Refills

All right here's another interesting project I had the opportunity of working on -- and, yes, that's sarcasm. Recently Johns Hopkins opened a new outpatient pharmacy in the Howard County Medical Pavillion. Though this pharmacy carries the Johns Hopkins name and logo it sits in a building in a very secluded location that is not associated with the hospital . When they say location is everything, believe it. This pharmacy gets very little business and has operated at a loss since opening about a year ago. All of the outpatient pharmacy managers have made the success of this new pharmacy one of their top priorities within the last year. We literally have meetings every week concerning marketing and advertising. Okay that's the background on the Howard County pharmacy.

In the pursuit of answers as to where all the business for Howard County is going, Nathan (the Director of Pharmacy/my preceptor) asked me to figure out the refill retention rate for Howard County in the month of May. First I had to define refill retention rate as a prescription with valid refills remaining, to be filled in the month of May. Seems easy, right? Just find out how many possible refills could be filled in the month of May and compare it to exactly how many refills were filled in the month of May. Considering the computer system used here in the outpatient pharmacy is literally based on MS DOS the process took way too long. At first I was told I would have to manually examine, one by one, each of the scripts written in the last three months (to account for 90 day supplies), and then track their refills to see if they were filled in May. That's over 2,000 scripts! Instead of doing that I decided to be smart about the process and pass it off to somebody else ... just kidding. I did, however, use one of the IT guys here to transfer the scripts from the operating system to Excel. With this information, I was able to to produce a refill retention rate in only a few hours. We now have this rate and it's not the answer we were looking for, as this pharmacy has a very high refill retention rate (81%) when compared to the national average (47%).

Not to be defeated, I looked through the data again to determine the trend in the refills and to gather new information. We found that one of the highest rates of non-compliance came from the OB/GYN patients. This information was passed to our safety division which launched a campaign to partner our pharmacy with the OB/GYN clinic in the Medical Pavillion to promote compliance among their patients. Patients now have the option to be enrolled in automatic refills not only for their OB/GYN meds but any other meds they happen to be taking, with the option of free delivery. The pharmacy benefits with more business, the patients benefit with greater care, it's a win-win situation. The really great thing about this situation is when you see not only what corrective actions went into effect, but also the outcome of these actions. We are able to assert the role of pharmacist into pre-natal care by building a partnership with OB/GYN physicians and clinics. This partnership has the potential to drastically increase patient outcomes, not to mention increase business for the pharmacy. You have to love when a plan works out...