Smooth Sailing: A Case Study on Medication Adherence

Our case study shows how Baptist Health in Louisville uses Medication History for Populations to close gaps in medication adherence and get better reimbursements.

“If I call a patient on Wednesday, by the next Monday I’ll know if the prescription was filled,” says Nilesh Desai, Chief Pharmacy Officer, Baptist Health.

Calling a patient on Wednesday and knowing the status of a prescription in just five days is a bigger deal than you’d think. Typically, relevant medication data simply took too long to arrive. It could take up to a month to find out the patient never filled their prescription.

But why didn’t they fill the prescription? Was the medication too expensive? Too many side effects?

Lost in Spreadsheets

The answer could be yes on both counts—too expensive, too many side effects—but you wouldn’t know it until you had a chance to ask the patient. And to do that would mean knowing who to call for outreach.

As with many health systems and clinics throughout the nation, Baptist Health used spreadsheets to coordinate and track patient medication lists. Solutions such as Medication History for Populations didn’t exist. It was an irritating, manual process. In the meantime, a month-long delay meant that some patients would be non-adherent much longer than they needed to be.

That is, until Desai’s team began pulling data straight from pharmacies and payers with Medication History for Populations.

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Improving value-based care with more timely data

Who wasn’t taking their medication? Who should get a phone call for outreach?

Suddenly, it became much easier to get answers to these questions. By knowing who to call and then exploring options with the patient, Baptist Health in Louisville, KY, could change the prescription to one that worked much better for the patient.

• Integrated workflow: Medication History for Populations is integrated directly within Epic’s electronic health record (EHR) software. As Desai says, “The integration between Surescripts and Epic gets the job done the way it needs to be done.”
• Clean data: The uploaded files are clean and arrive daily. Then, depending on the payer, Baptist Health has access to all the data it needs through Epic (Medication History for Populations successfully matches 95% of patients on Baptist Health’s population lists).
• Better reimbursements: Baptist Health can demonstrate to payers the patients they’ve identified for outreach based directly on what the data says about medication adherence, for a proactive value-based care workflow (and higher stars ratings linked to better reimbursements).
• Done quickly: Baptist Health providers can see a patient’s medication adherence in two or three days—sometimes within 24 hours.

“It’s a better quality of life,” Desai says. “A better outcome for the patient.” And there was no more poking around in spreadsheets, which is helpful for pharmacy staff and providers at Baptist Health, too.

As Desai says, “It’s literally smooth sailing.”