What was the challenge, opportunity or issue faced?
There is a significant patient experience “gap” that exists as patients transition to outpatient care. Specialty and home infusion pharmacies can work in collaboration with hospitals to improve overall patient experience outcomes.
What did you do to address it?
Our first objective was to better understand the existing national HCAHPS metrics related to “Transition of Care”. More specifically, we wanted to identify how our pharmacy and nursing teams could work in collaboration with hospital system partners to improve care. A virtual patient experience “cliff” exists as patients are discharged from the inpatient hospital setting. Continuity of care is a challenge in healthcare, and this fact gets magnified when a patient’s journey starts in an institution that has a formal patient experience (PX) program and is then transitioned to an outpatient provider that is lacking on this front. How can a PX service recovery opportunity take place if there is no feedback loop?
According to Medicare’s Hospital Compare website, only 52% of patients “Strongly Agreed” they understood their care when they left the hospital. Consider the published quarterly HCAHPS reports that show on average more than 8,400 patients complete this survey daily. This means 3,360 of 8,400 patients do not “Strongly Agree” they understand their care on a daily basis! This is startling data that could have a detrimental impact on patient healthcare outcomes.
Being admitted to a hospital is a stressful and costly event. The inpatient setting insulates the patient with experts to lead in their specific care. However, when a patient is discharged, the care responsibility ultimately returns back to the patient. It is critical that patients understand their health status and future treatment plan, but 48% of them don’t. This poses a significant challenge to outpatient service providers like specialty pharmacies that are tasked with maintaining continuity of care. An uninformed or disengaged patient at this stage is in dire need of PX service recovery. This is where Heritage Biologics identified an opportunity for a PX program in the pharmacy setting to “Bridge the Gap.”
Our Executive Leadership team recognized the importance of allocating the proper resources to build a first-in-class PX program in a pharmacy. We sent eight employees through The Beryl Institute Body of Knowledge Patient Experience Leadership Program. Amanda Walker became the first Vice President of Patient Experience in the pharmacy industry and achieved Certified Patient Experience Professional (CPXP) designation offered through the Patient Experience Institute. We enlisted the guidance of established PX leaders like Sean Rodriguez from Barnes-Jewish Hospital to further create a program that would align with hospital priorities.
What were the outcomes?
Our pharmacy is focused in the rare disease space where patient experience can dramatically impact outcomes. We expanded our PX program into the RXPX Initiative with the mindset that a movement was needed within the entire pharmacy industry. We have worked tirelessly to secure additional pharmacy partners and colleagues to join the mission to put the patient back in the center of the care continuum. The momentum and interest around RXPX continues to grow, and we recently formed a partnership with a large health system that includes 11 hospitals. Additionally, we have successfully launched an RXPX pilot program with a large academic medical center.
The RXPX Initiative was created with an emphasis on capturing and reporting actionable health insights. We partnered with Customer Feedback Systems and CareExperience vendors to design an innovative PX feedback software tool. We developed a new Patient Reported Outcome Measurement (PROM) and Quality of Life (QoL) platform called “rarecare”. These systems provide us with real-time analytics that have improved patient health outcomes. Additionally, Dr. Mahek Shah from Harvard Business School’s Institute for Strategy and Competitiveness worked with us to incorporate our RXPX data into our industry-leading value-based Therapeutic Management Partnership model.
RXPX PROGRAM OVERVIEW
- “rarevoice” (Patient Feedback Survey)
- Collaborative Medicine Model (Hospital Partnerships)
- Clinical Outcome Improvement (Value-Based Approach)
- PROMs & QoL Metrics (“rarecare” Platform)
- Therapeutic Management Partnership Program
Measuring and Sharing Data
Heritage Biologics is committed to measuring and sharing our real-time outcomes data with our provider partners. The data includes outcomes from multiple data sets including the RXPX standard measures that we created to align with hospital HCAHPS. We have captured 149 RXPX “rarevoice” surveys year-to-date. Patient engagement is a core focus for our clinical staff, and our 97.8% survey compliance reflects that priority. Detailed insights have uncovered specific PX service recovery opportunities that we have been able to proactively address with hospital system partners. These collaborative care examples have allowed hospitals to address lingering concerns that patients had about their care as they were discharged.
One of the most powerful tools that we provide in our RXPX program is an exclusive communication platform that connects patients to a specific RXPX Navigator staff member. We have identified significant insights through this patient relationship model. Overwhelmingly, patients report being more satisfied with our service compared to their previous experiences. Of the 149 completed surveys, 100% would recommend our service to a family member or friend. (Strongly Agree: 72 / Agree: 77)
Empowering Provider Partners
Finally, the RXPX data that is reported back to our clinical provider partners has set a new standard for specialty and home infusion pharmacies. Our customized Patient Snapshot reports are clinical recaps that incorporate the complete healthcare dashboard of each patient. These reports are shared directly with the physicians and nurses that have transitioned their patient to our care. This collaborative approach to therapeutic management has resulted in better overall health outcomes.
- Patient Engagement Measurements (149 Total Surveys Completed Year-to-Date)
- PX Survey Results (97.8% Survey Compliance; 100% Would Recommend)
- Clinical Collaboration Ratings (16 RXPX Service Recoveries)
- Hospital System Feedback (Established a New Standard of Pharmacy Care)