Pharmacy

Startup founders said they will use the funding to build out a nervous system for healthcare that connects providers, patients, pharmacies, labs and specialists. 

The money will help states improve data collection and analysis to better understand how to prevent opioid abuse, curb deaths and treat addiction.

In response to the growing opioid epidemic in the state, Pennsylvania Governor Tom Wolf announced the launch of the Prescription Drug Monitoring Program this week. State officials hope it will help to spot patients battling addiction and allow for intervention.

CVS Health Research Institute shows potential for $38 million to $63 million saved per 100,000 health plan members.

As patients learn to manage high-deductible plans and health savings accounts, convenience, accessibility and neighborhood connections are shaping patient's financial decisions.

With an eye on improving safety, increasing compliance and reducing waste, an increasing number of hospitals and health systems are looking to insource and automate their IV compounding processes.  

Struggling with long wait times, the Veterans Affairs Health Care System is trying something new: a partnership with the CVS Pharmacy chain to offer urgent care services to more than 65,000 veterans. The experiment begins today at the VA’s operations in Palo Alto, California. Veterans can visit 14 “MinuteClinics” operated by CVS in the San Francisco Bay area and Sacramento, where staff will treat them for conditions such as respiratory infections, order lab tests and prescribe medications, which can be filled at CVS pharmacies. The care will be free for veterans, and the VA will reimburse CVS for the treatment and medications. Whether the partnership will spread to other VA locales isn’t yet clear. The collaboration comes amid renewed scrutiny of the nation’s troubled VA health system, which has tried without much success to improve long wait times for veterans needing health care. Despite a $10 billion “Veterans Choice” program allowing veterans to receive care outside the closed VA system, vets nationwide wait for an appointment even longer than they did before the program started in 2014, according to a federal audit. The MinuteClinic partnership is not part of the Veterans Choice program. “The concern has always been, how do we make sure veterans get the care they need in a timely way and in a way that works for the veteran?” said Dr. Stephen Ezeji-Okoye, the Palo Alto VA’s deputy chief of staff. The deal indicates that the VA is willing to try outside partnerships to meet veterans’ needs, he said. “We want to have not just timely access but geographic access to care.” Sarah Russell, the Palo Alto VA’s chief medical informatics officer, came up with the idea, said Ezeji-Okoye. The VA will integrate MinuteClinics’ patient records with its own electronic health records to provide consistency of care, Ezeji-Okoye said. The Palo Alto VA fares better than some other facilities nationwide in providing timely care to veterans, according to VA data, and Ezeji-Okoye said most patients with urgent care needs are seen quickly. But the system was so busy in the past year that about 11 percent of appointments at its network of hospitals and clinics — which stretch south from Sonora to Monterey — could not be scheduled within 30 or fewer days, which is considered an acceptable timeframe,VA data show. That includes appointments that would require urgent care. More than 5,000 appointments system-wide were scheduled more than 30 days out, but each hospital and clinic’s performance varied widely. At a Fremont clinic, less than 2 percent of appointment requests could not be scheduled within 30 days. At the VA’s rural Modesto clinic, by contrast, more than 17 percent of requests were not be scheduled within 30 days. Once the MinuteClinic operation is well underway, Ezeji-Okoye anticipates that between 10 and 15 veterans — from among the estimated 150 who call the Palo Alto VA’s advice nurse hotline daily — will be treated at the retail clinics on any given day. About 95,000 veterans are eligible to use the Palo Alto system, one of the VA’s largest in the Western United States. About 65,000 use it every year. The $330,000 pilot project will be evaluated after one year. CVS’ MinuteClinic president, Dr. Andrew Sussman, hopes it can be rolled out nationally if it succeeds. CVS is by far the biggest player in retail pharmacy clinics, operating 1,135 of them in 35 states. “We’d love to have that opportunity to expand after we go through this phase,” Sussman said. “We’re well suited to help because of our large footprint and ability to see people on a quick basis.” It is unclear, however, what the VA’s nationwide plans are. The Veterans Health Administration office did not respond to Kaiser Health News’ request for comment. Blake Schindler, a retired Army major who lives in Santa Clara near one of the participating MinuteClinics, was intrigued, but cautious about the MinuteClinics. He counts himself lucky because unlike some other veterans, he has access to the U.S. military’s TRICARE health insurance program for active and some retired service members. “It could make a big difference, but how much access are the veterans going to have? That was the big problem with the Veterans Choice program; it didn’t end up the way it was supposed to,” said Schindler, 58. “I’m always hopeful when I hear about these things; I keep an open mind until I have experience with it,” he added. This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation. Twitter: @HealthITNews Like Healthcare IT News on Facebook and LinkedIn

