Improving The Medication Adherence On Health Behaviors Across Races

The American Recovery and Revitalization Act of 2009 brought meaningful use of patient records to help increase the improvement of patient care. With certified electronic health record technology, one goal is to improve quality, safety, efficiency, and to decrease health discrepancies. Some more goals are to get patient and family engaged in their care, continue to improve care coordination, and maintain privacy and security of patient health information. In order to achieve these goals, healthcare facilities must continue to stress the importance of patient engagement and to use the patient portal for healthcare information (“Meaningful Use Definition,” n.d.). Patient engagement is defined as a person’s continued participation in dealing

Healthcare reform has created incentives to increase patient engagement to increase accountability, healthcare outcome and lower healthcare cost. In the early days of this movement, web portals were created with basic functions of requesting appointments, prescription refills, and paying medical bills (Butterfield, 2013). Today, patient portals allow users to access dictated visit reports, labs, approve access controls combined with the function of the web portals. As more health information is pushed to the portals, the users (patients and family) are more involved with healthcare decisions and more knowledgeable on available options that meet individual need.

The Department of Health and Human Services launched Healthy People 2020 to promote quality of life and healthy development across all life ages (Centers for Disease Control and Prevention, 2011). As a healthcare professional working at retail sector, one of the pharmacist duties is to improve medication adherence that promote better quality of life for all groups. One of the biggest challenges for healthcare professional is improve medication adherence after the initial discharged of the patient to prevent hospital readmission. According to a study by the New England Healthcare Institute (NEHI), nearly one in five patients discharged from the hospital is readmitted within 30 days and resulted in an estimated total cost of readmissions

Portals can help in manage poly-pharmacy, provide patient education, engage patient and family in the care of managing chronic illness (Fant, 2015). When patients have access to their personal health records, they feel empower and want to do something about what is not normal. For example, a patient who is newly diagnosed with chronic kidney disease will have series of labs depending on which stage the kidney disease is in (“Understanding your lab,” n.d.). If the patient has access to portal, than the patient can easily access the lab results and share with his/her neprologist, dietitian, dialysis center, and other provides that the patient sees. There is no delay in retrieving the information or faxing or mailing the labs to the patient. Portal is very convenient as patient can be sitting at the comfort of the home to view labs, order medication refill, or even schedule an appointment. Provider's office with patient portal states of increase in efficiency in the workflow. The secure messaging to the provider decreases the amount of phone calls. Patient portal is a win-win situation for both the providers and the patients. While this technology is beginning to get attention, it is one such powerful tool to involve patient if implemented and utilized

Electronic health records will be electronically accessible to vendors and clients. To protect confidential information a security code must be used to access information. The Institute of Medicine identified six goals for health care; medical care should do no harm, be valuable, patient-focused, relevant, fruitful, and unbiased. (National Academies, 2013). EHR can help increase patient-focused care; the patient will be able to view their records online and assist in guiding their care. When records are accessible online patients can see them and manage diseases, collaborate care with providers, and improve patient to provider communication (Ricciardi, Mostashari, Murphy, Daniel, & Siminerio, 2013). Patients that are well-informed about their care have better health outcomes compared to uninformed patients. Patients who are involved in their care are less likely to experience adverse effects, to be admitted to the hospital, and have a medication error from lack of collaboration with their provider (Ricciardi et al. 2013). For providers to receive funds under the meaningful use incentive to purchase electronic equipment, they must show medical decisions are patient driven. (Ricciardi et al. 2013).

The population is plagued by many chronic diseases, most of which is maintain by medications. Medication noncompliance whether by choice or inconsistent use, leads to exacerbations and lengthy hospital stays. These hospital stays get costly and detract from revenue generation and increases loss of productivity. One way to decrease hospital admissions is through the use of mHealth tools to help patients become more responsible and consistent with medication use.

