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Adherence escalating as problem in transitions

Medicare & Reimbursement Advisor Weekly, September 14, 2009

What’s the script trail from hospitals? Some of you have asked whether hospitals generate new scripts and, if so, what the ripple effect is. Although we have not yet formally studied this, I thought a few comments from our readmissions study (referenced later in this issue) would give some insight about how often hospitals change medications and the challenges they face:

“Patients are not aware of all medication names and dosages as are physicians who are not aware of multiple prescriptions to the same patient. As a result, it has been difficult to properly document preoperatively what the patient is actually taking and the dosages,” says Debbie Ward, RN, administrator at Sutter Health in California.

“With patients being taken care of by hospitalists, that information is not readily

available from the PCP like it would be if the PCP covered the hospital care. Many patients do not know all the drug names and doses that they are on. They also do not understand how to take drugs that they have been sent home with. This results in confusion and readmission from not taking medications or taking them the wrong way. As far as readmissions, ours quite often come from those patients who don’t take their medications as directed for whatever reason,” says Angie House, RN, a case manager at DeQueen Medical Center in Arkansas.

Questions: Are there managed market programs or tools you could adapt to assist providers in reducing the added time they spend at discharge on this process, or services or programs to assist institutions in ensuring proper referral to home health care or community case management follow-up?

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