ArchCare Senior Life, PACE is a Program of All-inclusive Care for the Elderly serving more than 200 participants from four Centers in Manhattan, The Bronx, and Staten Island.
In 2011, Archcare Senior Life, PACE identified multiple areas for improvement related to pharmacy. The PACE organization had been using a long term care pharmacy because the nursing facilities under the ArchCare corporate umbrella used the same pharmacy. The PACE executives decided that they needed pharmacy services tailored to the PACE model to assist with improving safety and efficiency. This would help the program meet the growing needs of the elderly population served and exceed participant and staff expectations for service.
“In 2012, we were excited to partner with CareKinesis to help bring our pharmacy practices out of the stone age and into the twenty first century,” says Henriette Kole, Executive Director of PACE at ArchCare. With one full PACE center in Harlem at the time, “we needed a scalable and innovative partner to helps us grow our PACE presence.”
ArchCare sought systems to improve control over medications, improve quality, and reduce medication risk. They had recently implemented an Electronic Medical Record, but were still also relying on paper medication dispense records. This resulted in the need for a pharmacy consultant to audit charts and reconcile between records.
For urgent access, physicians had a med cart of select medications but there was no system for tracking the process from inventory control to medication administration. The consultant pharmacist was also responsible for QA and retrospective medication management.
For dispensing, prescribers requested all participants’ needed medications each week by checking off each medication in an outdated electronic form. Routine medications were packaged in vials only, and they were lacking a good system for monitoring PRN refills and utilization. When the pharmacy delivered 7-day supplies of medications to the Center, ArchCare engaged in the huge task of medi-set repackaging and re-distribution to participants using a contract transportation organization for home delivery. At times, nursing staff resorted to personal delivery of medications via taxi to participants’ homes when the medication delivery missed the transportation.
ArchCare also wanted prospective clinical pharmacy services to help reduce the risk of medication-related problems and to achieve better medication outcomes.
With CareKinesis, ArchCare benefits from an accurate medication management platform through the EireneRx medication portal. When CareKinesis introduced the adherence packaging and 28-day cycle-fill system, there was much concern about managing medication changes and skepticism that it could work at ArchCare. The clinical staff soon realized that these enhancements plus home delivery saved countless hours of administrative work – hours that were soon reallocated to more meaningful participant care functions.
New on-site medication cabinets allowed urgent medications to be dispensed securely at each Center within minutes. And, real-time updating of inventory eliminated the need for strict oversight.
“Now, we have expert PACE pharmacists available 24/7 who provide us with prospective clinical interventions,” says Medical Director Debra Berg, MD. “Their medication risk mitigation software allows us to make informed decisions at the point of prescribing.”
According to Dr. Berg, “By e-prescribing and managing medications through EireneRx, we don’t have to worry about whether participants will receive their medications. Refilling PRNs is simple and reliable as well.”
Adds Ms. Kole, “Through the use of the meaningful-use certified system, EireneRx, we qualified for meaningful use funds in collaboration with our electronic health record system, Mediture.”
In a recent CMS survey ArchCare Senior Life, PACE received high marks for medication management. They have reduced meds per member by more than 10%, increased their generic utilization to 90%, and lowered QA pharmacy events.
“By partnering with CareKinesis, ArchCare is able to spend more time caring for participants and less time managing the medication process,” says Executive Director Kole.