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Product Effectiveness Benefits Realization Assessment of the Pharmacy Re-Engineering (PRE) Medication Order Check Healthcare Application (MOCHA) software.

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Presentation on theme: "Product Effectiveness Benefits Realization Assessment of the Pharmacy Re-Engineering (PRE) Medication Order Check Healthcare Application (MOCHA) software."— Presentation transcript:

1 Product Effectiveness Benefits Realization Assessment of the Pharmacy Re-Engineering (PRE) Medication Order Check Healthcare Application (MOCHA) software Tom Fagan Pharmacy Benefits Management Clinical Informatics Instructor

2 VETERANS HEALTH ADMINISTRATION Learning Objectives Understand the Mission of Pharmacy Benefits Management Understand the Background on Pharmacy Re-Engineering Project (PRE) including (MOCHA) Medication Order Check Healthcare Application Understand the reason and goals for Benefits Realization assessment of PRE including MOCHA by OHI PE Team Understand the data sources, methodology and rationale used in assessment Understand initial assessment findings and recommendations

3 VETERANS HEALTH ADMINISTRATION Mission of Pharmacy Benefits Management To improve the health status of veterans by encouraging the appropriate use of medications in a comprehensive medical care setting. Functions – Drug Benefit Design – Evidence-Based Formulary Management – Utilization Management – Staff Education – Patient Safety

4 VETERANS HEALTH ADMINISTRATION Clinical Informatics Application of Information Technology to deliver Healthcare Services

5 VETERANS HEALTH ADMINISTRATION (PRE) Pharmacy Re-engineering Background Began in 2002 Multiple Increments Project Management Main Goal to Improve VistA Pharmacy Package – Respond to Patient Safety Issues – Medication cost reduction – Improved workflow and process

6 VETERANS HEALTH ADMINISTRATION PRE Increments First Iteration Increment 1 – PRE Foundational Enhancement Increment 2 – Pharmacy Enterprise Customization System (PECS) Increment 3 – Medication Order Check Healthcare Application (MOCHA v1.0 ) (Non-Dosing) Increment 4 – Medication Order Check Healthcare Application (MOCHA v2.0 ) (Dosing) Increment 5 – Pharmacy Enterprise Customization System Enhancements Increment 6 – Enhanced Order Checks

7 VETERANS HEALTH ADMINISTRATION PRE Pharmacy Re-engineering Components MOCHA – Medication Order Check Healthcare Application PECS – Pharmacy Enterprise Customization System PPS – Pharmacy Product System

8 VETERANS HEALTH ADMINISTRATION Accessing PECS Have your ADPAC assign you the following security key: PSS_CUSTOM_TABLES_REQUESTOR Access PECS through this link: https://vapreapp1.aac.va.gov:8443/ct/public/ Welcome.action

9 VETERANS HEALTH ADMINISTRATION MOCHA V1.0 Medication Order Check Healthcare Application – MOCHA v1.0 Rolled out during the summer of 2011 Delivers a valuable enhancement to medication order checks in the Pharmacy and CPRS packages Utilization of a clinical drug database vendor, First Databank (fdb) Enhanced Therapeutic Classification (ETC) allows for multiple classes per drug, thereby reducing the number of clinically inexact or inappropriate warnings

10 VETERANS HEALTH ADMINISTRATION MOCHA V2.0 – MOCHA v2.0 (Dosing) Development Introduces dosage order check functionality which will reduce medication errors, adverse events, and potential deaths Provides an extremely valuable tool to VA clinicians in CPRS, Inpatient Pharmacy, and Outpatient Pharmacy Version 2.0 consists of a maximum single dose check derived from the patient’s age, weight, and body surface area (BSA) Currently installed in six test site environments with a planned national release of July 2012

11 VETERANS HEALTH ADMINISTRATION Stated Benefits of PRE Increased Patient Safety Increased Efficiency of Prescription and Order Processing Decreased Costs Increased Satisfaction Increased Regulatory Compliance

12 VETERANS HEALTH ADMINISTRATION Goal for Assessment Office of Health Information (OHI) Product Effectiveness (PE) Benefits Realization (BR) Assessment One key question – Is VHA realizing the intended benefits from the PRE functionality, and if not, what can be done to make needed improvements?

13 VETERANS HEALTH ADMINISTRATION Measureable Goals 1.Patient Safety 2.Increased Efficiency of Order Processing 3.Decreased Costs 4.Increased Satisfaction 5.Increased Regulatory Compliance

14 VETERANS HEALTH ADMINISTRATION Data Sources 1.PBM Database ProClarity Cube 2.HR Employee Cube 3.Non-Formulary Request Processing Reports 4.National Drug File support Group 5.PBM Inventory Data 6.PBM Order Check Analysis Worksheet 7.vaADERS 8.Office of Information IT Patient Safety Office Database:

15 VETERANS HEALTH ADMINISTRATION Surveys 1.VHA National Survey of Pharmacists 2.PE Customer Satisfaction Focus Groups 3.VA All Employees Survey 4.Survey of Healthcare Experiences of Patients

16 VETERANS HEALTH ADMINISTRATION Methodology Overview of BR Product Effectiveness Mission – Independent Assessment and Analysis – Benefit Realization - evaluate benefits against a specific outcome Initial Measurement (now) Post Implementation Performance (future)

17 VETERANS HEALTH ADMINISTRATION Methodology Scope PRE Multiple Increments – Initial – Post Implementation

18 VETERANS HEALTH ADMINISTRATION Rationale Measurements Findings Recommendations

19 VETERANS HEALTH ADMINISTRATION Initial Assessment Findings Establish a Baseline before PRE upgrades

20 VETERANS HEALTH ADMINISTRATION Initial Assessment Recommendations Patient Safety Alert Fatigue Staff Satisfaction

21 VETERANS HEALTH ADMINISTRATION Major Recommendation Measurements on Annual Basis Identify Trends due to upgrades

22 VETERANS HEALTH ADMINISTRATION Recommendation Monitoring Details 1.Safety Metrics 2.MOCHA 3.Staff Satisfaction 4.Work Flow

23 VETERANS HEALTH ADMINISTRATION Key Findings 1.Increased Patient Safety and Decreased Costs 2.Increased Satisfaction Mixed -MOCHA

24 VETERANS HEALTH ADMINISTRATION ASHP 2009 Drug Drug Interaction (DDI) Survey Pharmacists Identify Areas for Improvement Knowledge Gap –no formal education on how to evaluate and respond to order checks

25 VETERANS HEALTH ADMINISTRATION Summary Benchmark Established Increment Assessment Is VHA realizing the intended benefits from PRE if not what can be done to make needed improvements?


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