Managing Medications in an IDN or ACO

Mo Kharbat
Mo Kharbat

Guest post by Mohammad (Mo) Kharbat, RPh, MBA, director of pharmacy, ProHealth Care Inc.

Managing medications throughout several facilities within an integrated delivery network (IDN) or accountable care organization (ACO) is challenging. Recent Joint Commission surveys show that appropriate medication storage is the most common regulatory standard hospitals struggle with. As director of pharmacy at ProHealth Care Inc. (ProHealth), a regional integrated health network in Wisconsin with about 400 hospital beds, this is a challenge that I am all too familiar with.

One of my primary responsibilities is ensuring that all medications are well-managed throughout our facilities. As ProHealth has expanded to include a wider array of care delivery sites, medication management has increasingly become associated with high financial stakes. If medications are not well managed, hospitals lose money. Every pill that is unaccounted for translates to dollars lost for a provider. And when facilities fail to meet Joint Commission medication management standards, they risk valuable Medicare reimbursement funds.

Failing to automate the process of tracking and storing medications is akin to a bank using an abacus to count the money it stores. Fortunately, the latest advancements in health IT have made medication management throughout the continuum of care simpler than ever.  

At ProHealth, we are in the process of implementing Omnicell’s medication automation technology throughout our facilities. As more of our care sites bring on new automation tools, two features in particular have been beneficial to keeping our medication use in check: barcoding technology and connectivity between our facilities and our electronic health record (EHR) system. These tools are vital to ProHealth’s compliance with Joint Commission standards, which mandate that medications are properly and safely stored, that all prescriptions or medication orders are reviewed for accuracy and that medication orders are clearly written and accurately transcribed.

Critical Feature #1: Barcoding

All medications must now be scanned using a barcode scanner before being placed into a medication cabinet. Medications can then be tracked throughout the continuum of care – from storage to dosage – so we know exactly how much of every drug is being used, when it is being used and where. We are now able to view this data at any of our sites because our medication dispensing system connects with our EHR. This level of interoperability is invaluable as I now have access to drug usage information from anywhere in our IDN. This makes it easier to track shortages, potential diverters and any other changes in use that impact medication availability to our patients.

Critical Feature #2: Connectivity

All of ProHealth’s facilities, from hospitals to hospices, have benefited from the barcoding technology and connectivity across facilities throughout the medication management process. In particular, the facilities without pharmacies on-site have benefitted the most from these changes. Without access to a pharmacy 24/7, clinicians need more drugs on-hand so that they can get whatever their patients may need. However, storing a large quantity of drugs without automated monitoring technology allows too much room for human error, which reduces patient safety and increases the risk of losing money.  Nurses retrieving a large stash of drugs without the drug being tracked via barcode technology and a centralized database may risk giving an incorrect medicine or dosage without realizing it. The latest technologies in medication automation help to prevent and flag these mistakes, making it possible for all facilities throughout an IDN or ACO to have a large inventory of medications without increasing the possibility of medication errors.

Medication automation is the way of the future, particularly when managing multiple care sites within a large IDN. I am constantly striving to find ways to save time and money while improving safety and quality of care. Automated cabinets allow us to better track medication usage to forecast needs and allow each of our clinicians to access more of the medication when they need it without wasting valuable time manually entering medication data or contacting a pharmacy miles away.

IDNs and ACOs looking to prevent waste should consider automating their medication management.  Thanks to the latest advances in medication tracking, storage and distribution, patients can expect the right medication when they need it, even without a pharmacy on-site.  

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