By Nkechi Okwu-Lawrence and Elizabeth Woodcock

With medications being such an integral part of population health management, handling prescription refills in an effective manner is vital to success. As access teams become more engaged in efforts to improve refill management, it’s important to identify best practices. The Patient Access Collaborative invited three members to present their approaches to refill management, all of which are proving to be a value-add to their organization.

Laddy Rua, Contact Center Manager, Prescription Line, and Kirsten Peck, Contact Center Supervisor, Prescription Line, from Baystate Health discussed the efforts to improve refill management by focusing on their employees. Medical assistants work in the Patient Access Center, answering inbound calls from pharmacies and patients. They use work pools that are strategically managed to level the workload among the team. Per diems are staffed during non-business hours to further maximize efficiencies. Onboarding protocols for new team members include shadowing, side-by-side mentoring, and weekly one-on-one’s.

USF Tampa General Physicians initiated its call center decades ago; while scheduling is the primary function, there is an inbound patient clinical concern team. The team, as described by Christine Kilfoyl, RN, BSN, and Desiree Thomas, LPN, consists of nurses, medical assistants, and a recently hired pharmacist. Approximately 60% of the daily inbound calls to the clinical concern team are for prescription refills, with the team fully handling 80% of these calls. Kilfoyl notes that department relationships are “very, very important” for their team, in order to share knowledge and maintain currency. “Carve outs will kill you,” is a mantra for the team, which aims to standardize workflows and adhere to institutional policies to successfully manage refills in a centralized manner.

Ami Shumway, Operations Director, Loma Linda University (LLU) Health, details the team’s focus on first call resolution. This goal was a key driver of hiring pharmacy technicians, aiming to improve patient satisfaction and reduce the excess administrative burden being placed on the clinical teams where possible. Shumway and other access leaders engaged the LLU School of Pharmacy, which has aided in the recruitment of the technicians, as well as pharmacists and pharmacy students. A mere six months into the project, Shumway highlights that first-call resolution has increased by a notable 64% for prescription-related calls.

For PAC members, head to Webinars to listen to the panel of experts who presented on August 16, 2022 under the title, “Centralized Refill Management.”

Patient Access Collaborative members wrestle with access opportunities in all specialties, but Neurology has long been a particular challenge. We invited two members to present on their initiatives to improve access to neurological care through novel approaches. The University of Florida College of Medicine used existing faculty to form a new-patient access clinic, while Penn State deployed clinics that featured walk-in appointments followed by a more successful integrated care team approach.

Taking advantage of the complexity of the inpatient environment, the Department leadership at the University of Florida College of Medicine offered faculty the choice of working in a newly created outpatient clinic in exchange for hospital call. Physicians who opted in could fulfill their responsibilities via an access clinic week(s); residents were also staffed to the clinic. The clinic -- which shares space with the main existing outpatient clinic for the Department - operates five days per week, 10 hours per day. Forty new patients are scheduled per week; if patients require longitudinal care, they are subsequently scheduled for the subspecialty clinic. According to Vice Chair of Operations, Dr. Katharina Busl and Executive Director AJ Yarbrough, the access clinic has not only improved the lag time for new patients (142 days, on average, to 18 post-intervention), but also reduced ED readmissions. Relying on higher-value new patient visits, furthermore, the clinic is profitable. Read more about their work at Neurology Access Clinic: A Model to Improve Access to Neurologic Care in an Academic Medical Center - PubMed (nih.gov)