Jennifer Agee Manager Pharmacy System Legacy Health
Statement of Conflicts of Interest I have no actual or potential conflict of interest in relation to this presentation. 2
Today s Agenda Infrastructure and process to facilitate 11 digit NDC level replenishment Best practice wholesaler acquisition cost (WAC) strategies 3
CE Question It is possible and manageable to replenish at the 11 digit NDC level using an electronic medical record (EMR) with barcode functionality. A) True B) False 4
A Long History Well, it s inventory time again. You do the rocks and I ll do the sticks. 5
Then Came The 340b Program which requires a more detailed approach to inventory management 6
Demographics 3 DSH hospitals & central distribution center 7
EMR Electronic medical record supports barcode scanning at medication administration Barcode scanning facilitates: Patient safety Compliant NDC capture for billing Accurate 340b NDC replenishment 8
Team Dynamics IS analyst PharmD CphT analyst Financial analyst Continuity PharmD CphT analyst Build and maintain drug compendium Process NDC changes from distribution center Report and monitor medication charges Administer the 340b Program CPA 9
Collaborative Partner 10
Virtual Inventory Model Cybernetic approach (computer generated inventory) The amount of a particular drug replaced at 340b prices reconciles with the amount of that drug dispensed to 340b qualified patients 11
Retrospective Purchasing Look back Orders created from a split billing system are replenished retrospectively based on eligible accumulations 12
11 Digit NDC Replenishment The NDC is the charge code (one to one relationship) Inner NDCs Repackaged NDCs NDC purchases maintained in EMR contemporaneously Billing units per package are cross walked to source system build (EMR) 13
Crosswalk Mechanics Own NDC crosswalk maintenance Maintain daily to minimize WAC purchases Automate maintenance process by electronically comparing new NDC purchases or administered between split billing vendor and source build (EMR) 14
Legacy s IT Solution Download split billing vendor reports Import into unmatched review program (Access) Add NDC information from EMR compendium (SQL) HCPC HCPC unit of measure HCPC quantity Description Billing increments Add information from SQL data warehouse or source system Last purchased Last dispensed 15
Legacy s IT Solution Continued Add information from wholesaler catalog Purchase package size Purchase package units Purchase package quantity Review and input billing units per package (BUPP) conversion from EMR to wholesaler Develop export in required split billing vendor format (e.g.,.txt) Upload export to split billing vendor tool 16
WAC Out Of Control? 17
WAC Challenges Purchasing off contract Drug shortages Stock ups Alternate NDC use Initial NDC purchase Non provider based outpatient clinic purchases NDC scanning errors or inconsistent use Non barcode scan areas 18
WAC y Strategies Perform daily crosswalk maintenance Standardize procurement Monitor for non split orders on default WAC accounts Review WAC activity monthly to identify trends Utilize Apexus sub WAC contract Assess viability of provider based status for clinics Advocate for consistent barcode scanning in all areas Maintain NDC purchases in EMR contemporaneously 19
Back To The Cavemen It is important to make the time to set up your infrastructure! 20
CE Question It is possible and manageable to replenish at the 11 digit NDC level using an EMR with barcode functionality. A) True B) False 21
CE Question & Answer It is possible and manageable to replenish at the 11 digit NDC level using an EMR with barcode functionality. A) True B) False 22
Additional Questions? Jennifer Agee Manager, Pharmacy Systems Legacy Health 1015 NW 22 nd Avenue Portland, OR 97210 Phone: 503 413 7769 jagee@lhs.org 23