e-Health Conference 2013
Medication Management Support Services
(MMSS) at Central CCAC
May 27, 2013
Mary Burello-Cordovado
Senior Manager, Central CCAC
Outstanding care – every person, every day
Central CCAC
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Central CCAC
Meeting the challenge of increasing
complexity of care needs
• Growing demand for Central CCAC services
• Increasing complexity of care needs - 16% of the
total high needs patients provincially
• Almost 60% of our patients are transitioning directly
from hospital (about 35,000 in 2012-2013)
• Medication issues remain one of the biggest
challenges and opportunities in community care
Central CCAC
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Medication Management Support
Services (MMSS)
• Developed by Central CCAC in partnership with
hospital and community partners
• Central CCAC qualified in December 2011 under the
Medication Reconciliation Category
• Medication Reconciliation - helps providers work with
patients, families and other clinicians to ensure
accurate and comprehensive medication information
is communicated consistently across transitions of
care
Central CCAC
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Improving patient safety in
transitions in care through MMSS
• Reduces falls and improves pain management
• Engages patients in their care and is an effective way
• Results in safer transitions between care settings
• Builds capacity in the community to deliver a wide
range of home care services
• Improves quality of care for people with complex
needs, supporting them to live safely and
independently
• Enables information sharing - CHRIS to MMSS
Central CCAC
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The MMSS Process
Central CCAC
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Creating new technology
• Central CCAC’s secure web-based solution for MMSS
• Process improvement – exchange secure information
• Reduction in workload for CCAC staff and
Pharmacists/Rapid Response Nurses/Contracted Vendors
• Better accessibility and transparency of MMSS
information
• Broader range of information available to Central CCAC
• Improved data quality
Central CCAC
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MMSS Technical Infrastructure
MMSS – Medication Management Support Services
CHRIS – Client Health and Related Information System
DMZ – Demilitarized Zone
SSL – Secure Socket Layer
Central CCAC
Central CCAC – Central Community Care Access Centre
OACCAC – Ontario Association of Community Care Access Centres
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Medication Inventory and Schedule
Central CCAC
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Benefits: Process and Data
• Fewer handoffs = decreased risk of errors
• Complete and submit documents online – no faxing,
no printing saves time and resources
• Filed document sends automated message to care
coordinators to follow-up
• Better access to critical information
• Transparency and compliance of process and policies
• Improved data quality and reporting
• IMPROVED patient OUTCOMES!
Central CCAC
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Indicators
MMSS Indicator List 2012/13
Target
Q1
Q2
Q3
Q4
TOTAL
Provide MMSS to Eligible patients at risk discharged from hospital
or in the community (referrals made)
1760
544
425
412
432
1813
Unique patients served
1760
528
384
392
375
1679
% Discrepancies resolved
70%
79%
90%
90%
93
88%
% Medication related problems resolved
70%
89%
88%
87%
88%
88%
Total # of visits completed by Pharmacist
3067
885
745
698
710
3038
850
416
219
211
235
1081
Delay from time of referral to time of service
14 days
11 days
8 days
7 days
7 days
8 days
Delay from time of referral to time of service community
14 days
14 days
10 days
8 days
8 days
10 days
7 days
7 days
6.5 days
5 days
5 days
6 days
% of patients who reported a decrease in ED VISITS post
medication management
15%
82%
49%
50%
55%
67%
% of patients who reported a decrease in pain level post
medication management
30%
72%
89%
69%
29%
55%
% of patients who do have a reduction in falls
30%
45%
48%
53%
52%
62%
Reduction in medication post MMSS
Delay from time of referral to time of service hospital
Central CCAC
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Building on the success of MMSS
• Implemented to support patients returning home from
hospital who were at risk for falls, ED visits and
hospital readmits due to medication adverse events
• MMSS pharmacists (2009–2013)
• Spread to other high need patients with medication
management needs through MMSS database
• Rapid Response Nurses (2013)
• Palliative Nurse Practitioners (2013)
• Contracted Vendors (2013)
Central CCAC
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Discussion and Questions
View our MMSS video on www.youtube.com
Mary.burello@central.ccac-ont.ca
Central CCAC