Installing a new technology or system upgrade is an exciting prospect for the designated project manager. Installation is the culmination of a process that typically includes months, if not years, of planning, testing and executing. A new technology or system, however, may become a costly albatross if integration with existing technologies and systems and understanding downstream implications have not been part of the project.
Consider the electronic health record (EHR). Hospitals and clinics were both eager and wary when EHRs were first introduced. The mixed reaction was well founded — especially in organizations that did not fully anticipate the necessary integration to make the EHR functional, compatible and beneficial. Even today, there are EHR integration gaps that, if eliminated, could greatly improve the delivery of care and the patient experience. One such gap, for example, is the missing connection between EHRs and local community pharmacies, which was the topic of a previous Perspectives.
Benefits of integrated technology/systems
Medication safety, a topic causing headlines in today’s media, also comes to mind when considering the benefits of integrated technologies and systems. In 2006, the National Academies of Sciences (formerly the Institute of Medicine) estimated that at least 1.5 million Americans are sickened, injured or killed each year by errors in prescribing, dispensing or taking medications. Many hospitals and health systems have since implemented programs and processes to reduce medication errors; however, there is still much that needs to be done.
Kaiser Permanente takes an organizational approach to protecting patients from medications errors through technology and integrated care.
“Medication safety is a top priority in every setting where we provide care,” says Jamie Chan, Pharm.D., executive director for Medication Quality & Patient Safety in Kaiser Permanente’s national pharmacy program. “As pharmaceuticals have advanced in the benefits they offer, many therapies have become more complicated. It’s more important than ever that patients receive the right medication, in the right dose, and at the right time, and are monitored for harmful interactions with other medications.”
Kaiser leverages its EHR system that provides its clinical staff access to the most current medication information, including alerts about medications that should be monitored for negative interactions and dosing that appears to be outside recommended ranges.
Kaiser also utilizes specialized technologies and tactics that support its medication safety efforts, including:
- KP SureNet: a method of systematically identifying patients with potential care gaps, such abnormal lab results without timely follow up and use of certain medications without adequate monitoring
- My KP Meds: technology that continuously updates the patient’s medication list
- IntelliCab: “Smart” technology that uses radio frequency identification technology (RFID) to track prescriptions from provider prescribing to patient pick up
With a health system as large as Kaiser, these integrated technologies have far reaching benefits for patients, providers and pharma within its network.
Tapping expertise through outsourcing
Not all organizations have the expertise or resources to launch and maintain integrated technologies and systems. It is the smart C-suite leadership that recognizes this and turns to outsourcing to accomplish what cannot be accomplished internally. In some instances, outside expertise is in the form of data that helps pharma understand its competition and positioning, payers manage their drug coverage formularies and clinicians better understand coverage of the drugs they prescribe. In other instances, it may be more significant outsourcing that includes significant corporate relationships.
Eli Lilly knows the importance of finding the right resource to improve integration and service. Since 2008, the company has taken several strategic steps to reduce its fixed cost structure and to improve access to best-in-class development and manufacturing services. Long-term arrangements with Covance and Fisher Clinical Services, ensure expert oversight and integration of Lily’s drug manufacturing, packaging, labeling and clinical-trial materials distribution services.
Lilly also launched its fully integrated pharmaceutical network (FIPNet) to partner with expert service providers that can perform key functions more quickly and cost-effectively than Lilly has been able to perform in-house, and also Chorus, a completely rethought process for screening and selecting drug candidates.
It is not easy to change a deeply engrained culture that may be inadvertently enabling a project-silo mentality. To amplify success, it takes visionaries who see the benefit of:
- Resourcing expertise in the most viable way (enlisting the most influential internal and external resources)
- Limiting downstream chaos (avoiding unintended consequences and maximizing the benefit to all stakeholders)
- Connecting the entire healthcare network (ensuring technologies effectively interact along the entire continuum of care, including beyond the healthcare system’s walls)
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