Hospitals team up with drugstore chains to cut readmissions

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Rx_symbol_borderBy Eric Whitney, Colorado Public Radio

Patients who leave the hospital only to have to be readmitted within a few weeks cost U.S. taxpayers more than $17 billion a year.  In October, the federal government started cracking down on hospitals, penalizing them if too many of their patients bounce back.

That has hospitals searching for help from the corner drug store to manage the care of patients like Dorothy Irene Tucker.  She is a cheerful 73-year-old woman about to be discharged fromWashington Adventist Hospital just outside of Washington, DC, where she says they don’t let you sleep much.

“To draw the blood, they would come in, like, twice before morning,” Tucker says.

It’s pretty common for patients to leave the hospital sleep-deprived. Many haven’t been eating regularly, and lots of people are still coming to terms with whatever event landed them in the hospital in the first place.

It’s also common for people in this bewildered state to be handed several new prescriptions upon discharge. Tucker takes pride in being able to manage all the different drugs she takes, but it’s a big list, and even she isn’t sure exactly what she’s supposed to be taking once she gets home.

“I was on a lot of medications. It was, I think, all together 23 bottles. Twenty-three bottles!  So they might cut me back when I go home,” she says.

Washington Adventist thinks patients like Tucker could use some help keeping all those drugs coordinated, and the hospital itself could use some help – so they enrolled her in a new program to connect her to a pharmacist.

Dr. Jeffery Kang is a vice president at Walgreens, and describes the new role as “our grandfather’s Walgreens on steroids.”  Walgreens is now contracting with hospitals to eliminate conflicting prescriptions on discharge, and then the pharmacy will follow up with patients to make sure they understand all their medications and take them properly when they get home.

The new expense makes sense for hospitals because if too many of their patients bounce back into the hospital within 30 days of being discharged, Medicare cuts their payments. Health Care Researcher Dr. Jane Brock says medication errors can be a big factor in readmissions.

“We know that people who have medication discrepancies, or are not adhering to what the health care team thought they were adhering to, have at least double the risk of becoming a readmission,” she says.

Washington Adventist Hospital Chief Medical Officer Dr. Randall Wagner says his hospital was one of the first to contract with Walgreens, and he is happy with the program so far.  He says it’s harder for hospitals to monitor discharged patients and their medications than it might sound.

“The infrastructure of doing these call back programs is not merely that there’s a telephone and someone who can dial it,” Wagner explains.  “It involves creating a database, creating a group of people who can call, and if the patient doesn’t answer the phone, there’s someone else who can call back. There’s a handoff of information between the inpatient side and the outpatient side.”

Research shows that having a pharmacist follow up with recently discharged patients reduces the likelihood that they’ll get worse at home and have to come back. Walgreens competitor CVS Caremark is also in the field.

Dorothy Tucker got home and had three fewer medications to keep track of than when she was admitted.  She says she looks forward to working with the pharmacy so she can learn her new regime.

This story is part of a collaboration that includes Colorado Public RadioNPR and Kaiser Health News.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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