Pharmacy

Physicians are embracing electronic prescribing more rapidly than ever before, according to new data from Surescripts – especially in New York. In the Empire State, more than 48,000 providers have embraced digital prescriptions as a way to avoid fraud and abuse of prescription drugs – and a way to avoid fines. The deadline for complying with the state’s Internet System for Tracking Over Prescribing, or I-STOP, mandate for digital prescribing is March 27. [See also: NY e-prescribing law takes effect March 27, doctors now face fines for pen-and-paper.] Since March 1, the number of New York providers adopting electronic prescribing of controlled substances increased 28 percent, Surescripts reports. New York Is ahead of other states in e-prescribing adoption with 47 percent uptake, compared with numbers nationwide at just 8 percent. “The industry has made remarkable progress in adopting this critical technology that can have a direct and immediate impact on improving patient care and saving lives,” commented Surescripts CEO Tom Skelton, in a news release. Skelton pointed out that pharmacy adoption of the technology is nearly universal, with 95 percent of pharmacies in New York ready to prescribe controlled substances electronically. In 2013, more than two million Americans abused prescription painkillers such as hydrocodone, oxycodone and methadone, according to Surescripts. Drug diversion is a significant concern when it comes to controlled substances, officials say, with between three and nine percent of diverted drugs for abuse tied to fraud or forgery of paper prescriptions.  Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

The I-STOP legislation, first passed in 2012, aims to combat controlled substance abuse. A provision set to take effect at the end of this month requires doctors to prescribe almost everything electronically.

Hackensack University Medical Center is tapping new technologies to achieve more effective medication adherence, according to Hackensack UMC’s director of pharmacy Nilesh Desai. Hackensack UMC has been an early adopter of technologies and processes to advance medication safety and nurse workflows, Desai explained, along with interoperability between automated dispensing cabinets and EHRs. [Also: 11 essential quotes from notable HIMSS keynotes] Nurses are responsible for interacting with the automated medication dispensing cabinets, and the time they spend at the cabinets can be reduced significantly via more interoperable systems, for instance. Desai will discuss the hospital's progress in this realm during a HIMSS16 session titled “Impact of an ADC System on Medication Administration.” See all of our HIMSS16 previews Medical administration systems must be able to address patient-specific medications and offer robust inventory and data management processes, Desai said. Hackensack UMC tapped Omnicell, a provider of medication and supply management solutions and analytics software for healthcare facilities, to deliver automated medication management solutions throughout the 775-bed hospital. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

UPMC doctors are piloting a new program to administer gene tests to patients to determine whether they are likely to respond to medications. For example, a simple blood test can determine whether a patient with clogged arteries has a gene variant that makes them less likely to respond to blood-thinning medication. At UPMC, doctors are testing for that gene before prescribing medications to patients who receive a stent. With this pilot, UPMC is among first-mover health networks embracing genomics to improve patient care. NorthShore University Health System, for instance, earlier this year opened a pharmacogenomics clinic and is working to incorporate that data into patient records so clinicians can access what it called “systematic and discrete data points” when treating patients. [Also: Pharmacogenomics coming to EMRs] UPMC’s goal is to use clinical pharmacogenomics knowledge to individualize patient treatments – part of a broader program at UPMC that officials say could eventually include a wide variety of drugs to improve outcomes for patients. "Increasingly we are able to pinpoint gene variations and other factors that affect how patients metabolize drugs, allowing us to more precisely target the right drug for the right patient," said Philip Empey, assistant professor of pharmacy and therapeutics at the University of Pittsburgh School of Pharmacy, and the leader of the program, in a statement. [Like Healthcare IT News on Facebook] The genetic and clinical information that is gathered for the PreCISE-Rx program, also feeds UPMC's data analytics program, which is expected to lead to new scientific insights into how and why drugs work for some patients but not others, and to identify new drug targets. More than 700 patients are expected to be treated through this project at UPMC Presbyterian's cath lab in the coming year. Past studies show that 30 percent of patients are unlikely to appropriately metabolize clopidogrel (the blood thinning medication), and about 10 percent experience complications because of the blood thinner's ineffectiveness. The UPMC research team will follow up with patients and collect data to evaluate their outcomes. UPMC plans to roll out the program at other hospital cath labs and expand it to include other medications. Twitter: @HealthITNews

