As a rule, the more medications an individual patient takes, the greater the risk of suffering a negative side effect. The more intricate the medical scenario, the higher the risk of experiencing an Adverse Drug Event, a drug-related injury. Thus, there is a delicate balance between the clinical benefit of the medications, and the risk to harm as an aggregate, necessitating continuous evaluation of each medication, making sure harm does not outweigh the benefit.
Yet, the hunger for medications in the U.S. is growing with no end in sight. In a Consumer Reports study conducted in 2017, while the US population had only increased by 21 percent over the past two decades, there is a shocking 85 percent increase in the number of filled prescriptions, with more than half of the US population on a prescription medication. A typical American is prescribed up to four medications on average, not including over-the-counter drugs, creating complex medication scenarios and increasing the likelihood of an ADEs.
Currently, ADEs cause more than 100,000 deaths per year and impact more than seven million patients nationwide. ADEs can happen at any time, and any place: in hospitals, long-term care settings, ambulatory settings and at home. As outlined, ADEs are more likely to occur to patients with complex medical conditions who take multiple medications; ADEs mainly affect the fragile, the sick and the elderly.
These High Resource Patients are among the costliest to the healthcare system. According to a 2016 study by JMCP, five percent of the U.S. population accounts for 50 percent of all healthcare expenditures. 780,000 people were classified as HRP with multiple co-morbidities observed in 41.2 percent of the 15 million that met the study selection criteria. This means that the overall expenditure of the HRP population is an astounding 10 times greater than the rest of the population.
This is because HRPs have little reserves and any small change in their clinical status may induce deterioration and hospital admission. And with so many medications prescribed to treat multiple illnesses of highly fragile patients, adverse drug events are bound to happen and inflict an even higher clinical and financial burden. As such, continuous monitoring and assessment of risk is critical in keeping HRP patients at home and out of the hospital.
Regrettably, people that fall into the HRP category are usually treated by multiple physicians/specialists for their different issues. These doctors are usually exposed only to a partial view of the patients record, including medications being used. This issue is worsened by the fact that there is no uniform interoperable system to keep doctors aligned and in full view of a patient’s history and treatments, which could have facilitated better care, by preventing polypharmacy and further reducing adverse drug events.
There are a multitude of challenges to address in order to lower the occurrence of ADEs. Utilizing an AI-driven system that continuously monitors patient records, actively looking for hints and clues of emerging ADEs, contraindications and polypharmacy, can generate actionable clinical insights to providers, across the healthcare system to minimize the occurrence of ADEs significantly.
Patients and Caregivers Must Be Part of the Equation
As most ADEs happen at home, and the patient is usually the first one to experience that something is wrong, engaging with patients and caregivers is key to reducing harm. Using mobile technology to incorporate personal sensor data and patient reported symptoms may facilitate early identification of emerging ADEs and prompting early medical intervention. This would increase patient engagement and encourage them to proactively address evolving health circumstances and empower patients to become better advocates for themselves facing their physician.
Telehealth Solutions Taking Hold
Telehealth solutions are gaining more and more traction as replacements to physical visits to the physician’s office. It’s easy, fast and accessible, providing best practice for remote locations. The advantages are huge, but it comes with a caveat: there is no continuum of care. Once the telehealth session is over, the patient is left with an e-prescription and usually not monitored for medication related risks post-encounter. Implementation of AI technologies that can suggest a follow up telehealth session when a potential adverse event is identified, provides the extra layer of post-encounter protection.
Using advanced AI/Machine Learning technologies to provide alerts and interventions to providers, payers and most importantly, patients, we can better identify emerging ADEs before real damage is done, protecting patients and providers alike.
Date: June 04, 2019