The organization is staying ahead of the game by proactively monitoring its supplies needed for COVID-19
The ongoing COVID-19 pandemic continues to present new challenges for health system leaders, many of whom are facing critical shortages of personal protective equipment (PPE), medications, and other important supplies.
At Sharp HealthCare, the integrated delivery system based in San Diego, clinical IT professionals are using VigiLanz, a clinical surveillance software, to maximize the use of the supplies they do have, with alerts that are helping healthcare workers on the front lines.
Andy Williams, PharmD, BCPP, BCGP, Senior Clinical Pharmacist at Riverside University Health System, discusses how VigiLanz improves patient care.
“I’ve seen VigiLanz make some very strong, important interventions, especially in the realm of our pharmacokinetic monitoring,” says Williams, adding that VigiLanz serves as a second set of eyes for pharmacists.
Watch this short video to learn more about how Williams and his team are using VigiLanz to improve patient care.
Transcript:
I think the biggest benefit that VigiLanz provides for patient care is that it helps us work more efficiently, so we’re able to quickly get the information that we need, so that we can spend more time out on treatment team rounds or out directly interacting with patients on the unit conducting our pharmacist-led patient education groups. It helps us to take care of any reports or lab monitoring we need to do quickly and efficiently, so that we’re able to then realign our time on something else that could help strengthen patient care.
Since we are a psychiatric hospital, we may have a little bit unique methods in which we use VigiLanz. We use VigiLanz largely for our reports, so it’s able to help us with conducting our quality assurance measures. We’re able to run reports on which patients have received long-acting injectable anti-psychotics each quarter, and then cross compare that with their readmission rates. We’re able to use it to run our Joint Commission Hospital-Based Inpatient Psychiatric Services measures to see patients that are on two or more anti-psychotics. We’re able to use it to run whether or not they have appropriate labs, so if they have their lipid panels or their A1Cs for the patients that are receiving second generation antipsychotics, as well as for pharmacokinetic monitoring of Lithium or valproic acid sodium.
I’ve seen VigiLanz make some very strong, important interventions, especially in the realm of our pharmacokinetic monitoring. Many of our patients are receiving Lithium, which is a narrow therapeutic index drug, and with that, it has the potential for many drug interactions. It could be very easy for one of our pharmacists to overlook a lab or not see an out-of-range lab. VigiLanz is able to provide that safety net and that second look of eyes to alert us in real time if something is out of range so that we can act quickly, without leaving the patient exposed to a higher level or risk them receiving another dose when that really isn’t appropriate.”
Adrienne Carey, PharmD, BCPS, Clinical Pharmacist at Freeman Health System, discusses how VigiLanz improves efficiency and helps saves patients’ lives.
“VigiLanz impacts our efficiency because it shows us what we need to intervene on in real time,” says Carey. “We use our health information system also, but we are pretty much living in the VigiLanz system because it’s real time.”
Watch this short video to learn more about how Carey and her team are using VigiLanz to improve patient care.
VigiLanz impacts our efficiency because it shows us what we need to intervene on in real time. So we use, especially our clinical pharmacists on the floor, we live in the VigiLanz software. We use our health information system also, but we are pretty much living in the VigiLanz system because it’s real time. We use it for our medication reconciliation program, so our technicians use it to document all the information that they gather when compiling the patient’s home medication list. We also use it for our clinical pharmacists and our staff pharmacists throughout our system to document all of our activities to help us identify patients that might need some type of intervention from a pharmacist, whether it’s dosing or looking at their IV status or whether we can switch their medications from IV to PO. We look at their antibiotic usage to make sure that we’re covering their bugs appropriately.
We have seen VigiLanz help us identify life-saving interventions for our pharmacy department. For example, we have a rule to help us identify those that are on anticoagulants that have been discontinued or put on hold. So typically when you are on anticoagulants, that’s not something that’s put on hold and then stopped indefinitely; that’s usually something that’s temporarily put on hold and then we really need to resume it after your procedure or after whatever surgery we’re doing or test we’re doing is done. So it has helped us identify those people who it’s been put on hold but somehow it got missed putting back on. Without the anticoagulation, we run the risk of heart attacks, and strokes, and things like that, so the rules that help us find those patients who were on it but for some reason are no longer on it have been very important.
