introducing the medication recording system schedule ed castagna mom & pop’s small business...

Introducing the Medication Introducing the Medication Recording System ScheduleRecording System Schedule

Ed CastagnaEd Castagna

Mom & Pop’s Small Business ServicesMom & Pop’s Small Business Services

Doctor Prescribes Medication to improve patient during illness

Patient administers medication until some time

Patient and Doctor reevaluate continued need for medications

Doctors Prescribe and Doctors Prescribe and Patients AdministerPatients Administer

Current Doctor and Patient Current Doctor and Patient ProblemsProblems

Patient may not recall all their current medications

Patient may not be able to understand drug information given

Patient may not be able to administer medications well

Patient may be unwilling to take additional medications

Patient may not understand drug paper documentation

Patient may not know how to add medication to schedule

Patient may be overwhelmed with the practitioner coordination needs

Patient may not be physically able to administer drug (for instance, standard Insulin Injection for arthritic patients)

Current Doctor and Patient Current Doctor and Patient ProblemsProblems

Improving Outcomes

Understanding Medications

Improving Continuity of Care

Improved Ability to Control Medications Administration

Patient IssuesPatient Issues

Improving Outcomes

Continuity of Care

Training Patient re Medications

Improving Patient Compliance

Improving Patient Feedback

Doctor IssuesDoctor Issues

Improving Outcomes

Improving Continuity of Care


Improving Pharmaceuticals Dispensing, Renewals, Scheduling, and Delivery

Minimizing Costs

Pharmacist IssuesPharmacist Issues

Improving Outcomes

Continuity of Care


Improving Patient Compliance

Improving Patient Feedback

Improving Pharmaceuticals Dispensing, Renewals, Scheduling, and Delivery

Insurers IssuesInsurers Issues

Minimizing Cost

Minimizing Costly Emergency Room Visits due to wrong medicine, missed doses, double doses, inappropriate diagnosis, treatment options.

Insurers IssuesInsurers Issues

Updated: November 11, 1999

Time Medication/Results Dosage Doctor Since

Before Breakfast__ 6:30 am Blood Sugar Test _________ Dr. Feldman 1998__ 6:30 am Insulin 70/30 70 units Dr. Feldman 1999

Breakfast Time__ 7:15 am Ecotrin 5 mg Dr. Robeson 1999__ 7:15 am Synthroid .1 mg Dr. Robeson 1999__ 7:15 am Norvasc 5 mg Dr. Robeson 1999__ 7:15 am Centrum Gold pill Personal 1990__ 7:15 am Calcium/Magnesium 450/325 Dr. Robeson 1998

_

Sample Medication Recording Sample Medication Recording System ScheduleSystem Schedule

Sample Medication Recording Sample Medication Recording System ScheduleSystem Schedule

Updated: November 11, 1999

Time Medication/Results Dosage Doctor Since

After Breakfast__ 9 am Vasotec 10 mg Dr Eligeti 1998

Lunch Time__ 12:30 am Blood Sugar Test_________ Dr Feldman 1998

Before Dinner

__ Insulin 70/30 15 units Dr Feldman 1999__ Insulin 50/50 10 units Dr Feldman 1999

A Team Approach to A Team Approach to Medication Recording SystemMedication Recording System

Patient arrives at Doctor for checkup

Doctor suggests additional medication

is needed

Patient hands doctor Medication Recording System Schedule

All current medications appear on schedule


Doctor notes existing medications

Doctor prescribes medication , dosage, number of pills, number of administrations/day

Doctor suggests potential timing of dosage administration

Patient updates Medication Recording System Schedule with new medication


Patient shows Medication Recording System Schedule to Pharmacist

Pharmacist checks for drug interactions

Pharmacist updates his view of patient with additional medication

Pharmacist delivers medication and blessing

Patient administers medications regularly based on schedule

Patient is in Hospital for something

Patient is medicated regularly in Hospital with Nursing Support

Patient is Discharged with pending medications needs

Hospital may give patients a day’s worth of drugs

Old Hospital Discharge Old Hospital Discharge ScenarioScenario

Patient is at home with a Discharge Summary they do not know how to read

Patient needs to verify information found on Discharge Summary to turn it into timely drug administration needs in outside world

Patient solicits Hospital Nursing Staff after discharge for help with unknown state


Patient solicits Primary Care Physician to help with unknown state

Patient Solicits Pharmacist to help with unknown state

Discharge orders may be continued, follow-up with Primary Care Physician should be recommended


