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Medication adherence is ‘the elephant in the room’


Some patients end up back in the hospital because they didn’t follow their treatment plan, for a variety of reasons. Colin Banas of DrFirst talks about the need to improve.

Health systems are paying more attention to medication adherence.

Colin Banas, chief medical officer of DrFirst, talks about the importance of ensuring patients are taking their medications properly. He says it's a key step in reducing costly readmissions. (Photo: Ron Southwick, Chief Healthcare Executive)

Colin Banas, chief medical officer of DrFirst, talks about the importance of ensuring patients are taking their medications properly. He says it's a key step in reducing costly readmissions. (Photo: Ron Southwick, Chief Healthcare Executive)

Hospitals are focusing on how people take their medications with a view on improving healthcare and the bottom line. If patients aren’t following the medication plan from the health system, they have greater odds of returning to the hospital. That’s obviously bad for the patients, and costly for hospitals, who can face penalties from Medicare for excessive readmissions.

Colin Banas, chief medical officer at DrFirst, says the focus on medication management is a necessity for hospitals.

“We are trying to get laser-focused as a country and as an industry around better outcomes, reducing costs, and the Quadruple Aim,” Banas says. “The elephant in the room is adherence.”

Banas spoke with Chief Healthcare Executive® about the need for greater attention to medication adherence. DrFirst, a healthcare technology company, develops solutions to improve medication management. Based in Rockville, Maryland, the company’s solutions are utilized by more than 300,000 providers, including 220,000 prescribers in hospitals and clinics throughout the United States and Canada.

Hospitals and health systems are taking a closer look at medication management as they continue to face financial pressures. Now, providers also have better data about the impact of patients who aren’t following their mediation plans, Banas says.

“If patients don't take the medicine and don't get on the treatment plan, you can just follow the logic as to what's going to happen, if a diabetic isn't getting their insulin, or if someone with high cholesterol isn't getting their statin,” Banas says.

“There's a lot of incentive to get it right the first time and make sure that we don't become the revolving door for our patients,” he adds.

About one in five medications are never filled, according to the Centers for Disease Control and Prevention. Half of the prescriptions that are filled aren’t taken correctly, either in dosage or duration, the CDC said.

The cost of nonadherence to medicine to the nation’s healthcare system is estimated to range from $100 billion to $300 billion annually, the CDC has estimated.

Some patients aren’t taking their medication properly because they can’t afford it. Nearly 3 in 10 Americans aren’t taking medications as prescribed due to the costs, according to a KFF poll in October 2022 found.

Sometimes, hospitals can place too much pressure on discharging patients as quickly as possible, and patients don’t have a full understanding of their medications they need to take, says Banas, who formerly worked as a hospitalist.

“I think it's a real disservice to the patients because that rush to get you out, doesn't leave a lot of time for the communication to make sure that you understand, ‘Here's the list. Here's what I want you to stop taking, here's what I want you to continue taking, here's how you take it,’” Banas says.

With a growing focus on medication adherence, Banas says DrFirst is well-positioned to thrive in the coming years. The company is continuing to grow and is adding more health systems, and is focusing more on acute care hospitals.

The company’s AI-powered solutions can reduce medication errors and can give clinicians an understanding of a patient’s medication history. Banas talks about the goal of reducing the “cognitive burden” on doctors and nurses, who routinely ask patients about their history and their medications.

“There's so much manual work in that, and it's not a good use of clinician time to re-transcribe things from point A to point B,” Banas says. “And those are the things that are wildly inefficient, and also sort of burn us out, or at least distract us from the real goal of clinical care.”

With hospitals still encountering difficult financial headwinds, some systems have had to scale back on their investments in technology. Health systems are also taking a harder look at technology solutions to ensure they can get a return on their investment as soon as possible.

With the need to reduce costs and readmissions, Banas says he’s optimistic about the company’s prospects. DrFirst is also looking to work with more providers in the growing specialty pharmaceutical market.

“We're picking up more and more business on the health system side, particularly focusing on acute care hospitals and medication safety, because it's a proven solution. There's actually a demonstrable return on investment,” he says.

Despite the challenges in the market, “There's still always a green space for us to grow in terms of medication management and medication safety.”

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