The HHS Office of the National Coordinator recently released the brief “Medication Adherence and Health IT” authored by Aja B. Williams J.D., M.P.A, Policy Analyst in the ONC Office of Policy and Planning. The brief emphasizes how innovations in health IT can be used to increase adherence rates to improve overall population health.
The brief points out that the methods used to measure medication adherence can be categorized as either direct or indirect. Direct methods include taking medications in the presence of a healthcare provider, by measuring the level or medicine or metabolite in blood, or measuring biological markers in blood once a prescription is taken.
However indirect methods can include self-reporting on medication taken, using patient diaries, obtaining pharmacy refill data, using electronic medication monitors, and other telemedicine devices, but may not be as reliable and accurate as using direct measures, but indirect methods can be more practical to use for routine clinical use.
In general the brief points out that the use of technology is leading the way to better medication adherence. The use of innovative health IT has accelerated the use of Electronic Drug Monitoring (EDM) systems to measure adherence. EDMs use monitoring devices such as Medication Event Monitoring Systems (MEMS) which can be a pill bottle cap embedded with a microprocessor that records the time and date of each bottle opening.
Other advances include using technology to track pharmacy refill data and then sending the automated alerts to the prescriber when the medication has not been filled. Two of the most common sources of pill information now comes from pharmacy claims data and medication history transactions that are available through the Surescripts e-prescribing network.
Health IT can also be used to improve adherence by using data captured in an EHR that can use predictive modeling to identify patients who are least likely to adhere to medication regimens and intervene to prevent non-adherence. It is thought that the greatest opportunities for health IT to improve medication adherences are in the areas of consumer engagement and predictive analytics.
Go to www.healthit.gov/sites/default/files/medicationadherence_and_hit_issue_brief.pdf to view the full brief.