Automation Powers Health Park Pharmacy’s Care Transition Solution

Steve Adkins, PharmD, RPh

Pharmacies provide so many supportive services for skilled clinicians when patients are in hospitals & skilled nursing facilities. However, when that same patient with 10 or more medications gets discharged, they are forced to manage everything on their own. It just doesn’t make sense.

Steve Adkins, PharmD, RPh

Intoduction and Background

Health Park Pharmacy in Raleigh, North Carolina, started working with some of the State’s most complex “medical at-home” patients in early 2007.

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.

The Challenge

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 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.

The Decision

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 TCGRx automation.

This, coupled with the positive feedback he received from his industry colleagues about TCGRx, prompted Adkins to re-examine the company’s offerings. Soon after connecting with a local TCGRx sales representative, Adkins and his wife, Vanessa, found themselves on a flight to the company’s headquarters in Powers Lake, Wisconsin.

Several factors ultimately swayed Adkins’ decision to purchase both the ATP® 2 and the InspectRx® imaging system. These include:

  • Unparalleled Imaging Technology: The InspectRx Imaging System utilizes a 12-point electronic prescription verification system. The same technology used by the Federal Bureau of Investigations (FBI) for facial recognition in airports, is used to image each and every pouch to ensure that each patient gets the right medication at the right time, every time.
  • 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.
  • Culture: According to Adkins, the culture at TCGRx from the top down, was unmatched by any of its competitors. “Duane, Matt, and the entire TCGRx Team were filled with passion. That passion didn’t stop at providing a better machine. They truly want to be a partner by connecting us with the resources, industry partners, and opportunities to be successful.”

The Results

Since implementing TCGRx 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 that 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 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.

Make Strip Packaging Work

Adkins credits his amazing team and their partnership with TCGRx for meeting the challenge of scaling their post-acute care solution, while maintaining best in class patient outcomes, reducing supply costs and keeping labor costs in check.

“The last year has definitely had its share of stress. Luckily, we have an amazing team and we have had the support of all of the folks at TCGRx. I had a vision, a way to improve a broken system. Thankfully, we had two of the nations best pharmacists and the nation’s best automation company to help implement that vision. We couldn’t have done it without Jennifer Pippin, Diann Sutherland, and our friends at TCGRx,” said Adkins.

The ATP 2 Advantage