The healthcare industry is undertaking a structural change by aligning HIT with the delivery of care to improve quality, control costs, and enhance the efficiency of the system. The strategy is to build a national health information infrastructure that allows health information to be shared between providers, consumers, and payers in a patient-centric manner. The infrastructure change is taking place on three frontiers. First, providers are incentivized to use electronic health records in both inpatient and ambulatory medical practices. Second, local and nationwide health information exchange (HIE) systems are being built for providers, payers, and other health information users to access

This feature links patient portals and EHRs to consumer health information (Medline Plus, 2015). For example, MedlinePlus Connect is a free service of the National Library of Medicine (NLM), National Institutes of Health (NIH), and the Department of Health and Human Services (HHS) that offers an added benefit to the provider-patient relationship as an authoritative up-to-date health information resource for providers, their patients, and their families (Medline Plus, 2015). Implementing MedlinePlus is a one-time effort, doesn’t require registration, and can be configured to link to more than one source of consumer health information (Medline Plus, 2015). Medline Plus links both health care, drug, and lab data results through medication codes, and an EMR/EHR system that has the capacity to use Medline Plus is a great asset in helping the practice achieve one of the criteria’s for meaningful

My place of employment also has many Patient Portal are popping up just about everywhere in hospital where clients can have ease of access. Chamberlain College of Nursing (2015), argued that “the PHR is a great tool for healthcare consumers to partner in their own care. From the changes that are occurring in healthcare, if clients do not take the initiative to participate in their own healthcare through the PHR’s, then there is no way to validate if everything in their record is accurate.

According to Health IT News (2016) Digital technologies have improved care delivery in a number of areas. Providers need to align Electronic Health Record (EHR) systems and health management systems with consumer’s needs. Portability and easy access of an EHR system are necessary to empower consumers to engage in their care plan. The following examples indicates how health care providers could align technologies with consumer demand:

There is an increase in the use of patient portals among older patients due to the following reasons: ability to manage their chronic illnesses, and the ability to easily communicate with their physician when they are having questions or changes in their healthcare condition. The truth is that many generations of people who are computer literate are getting older now. This makes it easier for them to easily adapt to the introduction of the patient portal. Nevertheless, there are still many older people that are finding it difficult to adapt to these new healthcare tools (Heath, 2016). I think the number of older people using patient portals would continue to increase. The real issue is some older patients complained that they are not aware

Statins are drugs used in the treatment of many diseases including hypercholesterolemia, ischemic heart disease (angina, chronic heart disease and myocardial infarction), cerebrovascular accidents and peripheral arterial disease. Adults with a history of cardiovascular disease (CVD) or those with a 10-year risk of developing CVD should start statin therapy as a prophylactic measure. As a result of all these indications, statins are one of the world’s most prescribed drugs (1).

Adherence of antiepileptic medication is the main requirement to achieve the efficacy of the therapy of epilepsy treatment is done. A good quality of life found in someone who can run a function and its role in everyday life as well. This research aims to know the level of antiepileptic medication adherence, quality of life in epileptic patients, as well as the relationship between antiepileptic medication adherence with the quality of life in epileptic patients in outpatient RSUD Prof. Dr. Margono Soekarjo Purwokerto.

Multimodal interventions focusing on multiple barriers of medication adherence have mostly shown improvements in medication adherence and reduced health care utilization. For instance, the Ashville projects that combined expanded medication therapy management (MTM) and disease management services, showed improved clinical outcomes and reduced overall costs in studies targeting commercially insured patients with diabetes, hypertension/dyslipidemia, or asthma.40-42 Similarly, Pringle and colleagues evaluated the impact of a large-scale, pharmacy-based intervention on five chronic medication classes and found that, compared to the control group, the intervention group had improved adherence for all medication classes.43 Zillich and colleagues

A typical pharmacy model includes patients bringing in a new prescription or calling the pharmacy if and when they remember to get their prescriptions refilled. The pharmacy staff answers phone calls, contact physicians, waits an unspecified amount of time before the physicians’ offices call back, and then the prescription order is filled. The expectation is then that the patient arrives at the pharmacy to pick up his medications. While this model has been around for many, many years, it is wildly inefficient. Patients with multiple prescriptions call the pharmacy multiple times per month, which leads to multiple repetitions of the process described above. This leads to a number of unknowns and the pharmacy staff is bombarded with multiple hurdles to overcome and most importantly, the workload is significantly increased. There is a lack of ability to track patients with chronic disease states and multiple medications.2 Furthermore, adherence rates are not tracked due to lack of time, and health outcomes are less than optimal.3,4 This prompts one to ponder – what can be done differently to help free up the workflow while promoting medication adherence?