Interview with Norma Jean Betts, South Hill Family MedicineIn a recent press release, we announced that Cureatr had extended its offer to provide our medication management software, Meds 360°, for free to all healthcare providers on the front lines of the COVID-19 pandemic. In this interview, we spoke with Norma Jean Betts, a licensed practical nurse (LPN) at South Hill Family Medicine (SHFM) in South Hill, Virginia. SHFM is a medical practice and urgent care facility specializing in family medicine, radiologic exams, bone density testing, electrocardiographs, and spirometry. Norma Jean and her colleagues are one of the dozens of provider organizations taking advantage of Cureatr’s COVID-19 response program.
Norma Jean discusses how Cureatr’s Meds 360° has impacted the way SHFM delivers care during the pandemic.
Q: Can you tell me a little bit about yourself, your role as an LPN, and your daily routine at SHFM?Norma Jean Betts: I have spent my entire seven-year career as an LPN with SHFM. I switched careers from retail to nursing, and it was the most wonderful change I could have ever made.
My role is a little different than the other LPNs here at SHFM because I double as our information technology (IT) manager. But my main clinical responsibilities include providing routine patient care, assisting the doctors and providers that use our facility, serving as a liaison between patients, their care team, and their insurance provider(s), supporting patients with home-based care and preventative lifestyle changes, and helping patients manage their medications.
I have a typical routine that may vary slightly depending on the day and the patients we have scheduled. I start each day by reviewing the schedule and confirming which patients are booked for in-office and virtual visits. I interview each patient, asking them about current problems, medications, and allergies, and review and update their records accordingly. I assist nurses and our doctors with patient care in any way that I can. I help document the patient’s treatment plan and answer any question or concerns they may have about it. Finally, I help coordinate patient referrals.
Q: How has COVID-19 changed your routine and how you provide care to patients?NJB: The biggest change is the decreased frequency of in-office visits and the increase in virtual interactions. We have been trying to keep our high-risk patients out of the office by encouraging virtual appointments. I normally ask patients to bring all of their medications with them for in-office visits, but since this health crisis began, most patients who visit the office now leave their medications at home for fear of contamination, which makes medication reconciliation more challenging. Because of the increase in virtual visits, we have had a little trouble keeping up with the schedule as some patients, especially some of our elderly patients, have difficulty getting on to the video calls.
Q: How has Meds 360° helped you overcome these barriers to care?NJB: Meds 360° has definitely helped us with both challenges. Whether the medication review is virtual or in person, I can look up the patient’s medication history in Meds 360° and use it as a starting point when reviewing medications with the patients rather than relying on their memory or their pill bottles. For virtual visits, it has helped us keep up with the schedule because it greatly reduces the time it takes to perform a proper medication reconciliation which makes up the time spent on technical difficulties.
Q: What prompted you to reach out to Cureatr?NJB: As SHFM’s IT manager, I am responsible for researching IT solutions to help solve the facility's problems. I wasn’t looking for a medication management solution specifically but rather researching what resources were available for nurses and doctors to help assist with the pandemic. I found Cureatr listed on a COVID-19 resources directory. After looking into the company further, realized how big of an impact Meds 360° could have in dealing with increased volume due to the pandemic and alleviating our existing medication management problems. The reliability of our current electronic medical record's (EMR's) medication history data had been an issue, and I recognized the potential for Meds 360° to solve that problem.
Q: Since using Meds 360°, what are some of the improvements you have seen in your medication management efforts?NJB: The biggest improvement is the accuracy of our medication history data. As I mentioned, we can’t always trust the medication data coming from our EMR. It sometimes doesn’t pull in all of the patient’s medication history, which makes reconciling the medication list with the patient challenging.
Meds 360° has also improved the quality and efficiency of patient calls. For example, so many patients don't know their medications by name. They will tell me things like, “I don’t know, it is a little round pink pill.” Before using Meds 360°, I would need to help the patient remember the name or call the dispensing pharmacy. With Meds 360° I can click into the medication on the patient’s record and show them an image of the pill, which has been a huge timesaver.
Q: What specific processes has Meds 360° improved for SHFM?NJB: The three processes most affected by Meds 360° are virtual medication reviews, post-discharge medication reconciliation, and confirming patient medication compliance. Because of the reliability issues of our EMR's medication data, I had to rely on what the patient said versus what the discharge information said, which didn't always match up. Sometimes patients forget, they don’t know their prescription specifics, or they are on really complex medication regimens. It would take me 10 to 15 minutes to complete a full discharge medication reconciliation and I still couldn’t be 100 percent sure the medication reconciliation was accurate. With Meds 360°, I can complete this process in 5 to 7 minutes tops and rest assured knowing the information is correct.
We’ve also been using Meds 360° to support remote, post-discharge medication reconciliation. Oftentimes, patients are unsure of what they were prescribed. Other times, we don’t have access to the discharging hospital's EMR. Meds 360° gives us a more informed starting point when conducting post-discharge phone calls.
Meds 360° has also saved me lot of time confirming patient medication adherence. Our practice receives nonadherence alerts from our pharmacies when patients don't fill or may not be taking their medication. With Meds 360°, I can quickly pull up a patient's medication history and verify if they have or haven’t filled the prescription without needing to call the patient to confirm that it was filled.
Q: What are some of your favorite things about Meds 360°?NJB: My favorite thing about Meds 360° is its reliability. I can be sure that if I search for a patient in Meds 360°, I am going to get a complete and accurate medication history for them, even for medications from different prescribers.
Another thing I love is the timeline view. This makes it very easy to see if a patient had a gap in therapy or if they failed to pick up a medication so I can call the patient and see what the issue is.
I mentioned this earlier, but I also love that the program includes pill images for every medication because it greatly helps patient recall.
Q: Can you share a specific time Meds 360° helped improve care for one of your patients?NJB: I have a lot of stories I could share, so I'll share a more recent one. A patient of ours recently hired a caregiver who was not familiar with her medication regimen. Due to a formulary issue, we had to change one of the patient’s medications, but a provider at a different facility had also changed the prescription. This patient ended with a therapeutic duplication.
Thanks to the alerting capabilities in Meds 360°, I was immediately aware of the duplication as I was able to easily see that she filled both prescriptions. I quickly called her caregiver, informed them to have the patient stop taking one of the prescriptions, and prevented a potential drug-related health problem, or worse, a preventable drug related readmission.