Preparing a Pharmacy for HIT

Brenda WilsonAltaf PraslaMichael Yao

Mandi TaveechaiBAMM HIT Consultants

Lone Star Circle of Care: Lake Aire

• Community Health Center• Most patients are uninsured or under Medicaid or Medicare• 2 Pharmacists• "Medium Size" Pharmacy

o Peak on Mondays: 240 prescriptions filledo Other days: 170 prescriptions filled

• Currently have QS/1-NRx • 5 Computers

Current Problems

• Two different systemso Physicians:NextGen o Pharmacists: QS/1-NRx

• Almost all (over 99%) of prescriptions are hard copies or faxed from across the hall

• Phone occupies the majority of the staff's time• No up-to-date guidelines for patient counseling

Charter StatementProject Overview Provide research, quality analysis, and recommendations to address

"meaningful use" in the pharmacy and assist in improving work flow efficiency.

Stakeholders The pharmacy and clinics at Lone Star Circle of Care Adult Wellness Center: Lake Aire Location

Key Goals • Eliminating hard copies and faxes for "internal" prescriptions• Reduce phone call time to less than X% of pharmacy's staff labor.• Improving interoperability and workflow.• Providing the pharmacist the most recent medication guidelines for

counseling.

Key Benefits The pharmacy will be more efficient, reduce costs and provide more service at better quality with the same staffing levels (scalability).

Charter Statement Cont.Key Deliverables • Scope Statement

• Budget• Current Workflow Diagram• Spaghetti Diagram• Summary of current vendors • Recommendations• Final Assessment

Measures of Success The pharmacy will be provided with a comprehensive, object report and recommendations relating to "meaningful use" and workflow efficiency.

Key Assumptions • The pharmacy will support and finance the project internally.• QS1 is functional in the pharmacy and NextGen is installed in the

clinic.• 5 computers with scanners and fax machines.

Scope • Helping the pharmacy's current system (QS1) interface with the clinic's current EHR (NextGen).

• Assist the pharmacy in choosing the appropriate IVR (Integrated Voice Response) system. 

• Provide recommendations for improving efficiency and workflow.

Deliverables

Scope Statement

• Provide counseling and recommendations for interoperability.

• Assisting the pharmacy in choosing the appropriate IVR vendor.

• Provide recommendations for improving efficiency and workflow. 

Spaghetti Diagram

Workflow

Workflow: Front Counter

Workflow: Back Counter

Workflow: QA and Checkout

Getting Connected: Switch Vendors?

Pharmacy Software Vendor Comparison

Getting Connected: Electronic Prescriber Networks• Frequently advertised with pharmacy software • The Largest: SureScripts• Also supported by QS/1: ProxyMed, Emdeon, RxNT• Charge per script

o SureScript's 25 cents/script (but free to doctors!)o "Script Brokers" o Geared towards independent pharmacies and chains

• Solves the problem of arbitrary EHRs connecting to arbitrary pharmacies

Preliminary Recommendations

• Since the pharmacist is currently happy with QS/1, we recommend connecting NextGen and QS/1 using their HL7 e-script add-on modules. o NextGen and QS/1 e-script modules: $42,000

• Also, QS/1 offers IVR Systems, so it would be easy to add that module to their current software. This is around $6000-$7000 per site.

Recommendation: Automation

• Baker's Shelves• Pill Counters• Robotics

Final Price Tag

$49,000

Questions?

Special Thanks to:Corbin Ferrell, Director of Pharmacy Operations

and Joe, Pharmacist at Lake Aire LSCC