Finally getting it right: Transitions of care

The first public hospital in the United States was founded in 1751, meaning the U.S. healthcare system has been working to manage transitions of care for more than 250 years. Yet, despite all of this time and opportunity to get care transitions right, we still struggle with coordinating patients’ movement from hospital to skilled nursing, long-term care or home, and from provider to provider across the continuum of care.

And it’s far from an inconsequential problem. Nearly 1 in 5 Medicare patients are readmitted after a hospital visit, at the cost of over $26 billion annually. Yes, that’s a “B” for billion and that’s for the Medicare population alone. Fortunately, there are some straight-forward best practices to mitigate this problem relative to medications.

Prescriber-to-pharmacist communication — One of the best improvements we’ve experienced is simply including on the face of discharge prescriptions a direct phone number to the hospital’s Emergency Department pharmacist or acute inpatient pharmacy. Community pharmacists are often “flying blind” when it comes to sifting through what happened while a patient was in the hospital or ED. That communication channel needs to be facilitated — so the pharmacist can easily contact the acute care providers and seek clarity on any medication questions or discrepancies.

Patient-to-pharmacist communication — In a recent report, 38% of patients used more than one pharmacy to fill their various prescriptions. This isn’t surprising with the rise of discount drug cards and competition among community pharmacies for individual prescriptions. Unfortunately, this limits an individual pharmacist’s ability to have full visibility into a patient’s medication profile, and can cause delays in getting the full information or, worse yet, prevent the pharmacist from discovering potential dangerous drug reactions from a medication filled elsewhere.

But there’s an easy solution being used by a growing number of patients today, often recommended by their physician. Medication counseling and coordination by a remote clinical pharmacist as an extended member of the care team is a convenient, cost-effective way for these pharmacists to have a private conversation that pulls all of the patient’s medication information together. This cannot only catch avoidable medication errors but also opens a discussion about ways patients can cut down or change some of their prescriptions and save money in the process.

Telepharmacy is an ideal solution that provides undivided attention to a patient’s counseling and monitoring needs without the distractions encountered by filling prescriptions, answering phones, and addressing other customers’ needs. As we say at RxLive®, it’s good to check your meds, and we’re here to help patients and their busy providers do so.

Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.