Using an Electronic Medication Refill System to Improve Provider Productivity in an Accountable Care Setting

Area of Science:

• Health Services Research
• Pharmacy Practice
• Primary Care Medicine

Background:

• Primary care providers (PCPs) often lack adequate support for medication management within integrated health systems.
• Challenges in medication reconciliation, adherence, and patient outcomes persist nationally.
• PCPs require enhanced resources for high-quality, patient-centered care in accountable care settings.

Purpose of the Study:

• To evaluate an electronic medication refill system designed to support primary care providers.
• To assess the impact of a centralized refill management service on PCP workload and efficiency.
• To identify key lessons learned from implementing a pharmacist-led medication refill service.

Main Methods:

• Implementation of a fully electronic medication refill system managed by a centralized pharmacy team.
• Development of 16 disease-specific protocols to handle approximately 80% of refill requests.
• Clinical pharmacists performed medication reconciliation, dosage adjustments, and pharmacy coordination.

Main Results:

• The service managed 302,592 refill-related tasks in 2014, authorizing 140,350 refills and numerous interventions.
• Physicians estimated daily time savings of 20-30 minutes per PCP.
• Estimated cost savings of $33-$50 per physician per day, with higher savings including other clinical staff.

Conclusions:

• Electronic medication refill services, supported by clinical pharmacists, can significantly offset PCP workload.
• Successful implementation requires organizational leadership and champions for process reform.
• Integration challenges, such as the lack of clinical pharmacist profiles in EHRs, need to be addressed for broader adoption.