Primary Care Physician prescribes those medications from Hospital to be continued for patient

Pharmacist delivers newly prescribed medications

Patient is satisfied that the Primary Care Physician has evaluated Hospital medications handoff to home


Patient is in Hospital for something

Patient is medicated regularly in Hospital with Nursing Support

Patient is Discharged with pending medications needs

Medication Recording System Schedule is created for patient

Hospital may give patient sufficient dosing till Primary Physician visit

Hospital Discharge with Hospital Discharge with Medication Recording SystemMedication Recording System

Patient is at home with a Discharge Summary and a Medication Recording System Schedule they find easy to understand

Patient fills prescriptions based on Medication Recording System Schedule.

Patient Solicits Primary Care Physician to understand issues relating to Discharge Summary at a lower priority than immediate medication needs.


Primary Care Physician coordinates with Hospital Staff to understand Discharge Summary. Patient consults Primary Care Physician to help with unknown state

Pharmacist coordinates with Hospital Staff to understand Discharge Summary.


Primary Care Physician prescribes those medications from Hospital to be continued for patient

Pharmacist delivers newly prescribed medications

Patient is satisfied that the Primary Care Physician has evaluated Hospital medications handoff to home


Old Doctor’s Office VisitOld Doctor’s Office Visit

Patient visits Primary Care Physician noting symptoms

Doctor evaluates symptoms and prescribes medication

Patient gets prescription from local drug store

Medication Information shows side effects which patient decides not to bear the risk of

Old Doctor’s Office VisitOld Doctor’s Office Visit

Next Patient visit Doctor notes no further improvement

Patient confides in Doctor that the side effects were not acceptable. Is there another way of treating

Patient may have put himself at risk

Doctor’s Office Visit with Doctor’s Office Visit with Medication Recording SystemMedication Recording System

Patient visits Primary Care Physician noting symptoms

Doctor evaluates symptoms and prescribes medication

Doctor reviews medications and side effects and gains patient’s approval for intended treatment plan.

Doctor revises Medication Recording System Schedule with new medications

Doctor’s Office Visit with Doctor’s Office Visit with Medication Recording SystemMedication Recording System

Patient gets prescription from local drug store

Doctor Tickles Patient in timely fashion to evaluate if the medications are being taken.

If Patient is not fulfilling treatment plan, Doctor offers another visit with alternate treatment plan.

Problems Addressed by Problems Addressed by Medication Recording System Medication Recording System

Doctor rely on Patient’s ability to followup with medications

Patients have a hard time understanding specifics of Doctor’s medications requests, interactions between medications, foods

Let’s attempt to make it easier for patients to administer medication prescribed by Doctors

Medication Recording System Medication Recording System ScheduleSchedule

Patients carry schedule to Doctor’s office for visit

Doctors have list of medicines readily available to make optimal decisions

Patients have best chance of following Doctor’s orders.

Internet Solution allows access if Patient does not have schedule on hand.

Patient BenefitPatient Benefit

Patients are more able to understand medicine administration needs. These functions are currently only offered in Hospital Settings, with Nursing Delivery.

Easier to comply than reading the bottles for frequency of medications delivery

Responsibility is appropriately on caregivers to assist with scheduling the medication administration

Doctor BenefitDoctor Benefit

Doctors have a list which can be used for allergies, current medication information rather than patient’s memory.

Doctors have agreement of the patient that they can handle the new schedule before the patient leaves the office.

Patient has a greater ability to implement doctor’s intended medication schedule.

Pharmacist BenefitPharmacist Benefit

Pharmacists have a schedule which can be used for allergies, current medication information rather than relying on a patient’s memory

Pharmacists can facilitate drug interaction checks more successfully against a full medication schedule.

Pharmacists can coordinate monthly renewal needs for renewable prescriptions

Insurer BenefitInsurer Benefit

Patients who are able to follow the schedule will be less prone to costly Emergency Room Visits based on medication administration failures.

Improved continuity of care among caregivers aware of a patient’s medication needs should improve patient outcomes, wellness, and minimize costs

Empowering Claimants and their family frees up scarce resources


Thank You


Q & A

Other Scenarios (Doctor’s Office, Discharge from Hospital) needing to be addressed

Are you comfortable with the program

introducing the medication recording system schedule ed castagna mom & pop’s small business...

Documents

patient problemspatient

view of patient

blessing patient

discharge summary

medications wellpatient

drug interactionspharmacist

hospital nursing staff

drug information givenpatient