Consolidation, increased regulation and shortages of critical medications are just a few issues that have health system pharmacy managers scrambling. "We are being faced more and more by challenges within the system," said DeVere Day, pharmacy automation and technology manager at Salt Lake City-based Intermountain Healthcare. "We're facing challenges from an expense standpoint. There are certainly compliance and regulatory concerns. Automation has become very expensive for many hospital systems. Sterile compounding is a concern with hazardous drug therapies and medication shortages in the industry have created a lot of heartache." See all of our HIMSS16 previews Day will be presenting "Transforming the Pharmacy Supply Chain," an exploration of Intermountain's implementation of a central pharmacy supply chain center for its entire enterprise, and the strategic decision making that has resulted in pharmacy savings to the tune of approximately $3.5 million companywide in 2015. "We distribute about 4.5 million doses a year within our system," Day said. "The majority of those go to our 22 hospitals but we have 185 clinics we have begun working for as well, so we are now supplying many of the clinics within our system." Day cited technological platforms including carousels, packaging machines and a third-party software tool that enables staff at the supply chain center to visualize inventory at other Intermountain facilities. Those other facilities, in turn, can use that software to place orders directly, with each hospital's central pharmacy responsible for internal distribution. The technology is just the enabler of astute strategic thinking, however. For example, Intermountain compounds only nine IV drugs, and the focus on those leads to approximate savings of $500,000 annually over buying those drugs from a wholesaler, Day said. He cited rapidly changing industry status, such as the recent merger between Pfizer and Hospira, and AmerisourceBergen's announced purchase of compounder PharMEDium, as elements the central supply chain center can help cope with. "We have put ourselves into a position where we can adapt to market changes, and the market is changing so fast it's hard to predict where your greatest impact is going to be," he said. And while Day explained that economies of scale at a larger system may yield benefits smaller organizations can't match, that's no reason not to evaluate just what can be done to improve efficiency. [Like Healthcare IT News on Facebook] "I guess the strategic planning side of it has value for anybody," he said. "Some of our shops are as small as 20 beds, some as large as 400, and we have found ways to provide value for all of those." Day will be presenting "Transforming the Pharmacy Supply Chain" from 4 - 5 p.m. March 1 at the Sands Expo Convention Center, Marcello 4401. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

Cincinnati, Ohio-based Mercy Health has saved more than $42 million on drugs since 2010 by building a formulary within its electronic health record platform. The move, according Wayne Bohenek, vice president of care transformation at Mercy Health, makes it easier for the system’s network of providers to order medications that are on its list and compliant with Mercy’s pharmaceutical contracts. The 23-hospital system went live with its Epic EHR in 2010. It took Mercy Health’s pharmacy and therapeutics committee three years to create the formulary -- a comprehensive list of medicines that Mercy Health would prescribe, said Bohenek. The committee, composed of prescribers from all specialties, evaluated the cost-effectiveness, side effects, comparable efficacy, indications and available literature for medications in 100 classes. [Also: Managed care pharmacies reap benefits of EHRs] Mercy places drugs in one of four categories: on the formulary and available from order sets; on the formulary but not available from order sets; restricted to a specific disease state or provider type; and neither on the formulary nor in order sets. These categories correspond to Mercy’s “bullseye” -- a visual representation of each medication class that committee members use to review their decisions.  For drugs that are neither on the formulary nor in order sets, Mercy built more than 800 therapeutic interchanges. When providers order a non-formulary medication, the system suggests formulary alternatives. If providers don’t choose an alternative, they document a reason. Mercy reports on the data to identify providers who routinely order non-formulary medications. “We generate reports on non-formulary drugs -- how many times they were ordered, and what the cost savings would be if we were to use a formulary drug instead,” Bohenek said. “We can provide that report by region and provider and have discussions with providers who are using non-formulary drugs. The reports show providers how much non-formulary drugs are costing the region.” “We’re pretty prescriptive about it,” said Susan Mashni, chief pharmacy officer at Mercy Health. “An extensive drug monograph is completed for each class of medications.” So far, Bohenek and Mashni said providers have been receptive tot eh workflow. “I think most prescribers see the reality of how much drugs cost and what the impact of prescribing them is,” Mashni said. “As long as it’s just an educational discussion, they’re very responsive to the concept that you’re going to improve patient compliance if you don’t give them the most expensive drug out there.” Mercy Health now has an average formulary compliance of more than 98 percent. [Like Healthcare IT News on Facebook] The formulary management is most effective with a single EHR across the health system because it enables the health system to make modifications as their contracts change and to monitor compliance.   The move to Epic – and the health system board’s insistence that 85 percent of content be standardized – provided the impetus Mercy needed to adopt a formulary. Prior to rolling out Epic, Mercy employed a mix of technology, primarily from McKesson and Meditech  – and paper. Twitter: @HealthITNews

Martin Shkreli, the infamous pharma CEO who drew widespread scorn for hiking the price of AIDS drug Daraprim from $13.50 a pill to $750, was arrested by federal agents Thursday morning on charges of securities fraud.

Emdeon, which bills itself as one of the largest, independent healthcare technology companies providing analytics, connectivity, communications, payments, consumer engagement and workflow platforms, today announced that the company is rebranding.

With e-prescribing of controlled substances legal nationwide, providers and pharmacies are empowered with a new technological tool in the fight against prescription painkillers. Now more need to use it.

Analytics firm Zephyr Health, a San Francisco-based startup that bills itself as an "insights-as-a-service" company for the healthcare industry, closed on a $17.5 million third round of funding, led by Google Ventures.