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University of Missouri Health Care

Virtual pharmacist provides cost-effective way to promote quality care

Pharmacists at the University of Missouri Health Care (MU Health Care) are changing the way they help patients and providers.

In early 2016, the Cerner ITWorks℠ organization launched a virtual pharmacy program named ViPRx. Through the program, a virtual pharmacist combs patients’ medical records for medication appropriateness at more than 60 locations — a task that would otherwise be nearly impossible.

The virtual pharmacist pays close attention to medications that could impact individuals living with diabetes. HealtheRegistries℠, Cerner’s registries and scorecards solution, tracks how the pharmacist’s recommendations would likely improve clinical indicators.

Within the first year, the virtual pharmacist’s recommendations helped MU Health Care improve all diabetes registry clinical indicators, such as cholesterol and glycated hemoglobin levels.

HealtheRegistries helps us justify interventions,” said Brad Myers, director of pharmacy, MU Health Care.

How does the program work?

A few days before a patient visits a clinician, the virtual pharmacist reviews his or her history and medications, paying close attention to medication and dosage appropriateness, medication adherence, potential medication interactions and checking that all immunizations are up-to-date. If necessary, the virtual pharmacist then recommends possible medication changes to the clinician.

Similarly, after the patient visit is complete, the pharmacist reviews prescriptions written by the clinician and intervenes if necessary.

“ViPRX helps physicians if their patients have any medication issues,” said Bushra Muraywid, pharmacist. “It helps them address issues in a quicker manner because they don’t have to do as much background work. It’s being done for them.”

Virtual pharmacist improves efficiency

MU Health Care uses ViPRx to control costs across its multiple locations. The virtual pharmacist can make suggestions and intervene at each clinic.

“MU Health Care has about 60 clinics, so we’re not able to embed a pharmacist in each of the clinics,” Myers said. “The technology creates an efficient workflow.”

Throughout 2016, clinicians agreed with the pharmacist’s lab monitoring suggestions 78 percent of the time, and they agreed with nonadherence counseling 72 percent of the time.

Improving diabetic care

One of the biggest successes came through improvements in diabetic care. Suggestions to change medications can enable improved patient health.

“We specifically started by looking at patients with diabetes,” Muraywid said. “The pharmacist really delves into the patient’s chart and medical record and makes sure patients living with diabetes are on the best and most appropriate medications.”

HealtheRegistries enables transparency to how the virtual pharmacy program, among other factors, improved diabetic care. The virtual pharmacist makes prescription recommendations to help curtail diabetes. The solution shows how those recommendations helped improve diabetic indicators, such as glycated hemoglobin (HbA1c) and LDL cholesterol levels.

HbA1c tests provide an overall picture of blood sugar levels, with lower counts signaling healthier patients. HbA1c less than or equal to nine rose from 66 percent in March 2016 to 72 percent in December of that year.

In addition, the number of patients who had their LDL rate under control rose from 65 to 74 percent.

Continuing ViPRx rollout

When ViPRx launched in March 2016, only one clinician used the program. Throughout the year, family medicine, internal medicine and endocrine specialists began to use the system. In the future, MU Health Care plans to expand the program.

“We wanted to make the program scalable and look at it over a long term,” Myers said. “We’re not creating a program designed for today without thinking about tomorrow.”

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.