Embedded Refills: Improving Workflow Efficiency and Optimizing the Medication Renewal Process

In this webinar, you’ll learn how Embedded Refills provides EHR-embedded insights fueled by evidence-based protocols, allowing staff to quickly approve prescription renewal requests on behalf of providers and proactively close gaps in patient care.

1. Embedded Refills: Improving Workflow Efficiency and Optimizing the Medication Renewal Process  Emily Rodriguez and Jessica McCay

2. Today’s Speakers Emily Rodriguez Director of Technical Success for Embedded Refills at Health Catalyst Jessica McCay   Director of Customer Success for Embedded Refills at Health Catalyst

3. Today’s Challenges with Refills Solution: Embedded Refills Implementation Overview Post Go-Live Support and Data Q&A

4. Poll #1 On average, how many minutes does it take to refill a medication? 1 – 3 minutes 4 – 7 minutes 8 + minutes

5. Poll #2 Who completes the majority of refills at your organization? Providers Pharmacists Medical Assistants/Registered Nurses/Pharmacy Technicians

6. Today’s Challenges with Refills Solution: Embedded Refills Implementation Overview Post Go-Live Support and Data Q&A

7. Impact on Staff 40 % Clinical work that is redundant or otherwise wasted effort IHI, 2019 4.5 Average minutes per renewal request it takes a pharmacist to review a patient chart J Am Pharm Assoc, 2013; J Prim Car Improper chart review and manual review processes and lead to safety and quality concerns Requests that are duplicate or not on the active med list McGuirt (2018) 9.5 % More pressure on staff to meet internal productivity measures (e.g. 24 hour turnaround time)

8. Impact on Patients Patients’ experiences with care correlate with adherence to medical advice and treatment plans Patients who don’t receive recommended lab monitoring for adverse medication effects Long turnaround on prescription renewal requests Ambulatory care and hospitals rank below internet retail, banking, and the automotive industry in consumer satisfaction American Consumer Survey, 2017 22.4%

9. Impact on Information Services 10 hrs. Time to build one protocol Analysts spend hours stuck in the middle of consensus discussions Lack of content maintenance = risk for inappropriate monitoring and lack of trust in decision support tool Highly demanded resource Limited number of staff and time 2,500 hrs. Time to create protocols for most commonly prescribed medications

10. Today’s Challenges with Refills Solution: Embedded Refills Implementation Overview Post Go-Live Support and Data Q&A

11. The Value of Health Catalyst Embedded Refills ™ Strengthen Analytics Accuracy & Trust Delegation Protocols enable staff to work top of license through delegation Optimization Expand on learnings to enhance efficiency and achieve a higher ROI Consensus Alignment on Clinical Rules that drive your protocols Implementation Embedded Refills drives efficiency and effectiveness

12. Poll #3 What percentage of your organization uses medication refill protocols? 0 – 25% 25 – 50% 50 – 75% 75 – 100%

13. Medication Office Visit Monitoring Delegation Level Protocols Single medication Single route Full therapeutic or pharmaceutical class All routes Protocol Components: Protocols can be constructed on a spectrum of specificity:

14. Monitoring Criteria Lab tests Vital signs Procedures or imaging Questionnaires or patient assessment tools Documents (i.e. controlled substance agreements) Health Maintenance topics Defining the Required Monitoring for Medications

15. Protocol Build: Diabetes Medication Metformin Metformin Combinations Cr eGFR HbA1c Visit Manual Review Message SGLT2: Ertugliflozin DPP-4 inhibitors DPP-4 inhibitors + Glitazone combinations Sulfonylureas Sulfonylurea + Glitazone combinations Cr HbA1c Visit Diabetes Supplies Visit

16. In Protocol

17. Off Protocol

18. Out of Protocol

19. Active Med List Checking/Medication Errors

20. Duplicate Checking

21. Poll #4 What is the average turnaround time for a requested refill to be completed at your organization? 24 hours 48 hours 72+ hours

22. Today’s Challenges with Refills Solution: Embedded Refills Implementation Overview Post Go-Live Support and Data Q&A

23. Implementation Overview INITIATION PLANNING EXECUTION MONITORING CLOSING Team Alignment Design & Content Stakeholders align, roles and responsibilities are assigned, and project team is organized Gathering of requirements, operational processes, and integration specs to be approved by sponsor Build, Test, Train & Go Live Embedded Refills configuration & IT build, end-to-end testing & user training, and product go-live Post Go-Live Support Series of check-ins with end-users. Focus on any issues, concerns, comments, or feedback Transition Transition to Embedded CSM for future technical needs, protocol & workflow optimization, and analytics dashboard review

24. Customer Project Stakeholders

25. Embedded Refills Resources Implementation Manager Responsible for overall success of implementation Customer Success Manager (CSM) Clinical Content, Analytics, Product, and Engineering Technical Success Manager (TSM) Responsible for both success of technical implementation as well as maintenance post go-live Behind-the-Scenes Resources Responsible for ongoing success, analytics dashboard, and optimization