My favorite part of working with VigiLanz has honestly been the customer support. So we have a person on the VigiLanz side on the customer support team that I can submit a ticket to at any moment and they are experts and they are wonderful at getting back to me very quickly and helping me work through whatever issue it is. I’m kind of a do-it-yourself person, so I usually try to create the rules or fix things that I want for our system, but sometimes I come to a roadblock and I usually submit a ticket and the pharmacist on their end has been absolutely wonderful to work with. That’s not something I’ve ever had with any software program I’ve used before.
Jill Bennett, PharmD, BCPS, Clinical Coordinator/Residency Program Director at Antelope Valley Hospital, discusses how VigiLanz has transformed work flows, and is helping staff members work smarter, not harder.
“Certainly the information that you put in more than represents what you can get out of it and the benefit it can add,” she says. “You can get to so much more than you can utilizing manual reporting.”
Watch this short video to learn more about how Bennett and her team are using VigiLanz to improve patient care.
Transcribed video:
On a day to day basis, VigiLanz really drives our work. It’s changed the way we work. We work smarter, not harder, and we’ve been able to really increase what we’re looking at. So, initially what we had to do manually by generating reports and looking at things like certain medications that were given intravenously that could be changed to oral therapy, we instead were able to have it filter through and look at whether or not the patient was on other oral medications, maybe was eating, those types of things that would let us get in tune to the changes that we could make more quickly.
It really drives our work flow. We have the alerts, that’s part of it. Another piece, is certainly our antimicrobial stewardship work. We utilize the antimicrobial stewardship list, and it’s really nice to be able to focus in on which patients need to be seen that are stewardship patients and then actually to be able to check them off and note when we’ve done the follow-up or when we’ve made the needed interventions. So things like drug-bug mismatches, being able to de-escalate therapy when we have those final culture results in, things like that.
I’ve been a real proponent of VigiLanz. I mean I always feel very comfortable in recommending it to other healthcare systems and I feel really lucky that we have this available to us because there certainly are a lot of people that want it and have not been able to justify it in the right way maybe to their administration.
Certainly the information that you put in more than represents what you can get out of it and the benefit it can add. You can get to so much more than you can utilizing manual reporting. So you do work smarter, you can get too many more things, and therefore you use your resources more wisely. It’s been really beneficial to us.
Freeman Health System, a 485-bed, three-hospital system in Joplin, Missouri, serves 450,000 people across Missouri, Arkansas, Kansas, and Oklahoma. It is the #1 hospital in Southwest Missouri and the #4 hospital in Missouri, according to U.S. News & World Report.
Challenge
Medication reconciliation, the process of creating an accurate list of a patient’s medications—including drug name, dosage, frequency, and route—is critical to reducing adverse events and ensuring patient safety.
Yet it can be a cumbersome and time-consuming undertaking, particularly when nurses are already overburdened. Medication reconciliation is also challenging because patients’ medications change frequently and patients often don’t maintain accurate lists.
“While it’s extremely important to quickly and accurately capture a patient’s medication information, traditional approaches that rely primarily on nurses and EMRs make this very difficult,” said Adrienne Carey, PharmD, BCPS, Clinical Pharmacist and Data Mining Program Manager at Freeman Health System. “We knew there had to be a better way.”
Medication non-adherence exacts a heavy toll, both on patients and the broader healthcare industry. According to a review in the Annals of Internal Medicine, 20 to 30 percent of medication prescriptions are never filled, and approximately 50 percent of medications for chronic disease are not taken as prescribed. Each year, this lack of medication adherence is estimated to cause 125,000 deaths and at least 10 percent of hospitalizations, costing the American healthcare system $100-$289 billion.
Solution
One of the first changes Freeman Health System made was related to staffing. Rather than relying solely on nurses for medication reconciliation, it gradually added medication reconciliation technicians (MRTs) to its team. It now has nearly a dozen MRTs working in the emergency room and other departments. “We started them on the cardiology floor as a pilot and their ability to ease the burden on nurses was so clear that we quickly hired more,” said Carey.
The MRTs meet with patients to go over at-home medication information. Then, they verify that information using another source such as the patient’s doctor or pharmacy, and document it in the EMR. “The MRTs are usually able to meet with patients more quickly than nurses can,” said Carey. “That means faster identification of at-home medications, and smarter medication decision making in the hospital.”