Getting pharmacists involved in patient-centric activities, including being part of clinical care teams, is a little easier thanks to telepharmacy technology. When Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, needed to optimize its pharmacy workflow with the goal of improving patient care, it turned to PowergridRx, a cloud-based HIPAA–compliant telepharmacy platform from San Francisco-based PipelineRx. Starting in February, Dartmouth-Hitchcock began deploying PowerGridRx in its hospitals across New England. PowerGridRx is a software as a service platform that aggregates, manages and optimizes virtual pharmacy management for health systems. In addition, it differentiates Dartmouth-Hitchcock's telepharmacy network and manages the order verification process for current and future facilities. The interoperable technology platform is designed to improve medication administration visibility between facilities and addresses logistical and budgetary challenges that arise from managing and staffing multiple care settings. [Also: Dartmouth-Hitchcock, Harvard Pilgrim join forces on population health] Sarah Pletcher, MD, medical director and founder, Center for Telehealth at Dartmouth-Hitchcock Medical Center, said the health system uses PowerGrid Rx as a tool in the delivery of telepharmacy services across wider landscape. "Our customers are the ultimate end user in that regard," Pletcher said. After going live in six hospitals Dartmouth-Hitchcock has processed thousands of patient orders: "We have data that suggests the benefit to the hospitals in that we are allowing them to load-level staffing and optimize their in hospital team sometimes deploying them to more patient care or clinical activities," she said. Pletcher pointed out that for many smaller rural and critical access hospitals, the volumes that they see on weekends for example, aren't enough to rationalize them having an in-house pharmacist. "But we are also finding hospitals recognizing the value of having telepharmacy support for scenarios where they want to allow their pharmacists to be out on the floors helping with patient care," she said. In a cancer infusion suite for instance, Pletcher explained that oftentimes pharmacists are part of clinical team working on projects where they might be involved in an electronic medical record implementation, or working on quality or formulary projects for the hospital. "Any time we can help extend their team to allow them to optimize their in-hospital team, we're happy to be there for them," she said. From a technology perspective, Pletcher noted that there are obstacles associated with integration and with host IT systems and EMRs. She said that with anything involving multiple hospital IT departments and multiple hospital EMRs, there's always a challenge – not just the technology integration, but cultural barriers where hospitals have different levels of comfort for how much bi-directional integration they want with outside software platforms. "Because we offer so many other telemedicine services this is something we are familiar with managing – the telepharmacy is the latest service – we have six or seven other 24/7 telemedicine services to hospitals where we've had to contend with IT or EMR integration. We kind of know to expect and support those conversations." Pletcher said Dartmouth-Hitchcock is expanding its telepharmacy program to more sites and more regions. "We're excited about the opportunity to further integrate our telepharmacy solutions with other clinical services." Industry insiders contend that the demand for PowerGrid Rx-type technology is on the rise for multi-site multi-facility organizations that are growing and want to tie their pharmacy network closer and closer together. "We want to create a platform that enables them to share pharmacy labor and pharmacy resources across their whole organization, opposed to having to staff individually each hospital within their network, this enables them to tie them to together," said Brian Roberts, CEO of PipelineRx. Roberts noted that among the challenges is to work with different and multiple types of IT systems. "Some of our customers have eight to ten different types of IT systems that they work with - we integrate back with their host IT systems and bring it into one platform." The other side, according to Roberts, is that they want a system that can capture policies and procedures for each one of their individual hospitals. So for example, if they were creating a central telepharmacy center they would want that telepharmacist to have information at their fingertips. "Our tool helps consolidate and bring policies and procedures into one software offering," said Roberts who added that because PowerGrid Rx is a cloud-based piece of software – there is no hardware on each individual site. "So we use the power of the Internet to build a private cloud that can manage all that information – manage the information and store the information for the hospitals." Roberts said CIOs like that because it’s a cloud-based piece of software that doesn't require them to have to go and do updates and update hardware; that's all taken care of from the PipelineRx side.

Cleveland Clinic clinicians will be available for on-demand visits at CVS Health MinuteClinics in Ohio via technology from American Well.

New research found variations in cholesterol levels that drew concern because they could potentially determine whether a physician at point of care would prescribe medication to a patient.