Surescripts processed 17.7 billion secure health data transactions last year. More than 2.5 billion of those were requests for patient medication history data to be delivered from pharmacies and pharmacy benefit managers (PBMs) directly into care providers’ EHR software.
Continued network expansion and rapid provider adoption of powerful technologies like electronic medication history are a good thing. But what real benefit does high quality medication history data offer? How is this technology helping doctors, nurses and other clinicians deliver safe, efficient and cost-effective healthcare?
I met with Stacy Ward-Charlerie, Manager of Product Innovation, to gain a deeper understanding of the critical role that accurate and complete medication history plays for patients and providers at the point of care.
Q: What’s new on the medication history front?
A: There have been two major developments. First, Surescripts welcomed the last remaining large national chain pharmacy to our medication history solution. With the addition of this organization, Surescripts gives certified healthcare providers access to medication history information for 310 million patients. That’s almost 95% of all Americans.
Second, a number of EHRs, including Allscripts, MEDHOST and Evident, began making the service available to their users across all care settings—ambulatory and acute. When you combine this with the fact that Epic, MEDITECH (through DrFirst) and Cerner users have been using medication history across care settings for years, we’re now able to deliver this information to EHRs used by 90% of prescribers nationwide.
Q: How can medication history impact patient safety and health outcomes?
A: Better medication reconciliation has been clinically proven to improve patient safety and outcomes. In fact, Cedars-Sinai Medical Center staff produced a study demonstrating that using Surescripts’ electronic pharmacy claims (SEPCD) or medication history for reconciliation (MHRs) would have prevented 35% of admission medication history (AMH) errors, and 31% of resultant inpatient order errors. And when they excluded the least severe medication errors, they concluded that the data was likely to have prevented 47% of the most severe AMH errors and 61% of resultant severe inpatient order errors. This is especially impactful when we consider these results on a national scale.
The study revealed a high rate of discrepancies between pharmacy claims data and the provider medication list. Aggregated pharmacy claims data available through the EHR may be an important tool to facilitate medication reconciliation in primary care. Of 609 patients, 468 (77%) had at least one medication discrepancy. The identified discrepancies included 171 patients (28%) with 229 controlled substance discrepancies.
Q: Is there a link between good medication history solutions and patient satisfaction?
A: Absolutely. Patients are frustrated by their healthcare experiences when it comes to health data access and data sharing between their various providers. According to our 2016 patient survey, nearly 50% of patients surveyed said their doctor is not aware of which prescription medications they’re taking. And they report spending up to six minutes of their average 15-minute office visit writing down or reciting medication histories.
As healthcare consumers living in a digitized society, patients expect that their providers will have convenient access to their complete medication information, whether they’re near home, on vacation or relocating. And patients concerned about privacy should also know the value of sharing medication history data, and understand that HIPAA provides for it.
But patient expectations go beyond their desire for convenience and privacy. Most patients believe that their doctor would be less likely to prescribe the wrong medication if they had more complete medication history information, and that lives are at stake when they don’t.
When patients ask their care providers, including their pharmacists, why they don’t have their medication history on record, they may learn that their pharmacy or their provider’s EHR, health system or practice isn't sharing their dispensing data. The reality is that nearly all U.S. pharmacies are currently contributing medication history data to the network. And as more of the pharmacy and EHR/provider markets opt to participate, the solution will continue to deliver increasing value to patients by informing a safe and seamless prescribing process for their healthcare providers.
Q: What is your vision for the future of medication history?
A. Electronic medication history is one of those health IT tools that holds infinite promise. Healthcare providers are using a wide range of solutions across and beyond care settings, whether during a hospital admission, at the doctor’s office, long term post-acute care stays or through ongoing population health management alerts and analytics.
Surescripts makes this information available at key points in time, and clinicians across the country are running with it, and leveraging it in new and different ways. This is the definition of actionable intelligence positively impacting a variety of patient scenarios. This is true nationwide interoperability coming to life and delivering safe and high quality care at scale. It’s a very exciting phenomenon to witness, and indicative of a bright future for American healthcare patients and the providers who care for them.