Centralizing Technology Between Medical Care Teams

Health care providers throughout the state of Hawai‘i are using new technology from a project led by the University of Hawaiʻi at Hilo that helped pharmacists manage high-risk patients’ medications across a variety of settings.

The technology was implemented and used in the federally funded $14.3 million “Pharm2Pharm” program, operated from the Daniel K. Inouye College of Pharmacy (DKICP). Pharm2Pharm established a set of tools that were implemented through Hawai‘i Health Information Exchange (HHIE) system to communicate important clinical information to support patient care.

“Through the health information technology we used for the Pharm2Pharm program, we were able to support pharmacists shifting from their traditional role of dispensing drugs into becoming a part of the patient care team,” stated HHIE’s interim executive director Francis Chan. “We believe this represents a unique integration of prescription medication information into an HIE.”

Chan is an author of a new study published in the journal Applied Clinical Informatics entitled A Statewide Medication Management System: Health Information Exchange to Support Drug Therapy Optimization by Pharmacists across the Continuum of Care. Co-authors include Natalie Pagoria from the nonprofit HHIE, Sheena Jolson-Oakes from Maui Clinic Pharmacy, and Reece Uyeno, Andrew Levin, and Karen Pellegrin from DKICP.

Researchers looked at pharmacists providing services for the Pharm2Pharm model in the state of Hawai‘i, which included 50 pharmacists who were authorized by HHIE to use the technology. This included the hospital pharmacists who enrolled patients into the Pharm2Pharm service as well as the community pharmacists assigned to manage their medications after release from the hospital.

The determined priorities that could be addressed through health information technology (IT) tools included:

• More efficient and secure ways to transmit care transition documents;
• Reliable access to outpatient translators;
• More efficient ways to identify outpatient medications for medication reconciliation;
• More efficient access to clinical information;
• A system to document and communicate reconciled medication list and drug therapy problems; and
• A system to manage the population of patients enrolled.

Technology tools that addressed those priorities, such as direct secure messaging, virtual translators, and a prescription fill history query system, were implemented. The pharmacists in the study made the transition from paper and faxes to this “suite of technology.”

“In the national effort to improve health care through the adoption of health information technology, pharmacists haven’t been included as ‘eligible professionals’ under federal incentive programs,” said DKICP’s director of strategic planning/distance learning Pellegrin, who directed the four-year Pharm2Pharm project. “We demonstrated that pharmacists adopted and meaningfully used the technology provided by HHIE to support their role as medication experts.”

This study was part of the Pharm2Pharm project, funded by the Centers for Medicare and Medicaid Services (CMS), which achieved an estimated 264% return on investment in the pharmacists through avoided medication-related hospitalizations.

Acknowledgement of federal funding: The project described is supported by Funding Opportunity Number CMS-1C1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.