Surescripts: Who are SigmaCare’s customers? How does Surescripts support the work you’re doing?

SigmaCare: Our clients are the LTPAC population. It’s a unique space that differs from acute care, but is similarly affected by regulatory programs, clinical and financial outcomes and a fundamental commitment to improving patient care.

The LTPAC marketplace partners with hospitals to communicate across care settings to decrease re-hospitalizations, reduce waste and improve patient outcomes. These partnerships are driven by payment reform and quality-focused regulations. Unfortunately, in the past, there weren’t many vendors or tools to bring together acute care, the LTPAC markets and providers. For example, acute care physicians work in both acute and post-acute settings; however, they have to use different tools in each, and the systems are rarely interoperable. It’s no secret that physicians have limited time. So asking them to learn different electronic healthcare records (EHRs) for every setting is unrealistic and inefficient. They depend on their provider partners to offer efficient and secure means, such as enabling mobile devices, to do what they do best: deliver holistic patient care and track it as they go.

SigmaCare wanted to partner with an organization that was interested in serving the LTPAC markets as well as a leader in real-time data exchange for providers, physicians and pharmacies. Surescripts is the right fit because of their proven success in exchanging prescription data and the unparalleled reach of their network. Together, we’ve created a system that gives our customers good options regardless of provider location—a key advantage that they expect and deserve.

In addition, Surescripts’ acute care expertise and proven ability to securely exchange Protected Health Information (PHI) is a bonus. While LTC and acute care providers differ, they share similarities and struggles when it comes Health Information Exchanges (HIEs), pharmacy connectivity and transitions of care. Since acute care is often ahead of the game in these areas, there are a lot of lessons that can positively transform the way we operate in long-term care (LTC). Surescripts has helped many acute care providers pave the way with advanced technology, and their success helps LTC providers bridge similar gaps.

Surescripts: So electronic workflows were slow to arrive to the LTC market. Why are they so critical to this type of care? What are the primary differences electronic workflows make to clinicians and their patients?

SigmaCare: In the past, all clinical interactions were paper or phone-based. We thought, “This is crazy. They can e-prescribe in a doctor’s office, so why not offer the same secure, efficient and risk-minimizing technology in LTC?”

Aside from the financial incentives, the lack of technology adoption in LTPAC has been scrutinized, particularly around frequent hospital readmissions caused by non-adherence or adverse reactions to prescriptions.

Put yourself in the shoes of a patient. You have a lot of previously prescribed drugs at home. Then, you get sick and have to go into the hospital. You try to recall for your care team everything you’re taking, but it’s very difficult to remember it all, especially in a stressful situation when you are sick. Then, you move into a nursing home where you’re prescribed some new drugs while undergoing rehabilitation. Then, you return home with a whole new regimen, but all of your old prescriptions are still there. You don’t know what prescriptions you should be taking anymore, but you don’t want to get sick again, so you take everything you have. You’re taking too much of something and there’s a bad interaction. Back to the hospital you go.

It’s during these transitions of care that patients are most vulnerable and depend on their care team to make educated decisions. It’s where the ball gets dropped most often because complete information does not follow the patient, simply because there are so many people involved along the way. This can create a vicious cycle that could easily be prevented by EHRs, e-prescribing and documenting transitions of care electronically.

For instance, take e-prescribing. Now, you have a medication record that follows patients across the points of care. It’s a patient-centric approach, rather than location centric, like paper records. Instead of going home with a two-foot pile of discharge prescriptions to decipher, everything’s waiting for you at the pharmacy with clear instructions and timely delivery.

Now, put yourself in the shoes of a LTPAC nurse. Your average day is very hectic. Somebody’s always handing off information while you work. Every time you have to sit down, pick up the phone or write down new orders, you have to be perfect. Multiply this by the number of discharges you process in a day, and the margin for error is significant. Naturally, the fewer times you transcribe something, the fewer opportunities there are for mistakes. So, with electronic tools, it’s far less perilous. There’s less transcription errors because you’re not actually transcribing. You’re not losing track because you were distracted. It’s much more efficient and safer for everyone involved. Patients get the right medication faster because the process actually works. And you get to keep doing this work that you’re so passionate about without the fear and consequences of making a mistake.

Electronic tools are also superior from a timeliness standpoint, because whenever a provider or practitioner needs to access a patient record, they have the most recent information. For instance, say your mother is receiving care from five doctors with different specialties, which is common as people age. If the updated information is not all there for each of those physicians during her office visits, then care decisions will be based on whatever the physicians can see. In this scenario, there’s virtually no way to avoid gaps, overlaps or contraindications, and there’s a whole host of problems that can result.

Surescripts: So, now that the tools have arrived, are providers and staff using them?

SigmaCare: Yes. In the communities that have instituted e-prescribing, the adoption rate has skyrocketed. Once it’s implemented, it’s quickly embraced because people instantly see how easy it is to use and how it gives them time back to do what they love most: take care of their patients.

And once you start handling controlled substances electronically, you get to play a key role in fighting the drug abuse epidemic. New York had a bit of a bumpy start launching Electronic Prescribing of Controlled Substances (EPCS), but now that it’s in place, it’s setting the bar for the rest of the country, and is destined to improve care and safety across the board.

In addition, the e-prescribing solution we have built with Surescripts enables our customers to become the ideal choice for their acute care partners. Because of our joint network and advanced capabilities, our customers are thriving, and helping acute care providers reduce costs and improve care.

Surescripts: Working with LTC facilities sounds like a difficult job. What motivates you?

SigmaCare: Many of us in LTPAC are members of the generation that’s “next in line.” This is a life stage in which we should be striving to constantly enrich or maintain quality of life. But as a nation, we’re facing a crisis. We’re all living longer because healthcare advances are keeping us alive longer. Plus, there is a huge number of us who are in the Baby Boomer generation and facing retirement. We will need expanded health services, and the proper resources in place ahead of time, so that our quality of life doesn’t suffer. For better or worse, this issue impacts the whole community of caregivers, including a patient’s family and friends.

But at SigmaCare, we’ve seen time and again how our technology solutions make everything more efficient. This gives the staff more time to devote to the patients, which in turn takes stress off of family, friends and other caregivers. Now, these loved ones can come to the residence for a visit and spend that time enjoying each other’s company, rather than worrying about medications.

So what keeps us going at SigmaCare is that we’re supporting the clinicians and team members who are on the front lines supporting these patients, their families, friends and other caregivers. It’s a domino effect, and it’s incredibly gratifying to be making a positive difference to so many people.