Better management of a patient's medications and improved medication adherence are essential to reducing hospital readmissions, according to a new report that proposes nationwide recommendations to slash rehospitalizations.
The guidlines, released today by the Network for Excellence in Health Innovation (NEHI), focus on the hosptital's role in medication management. While hospitals will pay the penalties for preventable readmissions, they must collaborate with patients, families and other organizations to create manageable medication plans that patients will actually follow.
"We knew that advancing technology and ensuring different electronic systems could communicate would be important. But, what we realized from speaking to providers in Connecticut and California is that person-to-person contact and communication between all stakeholders is just as important to achieve the coordination of care and medication adherence that results in reduced readmissions," says Thomas E. Hubbard, vice president of policy research, in an NEHI statement.
The report, "Reducing Hospital Readmissions Through Medication Management and Improved Patient Adherence," includes six "near-term" recommendations that hospitals can undertake:
- Adopt evidence-based transitional care models that will allow hospital staff to collaborate with local primary care physicians and other care providers
- Screen emergency room patients upon arrival to identify those at highest risk for readmissions--patients who typically have complex medication management challenges
- Talk to hospital staff about how to improve the quality of medication reconciliation
- Incorporate the patient-centered medical homes model into your orgnaization to encourage primary care physicians to become active partners in reducing avoidable hospital admissions by pro-actively managing post-acute care
- Assess opportunities that can more effectively use all pharmacy resources to promote better medication management
- Use Medicare Medication Therapy Management services, an opt-out benefit that allows eligible patients guaranteed access to medication review and planning service
In the long-term, the report says healthcare organizations should work to make real-time patient medication data available at all points of care; create a state-level discussion on how to use pharmacists with appropriate clinical skills to implement comprehensive medication therapy management; and explore opportunities to implement evidence-based changes to prescription drug coverage payment policy among all payers.
As the report calls for further discussion on how to use pharmacists in the transitional care process, that dialogue has already resulted in change in California with a new law that gives pharmacists "provider" status. Pharmacists are already making a difference in helping cut readmissions at Chicago's Mercy Hospital & Medical Center, where they work at a clinic for recently discharged patients helping them with medication issues.