Health Park Pharmacy in Raleigh, North Carolina, started working with some of the State’s most complex “medical at-home” patients in early 2007, adding services focused on transition of care.
Project Harmony Revealed a Greater Need
Patients on complex medication regimens frequently cycled in and out of hospitals, adult care homes, and rehab facilities due to the lack of a standardized care transition solution.
In an effort to support this growing population of patients, Health Park started adding a number of supportive services including: medication synchronization, monthly phone calls from a “health coach,” compliance packaging, and care coordination for post-acute care patients in transition from hospitals and rehab facilities.
In just a few short months, the care coordination and transition program had amazing success and boasted a mere 3% — 30 day readmission rate, compared to the national average of >25%. Adherence packaging was a cornerstone of this program and to date, the pharmacy had been facilitating adherence packaging by hand; however, due to the success of the program, they were having a hard time keeping up with the growing demand.
In early 2015, Steve Adkins, Owner of Health Park Pharmacy, and his team decided to create a system, they refer to as Project Harmony. The program was designed to eliminate confusion about a patient’s appropriate medication regimen, eliminate medication errors, overuse of narcotics and suboptimal use of medications, implement a standardized means of communicating medication reconciliation documentation to key community players, provide thorough follow through on referrals and develop significant and meaningful collaboration between institutional and community healthcare providers.
“Before Project Harmony, we had no idea that some of our patients were ever in the hospital or rehab facility. Those patients would go back to taking the regimen they were on, prior to the admission. That inevitably lead to a readmission,” said Steve Adkins.
After a few short months, Project Harmony had grown to a patient census of greater than 350, and gained interest from Well Care Home Health, one of the largest home healthcare agencies in North Carolina.
Automation Changed Everything
Adkins started investigating automated solutions that filled either pouch packs or multi-dose blister cards in 2012.
By the summer of 2015, Health Park Pharmacy was having a hard time keeping up with the adherence packaging demands of their growing patient base. Adkins knew that Health Park needed an automation company to help them keep up with the demands of their new home healthcare partner, without sacrificing quality assurance. Adkins had spent close to three years investigating each of the companies that offered automation for compliance packaging. He found that pharmacies throughout the nation with the highest rate of success, had one thing in common — they were all utilizing pouch packaging automation.
Several factors ultimately swayed Adkins’ decision to purchase both the ATP® 2 and the InspectRx® imaging system. Among them were:
- Facilitated Quality Assurance: The InspectRx compares the images of the medications in each of the packs, with an associated reference image that has been created and verified by a registered pharmacist. Medication packs with a solid green box denotes successful verification. Medications packs without verifiable images or potential errors are denoted with either orange or red boxes respectively. In such instances, a pharmacist will manually inspect those packs, corrections will be made if needed, and those packs are reimaged for final inspection.
- Efficiency: The combination of the ATP 2 and the InspectRx machines reduces the time and manual labor required to fill and dispense patients’ medications in adherence packaging.
Improved Care, Improved Outcomes
Since implementing pouch packaging automation, Health Park Pharmacy has seen significant growth in their program. Over the last twelve months, they’ve been able to onboard close to 1,500 patients. They’ve gone from an average census of approximately 350 in December 2015, to approximately 1,200 in December 2016 — almost a 250% increase in less than one year. The most important part to Adkins and his team is they have been able to grow this program without sacrificing quality or having to add significant labor costs. According to data from a CMS Innovation Pilot with Community Care of North Carolina, patients enrolled in Health Park Pharmacy’s Project Harmony Program have a 35% reduction in in-patient hospitalizations, 44% reduction in ED visits, and 25% reduction in the overall cost of care.
“We typically get between 5-10 referrals daily. While many of those come from our home health care partner Well Care, we also get a number of referrals from physicians, hospitals, rehab facilities, geriatric care managers, home care agencies, case managers from both major medical insurance companies, and a local Transitions CareChoices Team, started by Transitions LifeCare and Hospice.”
Adkins and his team have also been able to save significantly on labor and packaging costs. Adkins estimates they would have had to add approximately three full-time technicians to safely manage the new patients in hand-packed multi-dose cards. The labor savings alone exceeds $90,000 per year according to Adkins. Adkins also estimates they save approximately 50% in supply costs, compared to the hand-packed multi-dose cards.
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