When our loved ones are admitted to the hospital for any condition, it can be a stressful and frightening time for family members. Even more startling is that chances are they could be readmitted in as little as 30 days. Nearly one-in-five Medicare patients return within one month of being discharged. According to a report by NEHI, over half of those cases are avoidable. The total cost of readmissions range from $15 to $25 billion dollars per year.
Revolving Door Syndrome
There are several reasons that patients are ending up back in the hospital. According to a report by the Robert Wood Johnson Foundation, high readmissions can be blamed on of the quality of inpatient care, discharge planning and care coordination; the availability and effectiveness of local primary care. Many of these lapses happen when a patient leaves the hospital to return to assisted living and long-term care facilities.
A Dose of Confusion
The biggest culprit – according to a study by the Archives of Internal Medicine, is a lapse in drug regimens, meaning patients are taking the wrong medications or don’t have access to first dose emergency meds. In another study that cited medication errors as a main reason for hospital readmissions, researchers found roughly 19 percent of discharged patients had adverse events occur shortly after leaving the facility, two-thirds were due to medications. The Centers for Medicare and Medicaid Services (CMS) estimates those readmission rates due to medication non-adherence create an economic impact that is estimated to cost nearly $100 billion annually.
The Carrot and Stick
The issue of hospital readmissions and the cost has come under scrutiny in recent years. Hospitals have been put on notice by the Affordable Care Act to reduce the high volume of readmissions or face tough financial penalties. In order to avoid leaving money on the table, hospitals and the healthcare industry have had to address the medication adherence challenges that are driving up readmission rates.
Closing the Gap
You can’t ignore the numbers and the facts. If the top reason a patient returns to the hospital is due to lack of medication adherence, how can we make sure the “hand-off” from hospital to long-term care or assisted living is error-proof, simple and secure? It is important to ensure that patients get the first-dose and emergency meds they need if a healthcare emergency were to occur.
The Pharmacist's Role
In order to reduce these percentages and costs, hospitals and caregivers are turning to more stringent medication adherence products and procedures, especially when it comes to critical first-dose and emergency medication. Many facilities use “tackle box” systems that are essentially small boxes containing first-dose and emergency medication. These paper-based “tackle box” systems are provided by a number of long-term care pharmacies like Guardian Pharmacy. The box is transported to a facility. In the event of an emergency, caregivers simply have to unlock the box to access the medication then fill out necessary paperwork to document who opened the box, what was removed and provide details back to the pharmacy for inventory control and replenishment.
While inexpensive, it can present a host of security problems. Anyone can access the box and there is no tracking mechanism to tell who, when or if residents received their proper medication in proper doses. Documentation can be misplaced and when the paper trail is lost, thousands of dollars are lost. In addition, there is no efficient way to track off-site inventory.
There’s an App for That
Could the safe, error-proof answer be technology? I have been working in the healthcare industry for many years. I believe the challenge of closing the medication loophole is turning to technology for a secure, easy, turnkey approach to bridge this gap. These “smart” devices are being developed as a way to reduce liability, ensure caregivers can access the first dose medication quickly and respond to the pharmacy in real time with a record of what was accessed.
One device developed by Creative Strategies in Louisville, Kentucky is called statDISPENSE. It offers a simple turnkey approach that allows caregivers secure access to emergency drugs should an adverse event occur. Its padlock technology can turn traditional emergency medicine kits, or “tackle box” exchange systems, into a fully automated dispensing and tracking device that integrates medical record keeping and inventory management into an affordable, simple-to-use device.
statDISPENSE is operated by authorized caregivers through an intuitive mobile application that automates record keeping, billing and chain of custody while improving efficiency, security and accountability, making it easier for senior living and long-term care operators, along with their preferred pharmacies, to focus on the residents’ quality of life.
statDISPENSE offers a streamlined system that aids facilities and pharmacies in regulatory compliance and security while drastically reducing the chance for medication errors. Regulations for managing emergency medicine kits vary from state to state, with some states requiring only 24 hours to safely access, replace and update drug inventory.
With the ability to fit on any type of “tackle box” system, statDISPENSE is controlled by a mobile app on any iOS supported device such as iPhone or iPad. The software tracks every step in the process, ensuring that authorized caregivers can access the medication quickly and safely. The system tracks when medication is removed from the storage system and administered to each resident, maximizing control while limiting liability through comprehensive, automated record keeping.
Technology is rapidly advancing and, in turn, is helping improve the quality of life for everyone, but especially our loved ones in long-term care and senior living facilities by reducing the number of medication errors and hospital readmissions. It is important for long-term care and senior living facilities to keep up with the age of technological advancements and communicate medication needs between caregivers and family. There is still much work that needs to be done so front-line staff can provide the highest quality of care to their patients and give their loved ones the peace of mind knowing there is nothing to worry about.
- By John Humphreys
John Humphreys is the Senior VP Sales & Marketing for Creative Strategies. He joined Creative Strategies in 2016 with more than 25 years of experience in corporate leadership roles and technology start-ups.
Blair, M. (2013, February 11). The Revolving Door Syndrome: Patients Returning to Hospital Within Days of Being Released. Retrieved from http://www.rwjf.org/en/library/articles-and-news/2013/02/the-revolving-door-syndrome--patients-returning-to-hospital-with.html
Forster, A., Murff, H., Peterson, J., Gandhi, T., & Bates, D. (2003). The incidence and severity of adverse events affecting patients after discharge from the hospital. Annals of Internal Medicine,138(3), 161-167. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12558354.
Hubbard, T., & McNeill, N. (2012, October). Improving Medication Adherence and Reducing Readmissions. NEHI - Thinking Outside the Pillbox. Retrieved from https://www.nacds.org/pdfs/pr/2012/nehi-readmissions.pdf
Readmissions Reduction Program (HRRP). (2016, April 18). Retrieved from https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html
Schnipper JL, Kirwin JL, Cotugno MC, Wahlstrom SA, Brown BA, Tarvin E, Kachalia A, Horng M, Roy CL, McKean SC, Bates DW. Role of Pharmacist Counseling in Preventing Adverse Drug Events After Hospitalization. Arch Intern Med. 2006;166(5):565-571. Retrieved from http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/409914.