Medication Reconciliation: One Hospital has an App for That
By GABRIEL PERNA
Not every healthcare technology system is going to make sense for an organization and not every healthcare organization is going to make sense for a technology system. What often separates the industry-leading organizations from the rest of the pack are the strategic decisions that go into big investments.
Take for instance, the Cullman Regional Medical Center (CRMC), a 145-bed facility in Cullman County, Ala. Cullman, which has been honored by several national publications and organizations as an health IT industry leader, has always operated on a singular philosophy of using technology to drive patient safety and quality through performance. As a hospital that serves 150,000 patients and the only Level 3 trauma center between Huntsville and Birmingham, that’s how it’s got to be. This isn’t a new philosophy—it’s been in place for a while.
“We’ve had an electronic medical record (EMR) for eight years. We didn’t need the stimulus from the government to recognize an EMR is going to make a lot of sense for the patient and for the staff to deliver healthcare,” explains Jim Weidner, president and CEO.
Every single innovative, award-winning technology, such as its “Good-to-Go Patient Discharge Initiative” and its homegrown surgery tracking system, has gone through the ringer to ensure it meets those lofty standards. This includes the organization’s latest foray, the MedSnap ID Enterprise application, from MedSnap, a Birmingham, Ala.-based medication adherence vendor.
Easy, Low-Cost Technology
MedSnap and CRMC have a bit of a history, reveals Weidner. The Alabama company first introduced a product, a real-time infection tracker, to CRMC 10 years ago. The success of that product made it easier for the hospital to say yes to another beta product from MedSnap that he says can help with medication reconciliation, readmission rates, and nursing accuracy and efficiency.
The MedSnap ID application allows for providers to take a photo of various medications using an iPhone 4 or higher and then have those medications recognized and listed. The medications are placed upon a piece of grid paper five inches away.
One of the biggest reasons for high readmission rates, Weidner says, is not because of early discharge, but rather a lack of understanding from the patient side on taking medications. Quite simply, he says, it allows for the provider to know whether or not the patient is taking the right medication at the right time.
“The technology in of itself is impressive, but the simplicity and relative low cost to put this application in various parts of hospital made it a no brainer for us that this was technology that we wanted to embrace,” Weidner says.
Cullman has used the app in its pharmacy and home health areas, and the hospital plans on expanding to the emergency department in the future. For nurses out in the field or at home, this app provides more of a guarantee than asking patients to remember what they are taking. “In many cases, the patient doesn’t know. This quickly categorizes what that patient has been taking at home, which provides much more detail for the attending physician in the ER department…same goes for home health,” Weidner says.
CRMC is working towards automatic integration with the patient’s EMR, Weidner reveals. The provider uses CPSI (Mobile, Ala.) and connecting it with MedSnap would increase accuracy and efficiency, he says. Once the nurse verifies what is on the MedSnap list is in fact the same regiment of medications, he says, that information can be uploaded into the EMR and used to make sure the patient is on the right medications.
Building the database was one of the biggest concerns for Cullman in taking on the project, according to Weidner. He says the MedSnap folks worked within Cullman’s pharmacy, taking photos of all the medications in its formulary. The vendor also worked with a number of university healthcare settings, in Stanford and Auburn, and doing the same thing.
“That was our concern. That was the nurses’ concern. What is the reliability? You can imagine the Herculean effort, all the different medications, to have that in a huge database,” Weidner says. The database, through that work, has been able to cast a wide net, he adds.
Thus far, CRMC hasn’t gotten a true look at whether or not the MedSnap ID application has improved medication reconciliation and readmission rates. Eventually, Weidner says the organization will look at the data on a continual basis, the before and after numbers. Until then, it will just have to rely on its tried, true philosophy. For anyone looking to accumulate similar accolades with technology, he recommends doing the same.
“If you want to know where to use technology, look for an area of high risk to the patient if we get it wrong, an area that is an extreme cost if medications aren’t administered properly, and it’s fairly easy to see that these are the areas that if there is technology to help, these are the areas you need to invest in, in order to make a quantum improvement, and not just an incremental one,” Weidner says.