May 2014
"Cover My Meds"
Implementation Team
,
RNs
Family Medicine, Holmen Clinic
Mayo Clinic Health System - Franciscan Healthcare
La Crosse
,
WI
United States
In 2011 Emily Stanton and Nicole Anibas submitted a Pay for Performance goal to create a process to manage prior authorizations efficiently at the Holmen Clinic. They investigated the company Cover My Meds. Cover My Meds is a free online service assisting with the completion of prior authorizations. They provide instant chat support, create efficiency, and save time.
Representatives from Cover My Meds trained Emily, Nichole, Kathy Herbrand and Carol Jacobson to pilot the program at the Holmen Clinic. Holmen staff accepted Cover My Meds and implemented the use.
Following Holmen implementation Emily chose to spread information and encourage other departments to consider using Cover My Meds. She shared information at the Ambulatory Nurse Practice Council then worked tirelessly with nursing and information security to expand this service. An SBAR and PowerPoint presentation was developed and shared.
Situation: Prior authorization (PA) requests demand increasing staff and provider time. Some staff reluctant to use Cover My Meds (CMM)
Background: Inefficient processes requires extensive holding on the telephone seeking information and appropriate forms. CMM implemented in Holmen to create efficiency and decrease the delay of care related to medication management.
Timeframe of PA to provider
~Prior to CMM = 20 minutes to 3 days
~After CMM =5 -10 minutes
Timeframe PA arrival to final plan decision
~Prior to CMM = Unknown, estimated at 1-2 weeks
~After CMM = Average 4 days
Assessment: CMM provides a secure electronic service to expedite PA processing in a secure environment. Some staff find the use of CMM challenging and not efficient.
Recommendation: Write standard work for using CMM. Present to Primary Nurse Council. Educate staff to use CMM resources to assist when gaps are identified.
Implementing the service required contact and approval from our legal department and information security. It was approved by the Council, Legal and Information Security. In May 2013 Emily met with Cammie Jaekel, Nursing Practice Enhancement Specialist, and transferred the facilitation of this project to her. Cammie worked with Nikole Hoffman, Project Analyst, to ensure the capabilities of the program met the needs of our departments. Cammie then worked with Cheryl Pearse, Director, and the Cover My Meds representatives to set up log in identifiers for each department and training for staff at all MCHS-FH locations.
This impacts our financial sustainability by decreasing nursing and provider paperwork time, which frees them to focus on direct patient care. Searching for forms, calling, and holding on 1-800 numbers, and extended turnaround times are eliminated. Cover My Meds also provides data about the number of prior authorizations, top drugs prescribed, active, and top users. Cover My Meds is now a MCHS-FH too and en route to becoming a Mayo Enterprise tool that will improve care, save time, and precious health care dollars.
Emily worked with enthusiasm to implement this process in Holmen and then share its' benefits with others. Her goal was to ensure that patients receive the most cost-effective medication in a timely manner by implementing a process that is efficient and safe. It is with deep gratitude I submit Emily as the lead RN of this team.
The Holmen Clinic RNs would like to give credit to our director, Deb Cholewa. Deb provided support and guidance in many ways whenever we had questions in the development of the new process (helping to gather approval through legal services and several committee/council meetings, support once going live with the initial pilot, and assisting in the creation of the Job Breakdown Instructions are just a few of the many times she provided support). She supported the concept fully and encouraged that we share the success of this site throughout the MCHS-FH system for all staff to benefit of efficiency.
Team Members: Emily Stanton, Lead RN, Nicole Anibas, RN, Kathy Herbrand, RN, Carol Jacobson, RN, Cammie Jaekel, PhD, RN, Nikole Hoffman, Cheryl Pearse, Director, La Crosse, and Deb Cholewa, Director, Family Medicine, Holmen Clinic
Representatives from Cover My Meds trained Emily, Nichole, Kathy Herbrand and Carol Jacobson to pilot the program at the Holmen Clinic. Holmen staff accepted Cover My Meds and implemented the use.
Following Holmen implementation Emily chose to spread information and encourage other departments to consider using Cover My Meds. She shared information at the Ambulatory Nurse Practice Council then worked tirelessly with nursing and information security to expand this service. An SBAR and PowerPoint presentation was developed and shared.
Situation: Prior authorization (PA) requests demand increasing staff and provider time. Some staff reluctant to use Cover My Meds (CMM)
Background: Inefficient processes requires extensive holding on the telephone seeking information and appropriate forms. CMM implemented in Holmen to create efficiency and decrease the delay of care related to medication management.
Timeframe of PA to provider
~Prior to CMM = 20 minutes to 3 days
~After CMM =5 -10 minutes
Timeframe PA arrival to final plan decision
~Prior to CMM = Unknown, estimated at 1-2 weeks
~After CMM = Average 4 days
Assessment: CMM provides a secure electronic service to expedite PA processing in a secure environment. Some staff find the use of CMM challenging and not efficient.
Recommendation: Write standard work for using CMM. Present to Primary Nurse Council. Educate staff to use CMM resources to assist when gaps are identified.
Implementing the service required contact and approval from our legal department and information security. It was approved by the Council, Legal and Information Security. In May 2013 Emily met with Cammie Jaekel, Nursing Practice Enhancement Specialist, and transferred the facilitation of this project to her. Cammie worked with Nikole Hoffman, Project Analyst, to ensure the capabilities of the program met the needs of our departments. Cammie then worked with Cheryl Pearse, Director, and the Cover My Meds representatives to set up log in identifiers for each department and training for staff at all MCHS-FH locations.
This impacts our financial sustainability by decreasing nursing and provider paperwork time, which frees them to focus on direct patient care. Searching for forms, calling, and holding on 1-800 numbers, and extended turnaround times are eliminated. Cover My Meds also provides data about the number of prior authorizations, top drugs prescribed, active, and top users. Cover My Meds is now a MCHS-FH too and en route to becoming a Mayo Enterprise tool that will improve care, save time, and precious health care dollars.
Emily worked with enthusiasm to implement this process in Holmen and then share its' benefits with others. Her goal was to ensure that patients receive the most cost-effective medication in a timely manner by implementing a process that is efficient and safe. It is with deep gratitude I submit Emily as the lead RN of this team.
The Holmen Clinic RNs would like to give credit to our director, Deb Cholewa. Deb provided support and guidance in many ways whenever we had questions in the development of the new process (helping to gather approval through legal services and several committee/council meetings, support once going live with the initial pilot, and assisting in the creation of the Job Breakdown Instructions are just a few of the many times she provided support). She supported the concept fully and encouraged that we share the success of this site throughout the MCHS-FH system for all staff to benefit of efficiency.
Team Members: Emily Stanton, Lead RN, Nicole Anibas, RN, Kathy Herbrand, RN, Carol Jacobson, RN, Cammie Jaekel, PhD, RN, Nikole Hoffman, Cheryl Pearse, Director, La Crosse, and Deb Cholewa, Director, Family Medicine, Holmen Clinic