News: OIG okays pilot program to share patient data with pharmacists

The OIG greenlit a pilot program to share patient discharge data with pharmacists in an effort to improve care planning and decrease readmissions, Modern Healthcare reported. The permission was granted in an advisory opinion issued on Monday, December 11, by the agency.

Under the proposed pilot program, the drug maker would team up with a trade association, a Medicare Advantage plan, and a hospital system. Pharmacists employed by the Medicare Advantage plan would then receive real-time electronic access to certain discharge information for that plan’s beneficiaries, according to Modern Healthcare.

The pharmacists involved in the experiment provide medication therapy management services, meaning that the plan addresses drug and non-drug therapy, as well as lifestyle modifications associated with a given disease.

According to the OIG opinion, the pilot program would focus on patients discharged with one of the five diagnoses monitored under the Hospital Readmission Reduction Program: pneumonia, congestive heart failure, acute myocardial infarction, chronic obstructive pulmonary disease, and elective total hip or knee arthroplasty.

To accomplish this, the drug maker will develop an interface that takes clinical data directly from the hospital system’s electronic medical record, according to Modern Healthcare. The OIG said it has decided to approve the program despite a small chance of violating kickback laws.

Of course, for CDI professionals, this new pilot program poses another concern besides the kickback laws. Discharge summaries are often sparse, to say the least, so providing only that discharge information to pharmacists could pose a risk to patient care because of poor discharge documentation.

The OIG’s opinion does not explicitly list the information to be provided to the pharmacists, but CDI professionals should be aware of the potential implications of poor documentation.

Editor’s note: To read Modern Healthcare’s coverage of this issue, click here. To read the OIG’s opinion, click here.