(Management Case Study) Use of Pharmacy Technicians in Transitions of Care Discharge Services

Purpose: The patient hospital discharge process can present challenges to patients and medical teams when barriers arise limiting patient access to needed medications beyond discharge. Additionally, the patient discharge process is desired to be completed in a timely manner for both patient satisfaction, as well as, hospital turnover of available patient beds. The purpose of this program was to utilize pharmacy technicians to assist the medical team and pharmacy staff members with a smoother patient discharge process by helping patients overcome medication access issues.

Methods: An advanced pharmacy technician role, Transition Specialist – Patient Medication Liaison (TSPML), was created to assist with patient medication needs at discharge. These positions served as a liaison between physicians/providers, nurses, case managers and pharmacists in both the inpatient and retail pharmacy settings. Characteristic duties of these pharmacy technician positions included: identification of payment source of prescriptions at discharge (insurance, co-pay savings cards, patient assistance programs, etc.), referral to pharmacy prior authorization services, expedited prescription data entry and filling of prescriptions prescribed at patient hospital discharge, and facilitation of bedside medication delivery. The TSPMLs reviewed assigned patients daily to identify patients likely to be discharged. Patients to be discharged were identified by attending nursing unit huddles, communication with the multidisciplinary teams, and review of the patient chart within the electronic medical record for indication of possible patient discharge.  Once discharge patients were identified, TSPMLs would review medications prescribed at discharge to identify any troubling prescriptions related to access to the medication or financial need. Additionally, TSPMLs would work with the pharmacist or medical team if medication instructions seemed unclear or contained errors that required further review by a pharmacist.

Results: Over a six-month period, the TSPMLs were able to complete over 6,000 interventions. The most common interventions included: collected patient insurance information (n=2,565), transferred allergy information from the patient’s electronic medical record to the retail pharmacy software patient profile (n=2,470), contacted pharmacist or medical team to clarify discharge medication information (n=339), worked with social services to arrange payment assistance when pharmacy was unable to assist (n=190), performed medication cost inquiries (n=149), contacted pharmacist or medical team to ask if less expensive alternative medication available (n=75), and had prescriptions transferred based on patient preference (n=63). Additionally, the TSPMLs were able to utilize co-pay savings cards on 196 prescriptions savings patients over $100,000.

Conclusion: The results of this service show the role pharmacy technicians can play in transitions of care needs for patients at hospital discharge. With the incorporation of pharmacy technicians within the multidisciplinary health care team, team members are able to focus on other activities and allow pharmacy technicians to take away some of the administrative burden related to medications prescribed at patient discharge, while allowing patients to have more access to needed medications.