TABLE 2.
Medication Practices Inventory Scores by Domain and Percentage of ACOs that Scored 7 or Higher by Domain
| Domains | N | Mean Score (SD) | Percentage Scoring 7 or Higher (SD) | Components | MPI Component Numbers |
|---|---|---|---|---|---|
| Analytics and evaluation | 49 | 4.9 (1.9) | 12.0 (33.0) | Determine if Rx costs are offset by reductions in other services | 3 |
| Capture patient-reported outcomes in an accessible system | 6 | ||||
| Give providers performance data related to medications | 14 | ||||
| Identify medication-related target interventions | 25 | ||||
| Care teams and clinical protocols | 40 | 5.3 (2.2) | 22.5 (42.3) | Adhere to standard level of severity definitions for risk stratification | 10 |
| Implement pharmacist/nurse review of patient drug regimen | 13 | ||||
| Use provider incentives for adhering to care pathways | 15 | ||||
| Involve pharmacists directly in patient care | 23 | ||||
| Adhere to care pathways for targeted populations and conditions | 27 | ||||
| Discharge planning and transitional care | 42 | 6.4 (1.5) | 33.3 (47.7) | Dispense medications to patients before discharge and proactively follow up | 11, 17 |
| Discharge instructions to ambulatory physician | 21 | ||||
| Standardize transitional care protocols | 24 | ||||
| Reconcile medication lists and include in visit summaries prior to discharge | 32, 36 | ||||
| Health information technology | 41 | 5.7 (1.5) | 19.5 (40.1) | Notify pharmacies when Rx’s are canceled | 1 |
| Notify care providers when Rx’s are discontinued, changed, filled/dispensed, prescribed by another provider | 2, 4, 5, 9 | ||||
| Synchronize formularies across sites of care | 8 | ||||
| Transmit Rx’s electronically (controlled/noncontrolled substances) | 16, 38 | ||||
| Access regional health information exchange with Rx data | 18 | ||||
| Identify and notify all care providers of potential adverse interactions, known drug allergies | 20, 30, 37 | ||||
| Provide physician and pharmacists access to pharmacy and medical patient data, including alerts to gaps in preventive care | 26, 28, 33 | ||||
| Access electronic registry for specific disease states | 31 | ||||
| Use population dashboards or reports of quality metrics | 35 | ||||
| Patient education | 48 | 5.9 (2.1) | 31.3 (46.8) | Educate patients on diagnostic and therapeutic alternatives | 7 |
| Provide pharmacist counsel on prescribed medications | 22 | ||||
| Instruct patient on medication use prior to discharge | 29 | ||||
| Prescribing practices | 48 | 6.1 (2.3) | 34.7 (48.1) | Negotiate financial support for expensive drugs | 12 |
| Expedite prior authorizations for selected medications | 19 | ||||
| Encourage generic drug use when appropriate | 34 |
MPI = medication practices inventory; Rx = prescription; SD = standard deviation.