Choice is a wonderful thing. Up to a point. Sometimes, it is possible to have too many options. And sometimes what looks like a veritable smorgasbord of choices turns out to be fantasy. This reality is beginning to appear in the clinical pharmacy software arena. Let me explain.
Just a few years ago, our pharmacy ran on two software platforms: our pharmacy management system or PMS and our in-house electronic health record (EHR). As the first sprouts of pay for performance germinated, so too did platforms to collect the data generated by the pharmacist. Soon, our pharmacy was running platforms like Mirixa and Outcomes alongside our PMS. Fortunately, we could usually cut-and-paste information from our EHR into Mirixa and Outcomes to prevent the loss of too much efficiency.
With the emergence of new pay for performance initiatives, we are seeing many new networks emerge, and often these networks require specific software solutions as a condition to participation. Today, we have had to add platforms from PrescribeWellness, DocStation, and TabulaRasa to our
Just keeping the workflows of each of these platforms straight is nearly impossible, and most require work outside of our normal workflow. Each platform has its own unique spin on documentation, and each does some things well and others poorly. A bleeding-edge pharmacy today must use a veritable alphabet soup of documentation software today. This is a bad precedent.
After working with a number of different platforms, a pharmacy may decide that one specific platform works best for their practice and workflow: their choice for an EHR. Like our pharmacy learned many years ago, having a single patient record repository is an asset. Even if you have to input data into the alphabet soup, having a master patient record makes managing patient care much easier. But with patient records already spread over the alphabet soup, the pharmacy would have to start over, from ground zero, with their chosen EHR platform.
Not counting the data duplication issue, there is a more insidious problem emerging. The problem of data ownership and transportation. Each platform is a closed ecosystem, and despite the creation of the data originating in the pharmacy, each of these solutions claims some, or more likely all ownership of the data for themselves. If we assume for now that each platform will allow a pharmacy to export their patient records, the migration between platforms would still be a potential nightmare.
Today, during National Pharmacy Month, the profession stands at an important crossroads: Value-Based Reimbursement and Clinical Documentation platforms. The last time the profession stood at a similar junction was the emergence of electronic claim management. That decision did not go well for the profession, with pharmacies giving away their data only to allow a new breed of business, the Pharmacy Benefit Managers (PBMs) emerge and gain significant control over the entire industry.
The choice that pharmacists need to make today is simple. Pharmacy needs to maintain control over its own data. It is important for our patients, and it imperative for the longevity of our profession. The value of the pharmacist to the health care system does not reside in the platform they use, but in the care they provide. Pharmacy needs to resist the pressure to give away data. Pharmacists should lobby to eliminate the alphabet soup. Let quality and payer metrics define reimbursement, not acceptance of
About the Featured Image: Taken inside the “Star” stairwell in St. Paul’s Cathedral in London. This location has appeared in several movies including scenes in the Harry Potter movies (Hogwarts castle) and in Sherlock Holmes (2009).
