PHARMACY DATA INSIGHTS
RBI Pharmacy Insights, powered by the Johns Hopkins ACG System Rx-MGs provides a medication-based approach for describing the morbidity profile of an individual or population. Rx-MGs also form the basis of Pharmacy Insights predictive models.
Used in combination with the patient's Clinical markers, Pharmacy Insights' ACG Pharmacy markers produce a unique, more powerful and more accurate picture of the patient's overall profile.
USING PHARMACY DATA
For a handful of carefully selected chronic conditions where administration of medications is warranted, and where specific medications that should be taken continuously can be identified, RBI Pharmacy Insights provides indicators if a patient is receiving treatment and calculates potential gaps in availability of needed medications.
Those gaps can then be closed using the modality that's determined to best suited for that particular need.
CATEGORIZING PHARMACY CODES
RBI Pharmacy Insights classifies all pharmacy codes into pharmacy-based morbidity groups (ACG® Rx-MGs) using the following clinical criteria:
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Morbidity-type: symptom vs. disease
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Duration of morbidity: chronic vs. time-limited
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Stability of morbidity: stable vs. unstable
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Route of administration: oral, inhaled, topical, intramuscular, intravenous
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Therapeutic goal: curative, palliative, preventive
All pharmacy codes (NDC, ATC or other national codes) can be classified according to these clinical criteria. An active ingredient count is also made available.
COMBINING PHARMACY AND MEDICAL DATA
Get a better understanding of patient need and identify:
Patients taking drugs for conditions not in their medical claims history
Patients with both medical diagnoses and pharmacy indicators
Patients with medical diagnoses and no pharmacy indicators
Unusual pharmacy expenses
IDENTIFY GAPS IN NEEDED MEDICATION
For a handful of carefully selected chronic conditions where administration of medications is warranted, and where specific medications that should be taken continuously can be identified, Pharmacy Insights provides indicators if a patient is receiving treatment and calculates potential gaps in availability of needed medications.
Those gaps can then be closed using the modality that's determined to best suited for that particular need.
MEDICATION ADHERENCE
Patient adherence with therapy represents a major impediment to assessing clinical performance and contributes substantively to patient care costs and outcomes. The Pharmacy Insights RxGaps methodology, developed by Johns Hopkins was developed to capture patients with adherence issues and thereby improve their care management.
Pharmacy Insights employs innovative methods that increase the ability to detect genuine adherence problems by:
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Careful selection of conditions where chronic administration of medications is warranted,
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The careful identification of specific medications that should be taken continuously,
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Capturing prescribing patterns that introduce potential noise, and
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By identifying medications that may be validly substituted without introducing gaps in adherence.
Contact us to explore how you can significantly impact upon Medication Adherence, drive improvement in Quality and Risk Score accuracy and Clinical outcomes.