Freeman Health System also uses VigiLanz to support and streamline its medication reconciliation efforts. The pharmacy department worked with the VigiLanz clinical support team to create new rules in the clinical surveillance platform to identify patients needing medication reconciliation. When patients are admitted to the ER or to floors with MRTs, MRTs receive an alert to conduct a reconciliation. “After determining what our organization needed, the VigiLanz clinical support team helped us create rules that make the process much more seamless,” said Carey, noting that the rules took effect in June 2018.
Once the reconciliation is complete, a pharmacy team member reviews it, contacts the physician if there are any problems or errors, and documents the information and/or intervention in VigiLanz. Freeman Health System also uses VigiLanz to create an audit trail of who has made changes. Carey noted that the new workflow is a significant improvement over relying on the EMR, where information is not easily retrievable. “While clinicians can pull up a patient’s record and read the history in the EMR, there is no discrete data to track information such as which medications have changed or what problems nurses have already addressed,” said Carey. “We also use VigiLanz to customize intervention categories so pharmacists can better track the prevention of potential major and minor adverse drug events.”
Adrienne Carey, PharmD, BCPS explains how VigiLanz provides efficiency improvements to Freeman Health
Outcomes
Since adopting the new approach, Freeman Health System has completed an average of 1,400 medication reconciliations monthly. That has prevented nearly 30 potential major adverse drug events and more than 11,000 potential minor adverse events over a one-year period. The health system estimates that it has realized $4.7 million in potential savings from major and minor medication error prevention since July 2018.
“It’s had a huge impact,” said Carey. “We end up making a change to almost every med list that we touch. Those are things that we might have missed if we didn’t have this new system in place.”
In addition to improving care quality and avoiding adverse drug events, VigiLanz’s clinical surveillance platform has trickle-down benefits. “Their data-tracking capabilities help us better recognize our MRTs’ invaluable contributions,” she said. “It helped us make the case for expanding these staff to reach all patients in our facility.”
In addition to using VigiLanz to help avoid adverse drug events and make smarter medication decisions, Freeman Health System uses its clinical surveillance software to flag potential IV to PO conversion opportunities and identify inappropriate medication levels and duration. Overall, the health system estimates that VigiLanz enables it to avoid over $700,000 in monthly costs.
Healthcare systems across the country are equipping their healthcare providers with more patient data than ever before. While this represents significant progress, it can be difficult for physicians and other providers to turn that data into actionable information. In other words, they often lack the time and resources to sift through all of that data to gather the most meaningful insights that can be applied at the point of care.
Note: Want to earn continuing education credits for watching this presentation? Register for the HIMSS20 digital version here: Making Smarter Clinical Decisions, Faster.
Houston Methodist has found a solution that is leading to higher care quality and reduced costs. The health system is using a tool to provide real-time data (including cost data, as appropriate), related to patients’ medications, labs, and radiology studies—directly within providers’ clinical workflow. The tool also enables access to the state’s prescription monitoring program reports within the clinical workflow. And, it sends context-specific alerts to providers based on EMR, PMP, and VigiLanz’s clinical surveillance data.
Watch below to learn more from Houston Methodist’s System Director of Clinical Pharmacy Services, Michael Liebl, PharmD, BCPS.
DoseMeRx to integrate with VigiLanz clinical surveillance solutions for hospitals
MOORESTOWN, N.J., (April 02, 2020) – Tabula Rasa HealthCare, Inc® (TRHC) (NASDAQ: TRHC), a healthcare technology company advancing the field of medication safety, has partnered with VigiLanz®, the leading provider in clinical surveillance, to integrate with DoseMeRx™, TRHC’s precision dosing solution. The integration of DoseMeRx within VigiLanz’s award winning software platform will provide hospital customers with instant access to personalized dosing for vancomycin and other antimicrobials, optimizing pharmacy workflow and improving patient safety.
VigiLanz is the 2020 Category Leader for Antimicrobial Stewardship, Infection Control and Monitoring, and Pharmacy Surveillance by KLAS Research. This is the third consecutive year, VigiLanz ranked top for Pharmacy Surveillance and second year in a row ranking top for Antimicrobial Stewardship and Infection Control and Monitoring.
“Our partnership with Tabula Rasa HealthCare and DoseMeRx enables providers to easily optimize the dosing of vancomycin and other high-risk antimicrobials,” said VigiLanz Chairman and CEO David Goldsteen, MD. “This is especially critical with the release of the new vancomycin dosing guidelines, which are indicative of a growing trend toward increased medication safety. DoseMeRx brings immense value to pharmacists. Together, we’re excited to bring precision dosing to our customers.”
