Following her appearance at the 2nd Annual World Congress Summit to Improve Adherence & Enhance Patient Engagement in Philadelphia, Kristi Rudkin, senior director of product development for Walgreens, spoke with DSN about the company’s efforts to boost patients’ adherence rates. Here are excerpts from that interview:
DSN: What’s your overall impression of the conference? How committed are the participants to improving adherence and patient engagement?
Kristi Rudkin: It was about collaboration, and you could tell there was a path forward from last year’s conference. The detail and depth of the conversation — and what has been learned and tried over the last year — is impressive. I think as an industry we are moving toward being able to solve a good percentage of the adherence problem.
DSN: Adherence dovetails with so many things going on now in pharmacy. Are the health system and community pharmacy on the same page regarding goals like engaging patients and improving adherence?
Rudkin: Yes, I do think many of the stakeholders were on the same page, and much of the discussion was on how we do that collaboratively.
For me, one takeaway from the conference was that … it really will take a village of providers to help solve this adherence problem, with participation from pharmacy providers, health plans and prescribers working together to help solve this problem.
DSN: Are health information technology, electronic health records, e-prescribing, data mining, mobile-app refill reminders and other technologies providing new windows into patient behavior and aiding Walgreens in its effort to improve patient adherence rates?
Rudkin: I definitely believe that. Data mining is critical to understanding patient behavior, and the many ways we can reach people these days through technology — whether a mobile app reminder or by using our systems to inform the pharmacist about which patients are at risk — gives them more information about the patient at the pharmacy.
Part of what the data helps us understand … is how patients perform on adherence over time.
Also, e-prescribing has given us more insight into the problem of primary nonadherence, where the patient doesn’t pick up that prescription. If the prescription is coming right from the prescriber to the pharmacy, the pharmacy is at least aware that the patient should be getting this medicine, and can intervene.
DSN: In a case like that, what happens? Does the Walgreens central call center or a local pharmacist follow up?
Rudkin: It’s kind of a triage. The technicians make the initial call when a prescription has been in the pharmacy for about a week. The technicians can handle a lot of things, and sometimes it could just be that the patient says they’ve gotten samples from the doctor. But if the tech gets the impression that there’s something more going on, they will transfer the call to the pharmacist to intervene.
DSN: Has Walgreens considered adding dashboard technology or some other form of data access that pharmacists can pull up to give them a real-time read on individual patients’ adherence record? Or is that too much additional responsibility to put on the pharmacist?
Rudkin: That’s a good question, and I don’t think the industry has the answer to that yet. If we can use the systems corporately to tell the pharmacist that Patient A is nonadherent, is that useful information, and can it give the pharmacist a better look into where the patient is in their therapy journey? At this point, that’s been our primary focus. So we’re considering [dashboard technology], but we’re trying to leverage our technology to pinpoint those patients for our pharmacists, so they know who they have to intervene with. It’s not a decision they need to make or spend a lot of time thinking about. We try to do that for them.
DSN: Where is Walgreens in terms of moving ahead with a medication synchronization program?
Rudkin: We did a proof of concept in 2013, where we tested it on a very small scale. Now we’re looking to expand that to the pilot stage so we can understand where we can create efficiencies in the process, and make sure we can refine it so we can consider it on a larger scale.