information seamlessly from our patients’ electronic health records,” Carzoli said, “This lets us make better clinical decisions while also meeting the program’s data collection requirements.”
Looking ahead, Liberty Software continues building tools that help El Rio continue to improve and grow. They have developed an API to better connect the larger EHR system with Liberty’s platform. “This will take us light years toward integrating bidirectional information movement between the systems,” Carzoli said. “This was another customization that was a dream of mine for some time. We asked for it and Liberty agreed to make it work.”
This post is related to:Software (Pharmacy Management Systems)