The VigiLanz platform provides leading pharmacy surveillance and antimicrobial stewardship solutions for hospitals to generate real-time alerts that help clinicians make appropriate drug therapy decisions. Adding DoseMeRx will enable VigiLanz customers to easily implement the new national dosing guidelines for vancomycin – one of the most commonly used antibiotics in hospitals today.
“This partnership means convenient access for VigiLanz customers to the precision dosing capabilities of DoseMeRx to optimize the use of vancomycin in the acute care setting,” said TRHC Chairman and CEO Calvin H. Knowlton, PhD. “Our goal is to expand and scale the use of DoseMeRx, along with other TRHC platforms, to more pharmacists who will use it to optimize medication safety. This partnership does just that.
According to TRHC Executive Vice President for DoseMe/Hospitals Business Unit Charles Cornish, the opportunity to integrate DoseMeRx with the VigiLanz solution is of benefit to customers looking for a closed-loop solution to clinical surveillance and dose optimization. “VigiLanz and TRHC share the common goal of building easy-to-use clinical decision software with the ability to improve workflows and support pharmacists,” said Cornish.
About Tabula Rasa HealthCare
TRHC (NASDAQ:TRHC) is a leader in providing patient-specific, data-driven technology and solutions that enable healthcare organizations to optimize medication regimens to improve patient outcomes, reduce hospitalizations, lower healthcare costs and manage risk. TRHC provides solutions for a range of payers, providers and other healthcare organizations. For more information, visit TRHC.com.
About DoseMeRx
DoseMeRx is a Tabula Rasa HealthCare (NASDAQ: TRHC) solution. It is the first precision dosing software developed specifically for clinical practice. The DoseMeRx clinical decision support platform empowers healthcare providers to optimize dosing of high-risk parenteral medications to streamline operations, reduce adverse drugs events, decrease costs and improve patient outcomes. For more information on DoseMeRx, visit doseme-rx.com
About VigiLanz
Founded in 2001, VigiLanz is a privately held, rapidly growing provider of SaaS-based clinical surveillance solutions. The firm is focused on aggregating disparate EHR transactional workflow and documentation data across health systems to identify real-time clinical issues that avoid or minimize harm, optimize clinical outcomes and support preventive care. VigiLanz supports a large and growing community of hospital CMOs, CMIOs, CIOs, quality and safety teams, infectious disease and control specialists, pharmacists, and other clinicians dedicated to real-time inpatient and outpatient care. To learn more about VigiLanz Precision Dosing, powered by DoseMeRx, visit info.vigilanzcorp.com/precision-dosing.
Forward-Looking Statements
This press release includes forward-looking statements that we believe to be reasonable as of today’s date, including statements regarding Medication Risk Mitigation technology. Such statements are identified by use of the words “anticipates,” “believes,” “estimates,” “expects,” “intends,” “plans,” “predicts,” “projects,” “should,” and similar expressions. These forward-looking statements are based on management’s expectations and assumptions as of the date of this press release. Actual results might differ materially from those explicit or implicit in the forward-looking statements. Important factors that could cause actual results to differ materially include: the need to innovate and provide useful products and services; risks related to changing healthcare and other applicable regulations; increasing consolidation in the healthcare industry; managing our growth effectively; our ability to adequately protect our intellectual property; and the other risk factors set forth from time to time in our filings with the SEC, including those factors discussed under the caption “Risk Factors” in our most recent annual report on Form 10-K, filed with the SEC on March 1, 2019, and in subsequent reports filed with or furnished to the SEC, copies of which are available free of charge within the Investor Relations section of the TRHC website http://ir.trhc.com or upon request from our Investor Relations Department. Any forward-looking statement speaks only as of the date on which it was made. TRHC assumes no obligation and does not intend to update these forward-looking statements, except as required by law, to reflect events or circumstances occurring after today’s date.
Freeman Health System, a 485-bed, three-hospital system in Joplin, Missouri, serves 450,000 people across Missouri, Arkansas, Kansas, and Oklahoma. It is the #1 hospital in Southwest Missouri and the #4 hospital in Missouri, according to U.S. News & World Report.