26. EMRs Compatible with Embedded Refills Epic Protocol content is provided via import athena Direct integration via APIs Cerner Veradigm ( fka Allscripts) Direct integration to Health Catalyst APIs driven by Cerner ops jobs Direct integration to Touchworks APIs

27. Timeline of Implementation Identify Resources Schedule for Success Clinical: Alignment, Kick-off, Protocol Consensus Technical: Alignment and Kick-off Clinical: Provide r Champion, Nursing/Pharmacy Champion, Project Sponsor Technical: Ambulatory Analyst, Project Manager, additional technical resources based on integration

28. Timeline of Implementation IT Build Protocol Consensus Led by the Embedded Refills Implementation Manager Review of medication criteria to be integrated into the EMR Led by the Embedded Refills TSM Step-by-step guidance provided along with resources for a successful implementation

29. Timeline of Implementation Workflow Consensus Build Wrap-up and Testing Led by Embedded Refills Implementation Manager Define and s tandardize refill workflows Led by Embedded Refills TSM and Implementation Manager Configuration completion and end-to-end user testing

30. Timeline of Implementation Training Go-Live Led by Embedded Refills Implementation Manager User Acceptance, Training and Communication Plan, Schedule with refill staff Led by Embedded Refills TSM and Implementation Manager Coordinate buil d move to Production environment Establish go-live support model

31. Timeline of Implementation Week 1 2 6 10 12 14 16 ∞ Project & Protocol Kickoff Complete Protocol Consensus Complete Training & IT Build Refills Go-Live Start IT Build Continued Optimization & Maintenance Complete Workflow Consensus IT Kickoff

32. Today’s Challenges with Refills Solution: Embedded Refills Implementation Overview Post Go-Live Support and Data Q&A

33. Post Live Support Support Request Analytics Request Feature Request Embedded Support Ticketing Portal

34. Analytics Dashboard Pop Insights

35. 75%+ Percentage of renewals handled by staff 24 - 48 hrs. Turnaround time 30:1 Provider to staff support ratio Key Success Metrics Average Metrics Realized by Our Implementations

36. Renewal request is received via phone, fax, Surescripts, or interface message Provider or staff review patient chart for relevant renewal information Request approved/denied by provider or staff and necessary follow - up performed Average minutes spent per renewal request Workflow Efficiency

37. Enhancing Medication Refill Efficiency Increases Caregivers’ Time with Patients UnityPoint Health aimed to enhance its medication refill processes to enable caregivers to spend more time with patients and reduce costs. Given the millions of refill requests the organization handles annually, it is essential for the health system to assess and improve these processes regularly to boost efficiency. The organization adopted the Health Catalyst Embedded Refills™ application, which streamlined the medication refill workflow, increasing efficiency and accuracy and lowering labor costs. Implemented the Health Catalyst Embedded Refills™ application, integrating medication renewal decision support into the EHR workflow and streamlining the medication refill process. Established a centralized refill team to manage routine requests. Standardized review processes and patient handoff procedures. Responsible for managing millions of annual medication refill requests. Lacked a system for determining who handles specific medication requests. Impact: Without an improved process, UnityPoint Health would face ongoing inefficiencies, higher labor costs, and slower medication refills. $3.1M cost savings over two years, the result of 91.5K staff labor hours avoided processing medication refills. 17.1K provider labor hours were avoided , the result of processing 2.9M medication refills using the application. Less than a 24-hour turnaround time application for most medication refill requests.

38. Medication Refill Improvements Reduces Labor Burden and Saves $3.4M Community Health Network sought to reduce its medication refill labor burden, standardize and streamline processes, and increase the amount of patient-facing time available to providers. By implementing Embedded Refills™ by Health Catalyst®, the organization has achieved significant results, including reduced time spent on medication refills, enabling providers to invest more time in patient care, and expanding refill capacity without adding additional FTEs. Utilized Embedded Refills™ by Health Catalyst®, leveraging the power of standard, automated, protocol-driven workflows to decrease refill processing time. Providers and staff now have fewer in-basket refill messages and fewer repetitive administrative tasks. Medication refills are a critical yet labor-intensive task. Desired to enhance efficiency and improve the provider experience. Impact: CHNw needed to evaluate current practices and standardize medication refills for primary care, reducing the burden on providers and staff. $3.4M cost savings , the result of processing 1.7M medication refills via the Embedded Refills application and a 69% delegation rate . More than half of all medication refill requests are processed the same day—and nearly 80% within the next day. 13.4K provider labor hours and 102K staff labor hours avoided processing medication refills.

39. Emily Rodriguez | Director of Technical Success for Embedded Refills Jessica McCay | Director of Customer Success for Embedded Refills Alora Martin | Webinar Program Manager [email protected]