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ePrescribing in Hospice Care: A Safer Way to Provide Patient Care

Aging Care Coordination Care Delivery care transition Controlled Substances DoseSpot e-Prescribing e-Prescribing Benefits Healthcare home health housecalls Pain Management Pain Medications
October 5, 2023

Hospice care made its way into the U.S. in the early 1970s as a new way to provide comfort and support to people nearing the end of their lives. It is not focused on cures but on relieving pain and other symptoms of chronic illness, old age, and deteriorating health, and it is more than just patient care. Hospice workers are also trained to help families better understand and cope with the end-of-life process.

This concept has existed for centuries, but the modern hospice movement began in the United Kingdom in the 1950s when Dame Cicely Saunders, a British physician, founded St. Christopher’s Hospice in London in 1967, considered the first modern hospice.

Saunders believed that dying people deserve to be treated with dignity and compassion and should not suffer. She also believed that hospice care should be provided in a home-like setting, where patients could be surrounded by their loved ones.

Hospice Care Today

According to the National Hospice and Palliative Care Organization (NHPCO), there were 5,058 hospice agencies in the United States in 2020. This number has increased steadily in recent years as more people become aware of hospice care’s benefits.

Hospice care is delivered in various settings, including the patient’s home, a hospice facility, a nursing home or a residential care facility, or a hospital. Many insurance plans cover it, and often, there are no out-of-pocket costs for patients who meet the eligibility requirements.

One of the most crucial aspects of care is medication management and the ability to prescribe controlled substances. Hospice patients often take a variety of medications to manage their pain and other symptoms, and it is essential that these medications are managed correctly.

Tips for medication management in hospice:

“Medication management is a core competency for hospice care, and there are special considerations when you’re dealing with disease progression and changes in how patients’ systems metabolize certain drugs. Part of our role as a hospice-focused pharmacy benefit manager is helping our clients maximize comfort and safety. I always recommend leveraging technology to provide maximum visibility of patient medications for the hospice interdisciplinary team.”

Enclara Pharmacia, VP of Clinical Management – Ryan Krout, PharmD

Preventing medication errors for hospice patients

Typically, medication errors in hospice care are 0.1-1.0%. This is lower than the overall incidence of medication errors in healthcare settings, estimated at 2-10%. But, if your loved one is in hospice care, any error is too many.

The importance of getting the medication right for hospice patients cannot be overstated. Errors can have serious consequences, including pain, discomfort, and even premature death.

The most common of these can all be solved with ePrescribing:

Error TypeHow ePrescribing Helps
Dosage errors: When the wrong dose of a medication is prescribedLook for ePrescribing tools with a dosage calculator available within the application or easily accessible
Administration errors: When a medication is given incorrectly, such as at the wrong time or by the wrong routeePrescribing includes specific fields for prescriber notes where clear directions can be entered for the patient and then translated through the pharmacy with a medication consultation
Transcribing errors: When the medication order is incorrectly transcribedThe handwriting mystery is solved with the electronic transmission of a script directly to the pharmacy
Dispensing errors: When a medication is dispensed incorrectly, such as the wrong medication or the wrong strengthAlthough this type of error often happens at the pharmacy, ePrescribing leaves less room for miscommunication or misspellings of drug names, which can lead to dispensing errors

“Hospice care is 24/7, and when you’re dealing with emergent needs it’s a race against the clock,” Krout said. “Hospices need to have systems and safeguards in place to ensure they’re getting the right medication to the right patient in the timeliest manner possible.”

You must implement a culture of safety in all patient interactions. Here are some additional things that your care teams can do to help get medication right for hospice patients:

Hospice pharmacies play a vital role in medication management and safe prescribing practices

Hospice pharmacies specialize in providing medications to patients who are receiving hospice care. They work directly with providers to ensure patients can access the medications they need to manage their symptoms and stay comfortable.

As experts in this form of healthcare, they do more than just dispense and deliver medications. Here are some additional benefits of a hospice pharmacy to the total healthcare landscape:

According to a study published in the Journal of Pain and Symptom Management, hospice pharmacies dispense an average of 1.5 times more controlled substances than regular pharmacies due to the amount of pain medications prescribed. They also dispense a higher proportion of highly addictive and tightly controlled Schedule II substances than regular pharmacies. Most states now require a trackable ePrescribing platform for these prescriptions.

The clinical staff at these pharmacies also have a responsibility to help prevent medication errors, prescribe responsibly, and prevent the diversion of controlled substances.  

At DoseSpot, we will continue working to provide the very best end-to-end ePrescribing platform that helps to prevent medication errors and ensure patients receive high-quality care. Request a demo if you want to see our ePrescribing software in action!