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High Quality and Low Cost: Leveraging Drug Utilization and Clinical Benchmarking Data to Get Results

Brian O’Neal, Pharm.D., M.S., Carrie Cannella, Pharm.D., BCPS, Samaneh Wilkinson, Pharm.D., M.S., Casey Williams, Pharm.D., BCOP, Rick Couldry, M.S., R.Ph., Leigh Anne Scott, Pharm.D., M.B.A.

 

The University of Kansas Hospital, Kansas City, Kansas

Methods of achieving cost control at academic medical center pharmacies are wide-ranging with some of the most prevalent being inventory management, waste reduction initiatives, contracting, and formulary management. We set out to determine whether we could further impact drug prescribing by reporting service-specific drug utilization data and comparing our drug utilization practices to top-performing peers. The objective of the program was to use drug utilization and external benchmarking reports to align our drug utilization practices with those organizations who were achieving excellent outcomes in mortality and/or length of stay. We aimed to achieve cost savings as a result of this alignment while improving or maintaining our outcomes measures.

Our institution has access to the University Health-System Consortium’s (UHC) clinical resource manager (CRM), a data warehouse and external benchmarking tool that allows for comparison of resource utilization across participating institutions. The database has a wide variety of potential applications ranging from high-level outcomes comparisons to use of high-cost drugs. Users have the ability to query their own institution’s data for comparison to another institution, a selected grouping of institutions, or all participating institutions. We used a structured approach utilizing UHC CRM to identify Medicare-Severity Diagnosis-Related Groups where we had the greatest utilization-related financial opportunity relative to all other database participants. The end result of this effort was the identification of nine clinical target reporting areas totaling $1,217,292 in annualized potential savings. Once a reporting area has been identified and a top-performing peer group selected, we run a multitude of CRM queries to populate a drug utilization report template. The template is divided into three major sections: global measures, drug variances, and utilization trending.  Reports for each target area are distributed semiannually to attending physicians for the area and to medical staff leadership and pharmacy clinicians.

We developed a model with which we were able to identify the clinical areas with the greatest consumption of high-cost medications and pinpoint institutions with the best outcomes in these areas. We systematically identified variances in our drug utilization behaviors, as compared to these top performers, and then mimicked their behaviors in order to achieve better financial and clinical outcomes. Furthermore, distribution of the drug utilization reports has opened the door for greater pharmacy-physician partnering as we collaborate on guideline development and other interventions to troubleshoot and improve on the identified variances in drug utilization.

Reporting of drug utilization and external benchmarking data has been a valuable tool to assist in drug utilization efforts to align our practices with institutions that are achieving the best outcomes. Financial results have been documented with over $900,000 in annualized savings. Clinical outcomes have demonstrated a 12.2% weighted reduction in length of stay in our targeted reporting areas while maintaining or improving our mortality-related outcomes.

View a pdf of the poster from the Midyear Meeting (715 KB).