Pharmacy Practice News…

Medication Reconciliation in a Snap

Patients who show up at the hospital with handfuls of pills or lists of scrawled drug regimens pose an all-too-common challenge to pharmacists tasked with performing medication reconciliation. Fortunately, one new product may make this headache a bit less painful.

The MedSnap ID system consists of an optical pill recognition app that is compatible with an IPhone 4s or iPhone 5. In a typical scenario, a patient or caregiver brings from home all the medications the patient believes he or she takes. A health care provider pours a representative sampling of pills onto the tray, then holds the phone level above them and hits the Snap button on the iPhone screen. In a few seconds the system identifies and displays the names and strength of each drug (including some widely used over-the-counter drugs). It alerts for possible drug–drug interactions, drug–diagnosis interactions and allergy risks based on the patient’s medical history, if that information is known. Drug monographs for each of the thousands of compounds in the system’s database can be called up. According to MedSnap, more than 12,000 prescription pills and capsules are on the market.

The same tasks, done manually, can easily take 30 to 40 minutes, said Patrick Hymel, MD, an emergency medicine physician and the CEO and co-founder of MedSnap. “Identifying precisely what medications a patient is taking is a major safety issue and a challenge for pharmacists. We address the ‘brown bag’ problem of medication reconciliation: when patients are asked to bring in all their prescriptions, then show up at the pharmacy, hospital, or clinic with unmarked pill bottles or, literally, bags full of pills.”

One of Dr. Hymel’s goals is to make assessment of drug regimens a “new vital sign” that’s quick and easy to gauge. “We think this is very fertile ground in terms of how pharmacists can contribute to better outcomes,” he said.

MedSnap ID, slated for market release in the first quarter of 2013, will cost $69.99 annually for the software per iPhone, and $29.99 for the rigid “Premium Tray,” or $19.99 for two portable “pocket-friendly” Lite surfaces. Users supply the iPhones.

Beta Tester Gives Tool A High Score

“This is a potentially valuable tool for medication reconciliation and should allow clinicians to more accurately capture the drugs a patient is really taking rather than relying on recall,” said Michael D. Hogue, PharmD, FAPhA, FNAP, the chair of the Department of Pharmacy Practice and an associate professor at the McWhorter School of Pharmacy, Samford University, in Birmingham, Ala., one of the sites beta-testing MedSnap ID. “It’s an interesting device, a very innovative concept, and it’s very user-friendly and can accurately identify literally thousands of prescription medications.”

According to Dr. Hogue, several dozen pharmacy students have been voluntarily using the device during their clinical rounds and documenting its accuracy. The intent is to capture as many different medications in as many different lighting conditions as possible, ensure the system’s precision, round out the drug database and identify remaining weak spots and fix them.

The company plans to follow MedSnap ID with MedSnap PT for patients. In addition to drug and dose identification, it also will include medication management reminders and schedules, as well as alerts when patients are at risk for taking the wrong drug or dose. The device is intended for people who live independently, although it can be operated by caregivers of patients who are incapable of manipulating the device themselves, such as those in assisted-living facilities. A free version of the app for caregivers (MedSnap CG), and one that will provide secure data to electronic medical record systems (MedSnap Connect) also are in development.

Dr. Hogue also envisions the MedSnap systems as potentially valuable tools for ensuring medication adherence during transitions of care. For example, after a patient is discharged from the hospital, a community pharmacist could snap a photo of all the medications prescribed for home use. “If that patient prepares to take a medication at home and snaps an image of the wrong drug with the MedSnap,” said Dr. Hogue, “the system can warn them that it’s not what they’re supposed to take and prompt them to call their pharmacist or physician to get the correct information.”

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