Hospitals continue to struggle with properly educating patients on the safe medication use. Now, digital patient engagement solutions that leverage streaming video and powerful information-sharing tools may end those struggles. By Dr. David Medvedeff, CEO, VUCA Health
By Dr. David Medvedeff, CEO, VUCA Health
Medication safety remains a thorn in the side of the nation’s hospitals. Indeed, many have not implemented – even partially – best practices for medication safety recommended by the Institute for Safe Medication Practices (ISMP) and other safety organizations, according to the ISMP’s recent report 2014-2015 Targeted Medication Safety Best Practices for Hospitals.
For example, the report found only 11 percent of hospitals provide patients with education by a pharmacist for all weekly oral methotrexate discharge orders or even a drug information leaflet that contains clear instructions about weekly dosing. This despite the fact that “the frequency of patients discharged on weekly methotrexate should be manageable for typical pharmacy staffing to facilitate education by a pharmacist on this crucial topic.”
There are a number of reasons hospitals struggle with properly educating patients on safe medication use. One is the fact that, once the patient leaves the facility, medication adherence becomes a personal responsibility. The Center for Disease Control (CDC) estimates that up to 30 percent of prescriptions are never filled. Of those that are, only half are continued as prescribed.
A second, broader, issue is poor health literacy, which the Institute of Medicine (IOM) directly links to poor healthcare outcomes. In its 2004 report Health Literacy, a Prescription to End Confusion, the IOM stated that “efforts to improve quality, reduce costs, and reduce disparities cannot succeed without simultaneous improvements in health literacy.”
The Battle for Health Literacy
A study by the National Assessment of Adult Literacy found only 12 percent of patients surveyed demonstrated proficient health literacy. Further, according to the IOM, 90 million adults have trouble understanding and acting on health information putting them at an increased risk of hospitalizations, emergency room visits and even death.
Specific to medication safety, a study in the Journal of General Internal Medicine found 79 percent of patients misinterpreted one or more of the 10 common prescription label instructions they encountered. Along with comprehension issues, this can be attributed to confusing presentation of complex information. Indeed, crammed into the relatively confined space of a single medication insert is all the information a patient needs for appropriate use including dosage, side effects, and administration instructions.
As a result of confusion and limited comprehension, approximately 50 percent of patients do not take their medications as prescribed and therefore fail to realize the full benefit of treatment. They may even place themselves in danger of an adverse reaction. The burden of non-adherence is felt by both the patient and the prescriber. The CDC estimates that 30 to 50 percent of treatment failures are caused by non-adherence, leading to more than 125,000 deaths annually.
The economic impact is equally staggering; an estimated $100 billion to $300 billion in annual costs are associated with avoidable hospitalizations, nursing home admissions, and premature deaths. Not included in these jaw-dropping estimates are indirect costs associated with limited health literacy, such as the increased likelihood for chronic illness and disability, lost wages, and a poorer quality of life.
Seeking a Viable Solution
To combat poor health literacy, the Department of Health and Human Services (HHS) suggests some basic areas of focus including formal training in patient communication and implementation of visual technology. To that end, hospital pharmacies are increasingly turning to digital patient engagement solutions that leverage streaming video and powerful information-sharing tools to reinforce safe medication use.
One such facility is Methodist Hospital, a 192-bed community hospital in Henderson, KY. Methodist deployed MedsOnCue in its outpatient pharmacy to provide patients with on-demand access to prescription-specific videos and images of their medications along with other information pertinent to their condition.
According to Methodist Director of Pharmacy Brent Bridges, PharmD, the digital patient engagement solution brings “a powerful and innovative digital element to our patient education strategy, one that we expect to help reduce readmission rates by improving medication safety and keeping patients engaged in their care even after they leave the hospital.”
When evaluating options, it’s best to seek out solutions that include video libraries with information on all top-prescribed medications across multiple conditions that is gathered from prescription guidelines from the Food and Drug Administration (FDA), as well as patient packet inserts, medication guides, and consumer medication information. This ensures that content is comprehensive and current and that all pertinent information is included.
Information should also be reviewed and updated continuously based on findings from the FDA and the Agency for Healthcare Research and Quality, including current disease state guidelines, new indications and black box warnings.
For maximum benefit, the solution should be flexible, enabling videos to be embedded into hospital websites or patient portals so they can be accessed by patients on any computer, tablet or smartphone. By making the information accessible through multiple channels, patients are never without the information they need to successfully administer their medication.
Breaking down Barriers
To combat the sobering reality of poor health literacy, hospitals must account for all aspects associated with medication adherence ranging from heath care system factors to patients’ social and economic factors. From the healthcare system standpoint, the CDC highlights the “access to care and patient education material” as two of the largest problems in medication adherence, while patient social and economic factors include the “inability to access or difficulty accessing the pharmacy.”
Digital patient engagement solutions address these issues by delivering information such as proper usage, expected benefits and potential side effects in a way that ensures that all patients have access to the tools they need to benefit fully from their medications. They also remove the barriers that complex text often place in the way of comprehension and medication adherence, reducing the risk of medication error and improving care outcomes.
About the author
David Medvedeff, PharmD, MBA, is CEO of VUCA Health, providers of MedsOnCue and technology solutions that create a gateway to patient engagement and serve as an on-demand extension of pharmacists and other healthcare providers.
