As I listened to a presentation during the NJ HIMSS spring event yesterday, my mind started to wander — but not because I was disinterested in the material. Rather, it was because the words were hitting quite close to home. During this particular session, Indu Lew and Robert Adamson of RWJ Barnabas Health were discussing ‘Medication Management across the Continuum of Care Landscape,’ and I couldn’t help but reflect on how much — and, in some cases, how little — things have changed since I gave birth to my twins four years ago today.
Lew, who is Corporate VP of Clinical Pharmacy Services, and Adamson, who is Chief Pharmacy Officer, talked about some of the initiatives in place at their organization and some solutions they’re looking to install to facilitate better coordination when it comes to medication management. The reasons are obvious — improved adherence can lead to reductions in readmissions, length of stay, and ED visits, as they pointed out. But it’s more than just that; when every member of the care team is on the same page when it comes to medications, it can lead to improved outcomes and much higher levels of patient satisfaction.
I know that in my experience with labor and delivery, several of the strategies Lew and Adamson touched could’ve made a world of difference. To give a brief backstory, I delivered my twins 7 weeks early after an extremely stressful week during which I constantly underwent tests and monitoring. Although they were born relatively (thank goodness), they weren’t fully developed, which meant a month-long stay in the NICU and several follow-up visits with specialists.
Now, I realize much of the pharmacy management efforts are geared toward chronic care patients, but I can attest that they would’ve been just as beneficial to a new mom going through a scary ordeal. Here are a few examples:
- Electronic meds reconciliation tools that populate all data into the EHR. In preparation for my emergency C-section, I had to answer (yet another) series of questions about my history, and when I couldn’t recall the medication drug I had taken earlier in my pregnancy, the anesthesiologist became really frustrated. I didn’t understand why this information wasn’t already in my record, as my OB-GYN practice was owned by the hospital. And in my defense, someone who has just spent 24 consecutive hours hooked up to monitors should’ve have been put in that position. By that point, I’m lucky I could remember my date of birth.
- E-prescribing. When my son was discharged from the hospital, he came home with an apnea monitor and a prescription for caffeine that could only be obtained from a specialty hospital. You can imagine how fun it was while my husband and I frantically searched the diaper bag for the blue Rx slip during our first car ride with our tiny newborns.
- Meds to Bed, a concierge service in which medications are filled by the hospital pharmacy and delivered to the patient at bedside before he or she is discharged. This one in particularly is aimed at improving adherence among chronic disease patients (who account for 81 percent of readmissions, according to Adamson). But in my case, having pain medications in my possession before going home meant one less stop at the pharmacy, which can make a tremendous difference.
- Remote monitoring. At about 8 weeks, my daughter stopped gaining weight due to reflux. Luckily, our pediatrician was able to make a quick diagnosis. But to make sure she was on the right track, we had to bring her in every other day for nearly two weeks to be weighed (not exactly an easy task when you have another tiny infant at home). If we had been able to weigh her at home, it would’ve made life much easier.
While it would’ve been great to have these tools in place four years ago, the fact that organizations are making strides in this area gives me hope — for elderly patients who can’t list every medication they’re on, for diabetic patients who have trouble getting to the pharmacy, and for scared new moms who could use a little help.
By taking these steps, organizations like RWJ Barnabas are reconciling so much more than just medications.
[Happy birthday, Austin & Scarlett!]