Physician IT leaders believe that progress has been made to improve medication management, however, there is more work to be done to address gaps that could potentially impact patient safety, such as high drug costs and opioid abuse, according to a recent survey of chief medical information officers (CMIOs).
The Association of Medical Directors of Information Systems (AMDIS) surveyed CMIOs in U.S. hospitals about medication management initiatives and the impact on patient safety. According to the survey, sponsored by DrFirst, a Rockville, Md.-based medication management solutions provider, nearly 100 percent of CMIOs believe medication management improvement initiatives are having a positive impact and that patient safety issues are less likely to occur today, as compared to 5 years ago.
Among the top patient safety gaps identified by CMIOs is the “inability to prevent financial constraints” from impacting patients’ adherence to prescribed medications. In fact, 71 percent of the survey respondents cited concerns with the lack of price transparency—the ability to inform patients how much a prescribed medication will cost, including their insurance co-pay amount. Medication costs are a key concern for patients as well, as evidenced by a Truven Health Analytics-NPR Health Poll which found that 67 percent of patients who failed to fill their prescriptions in the last 90 days reported high costs as their reason.
The surveyed CMIOS also identified a major gap related to the opioid epidemic. Sixty-five percent of respondents cited the need for an integrated clinician workflow that makes it easy for clinicians to coordinate the entire medication management process, including electronic prescribing of controlled substances like opioids, access to state Prescription Drug Monitoring Programs (PDMPs) to identify patients’ opioid histories, and electronic access to prescriptions from other providers and locations to avoid potentially harmful drug combinations. Similarly, 41 percent shared concerns about providers’ abilities to prevent opioid abuse since they often cannot easily distinguish “drug shoppers” from genuine patients.
Overall, 82 percent of surveyed CMIOs agree that medication management improvement initiatives have had a positive impact on adverse drug events. However, only half of the CMIOs expressed satisfaction with the medication management process, while 12 percent indicated dissatisfaction. According to the survey, the biggest gaps in the entire medication management process are incomplete patient medication histories (80 percent) and misaligned medication reconciliation and care transition cycles that lead to misinformed decisions by care teams (75 percent).
“While the industry has clearly made significant strides to improve medication management processes, CMIOs remain troubled by a number of gaps that compromise patient safety and quality outcomes,” G. Cameron Deemer, president of DrFirst, said in a statement.
He added, “By leveraging data and medication management technologies, including those that provide easy PDMP access and price transparency at the point of prescribing, care teams are better positioned to drive safer, more effective care—and increase medication adherence for patients across the country.”
The AMDIS survey found that 91 percent of CMIOs believe the biggest gap in medication history adherence and monitoring is the lack of visibility into a patient’s medication adherence. In most cases, only pharmacies know whether a patient has filled a prescription. Eighty-five percent of CMIOs point to the lack of patient participation in the medication reconciliation process as the biggest gap for medication history availability in their organization.
In addition, CMIOs identified workflow variations across departments (91 percent), a lack of process buy-in and/or process compliance (77 percent), and a lack of process ownership (73 percent) as the top issues compromising patient safety.
Virtually all the surveyed CMIOs believe it is imperative to focus on the entire medication process when addressing patient safety concerns and process efficiencies; 95 percent also feel that reducing order entry and data validation burdens for pharmacy and clinical staff will enhance patient safety and process efficiencies.
