Pharmacy Inventory Informatics Group Update

1. Pharmacy Inventory Informatics Group Update

2. Workgroup Members • Marian Daum • Rose Grealish • Adelaide Quansah • Ester Song • Georgia Stefanidis • Jolene Hallcroft • Naeem Mian • Spencer Schaefer • Dionne Roney

3. Overall Objectives • To review current processes and software used for inventory monitoring at VA pharmacies. • To develop a method which will guide the pharmacies to properly inventory and report nationally inventoried medications, in accordance with PBM and OIG regulations • To develop a SharePoint site which will allow sites to post their inventory results. • To develop ways to automate the current labor intensive inventory process. • To evaluate software/reporting features that may be useful in VA pharmacies.

4. Main Objective • How to accurately track products to within 5% variance using VA software or other tools available to facilities.

5. Problems • Reports in VistA are package specific. Meaning that a facility must combine multiple reports to track usage. • There is a one report within VistA that intended to be combination report. This is the Drug Transaction Report. However it is inaccurate and is updated by a nightly background job. Which can means it is usually out of date. • Outpatient reports don’t exclude CMOP filled prescriptions. This is a problem with inventory. • Multi-divisional sites • Inventory on hand numbers are inaccurate. • Unit dose (inpatient) usage is inaccurate due to poor returns practices. • Multiple automation systems

6. Solutions • Third class software was developed to allow sites to look at outpatient usage by division and to exclude or include CMOP. • A FileMan routine was developed to look at inpatient usage according to BCMA usage and not by pick list usage. • Other reports and practices consolidated into a report and check list • Remedy tickets to fix the Drug Transaction Report

7. New Service Request • Convert the outpatient third class report to national report • Use BCMA usage to monitor inpatient usage. (with ability to edit if necessary). • Create a report that will estimate inventory on the wards. • Review all reports currently within VistA for accuracy.

8. Conclusion • There is no single report within VistA that will allow a facility to easily maintain and variance rate of less than 5%. • If a site is multi-divisional then outpatient VistA reports will be inaccurate. • In order to determine a variance of less than 5% facilities will have to use multiple VistA reports or use other vendor software (ScriptPro). • The information is in VistA, but very hard to get out.

9. Why were we fooled? • Management is looking at their facility as a whole. Purchases for all divisions and usage for all division are combined. • ProClarity and other tools are used. ProClarity has no problem determining CMOP prescriptions from local Rx’s • Analysis is usually done prospectively. Many potential problems resolve themselves over a few days (invoice processing, pick lists). • The longer time period reviewed the physical inventory totals become less important.

10. Accomplishments • New Service Request for improved inventory reports. • Draft guidance of determining pharmacy purchases and usage of a product. • Better guidance for annual wall to wall inventories. • VeHU presentation of Drug Accountability and inventory practices.

11. Future Objectives • Create a check list. • Finish national reporting SharePoint site • Begin working on best inventory practices guidance.