Medi-Span® Drug Data Case Study: HighFiveRx

Background

With 11 million people in the U.S. having five chronic conditions and an average of 13 providers, HighFiveRx was developed to help simplify and energize population health initiatives. It is a community medication management application that supports better medication reconciliation by pulling in all relevant data and intervening where it finds the most modifiable medication risk. Chief Executive Officer Keith Streckenbach and HighFive Health Leadership set out to solve their drug data challenges.

The Challenges

Application Speed

In order to both please busy customers and fulfill the HighFive Health mission of "reducing 50,000 readmissions for people with multiple conditions," co-founder and CEO Streckenbach says HighFiveRx needed sophisticated, efficient, and relevant drug data.

Speed to Market

"My customers are busy. If they’re sitting there waiting, that’s the death knell in healthcare," Streckenbach says. In developing the HighFiveRx community medication management application, he knew that returning reliable results with speed would be essential.

"Where the market is moving is a post-acute-care, population-health model," explains Streckenbach, who has been with HighFive since 2014. "What's missing in population health is medication management."

Data Normalization, Classification, and Grouping

Most providers base their view of a patient's medication history off of the current, active medication list in the EMR or the fill history in SureScripts, Streckenbach explains, but this might not always present a complete view of a patient's medications. "If we don't get everyone on the same medication use list or plan, (different providers) undo or counteract each other."

In its initial development, HighFiveRx relied on another drug data vendor to help the application perform the searching and sorting required for medication reconciliation tasks. With a previous drug data solution, Streckenbach says he couldn't achieve customer requirements in database testing. "There was an inability to segregate the levels of granulation."

The Solutions

Medi-Span Drug Data & the Generic Product Identifier (GPI)

Switching drug data vendors was imperative to the success of the application, so HighFive quickly began using the Medi-Span MED-File and RxNorm Cross-Reference File. Both of these data sources are built off of the Medi-Span Generic Product Identifier, or GPI. The GPI is a 14-digit identifier that allows for deep granularity in building therapeutic classification systems. After testing several drug data solutions, Streckenbach chose Medi-Span because he says the GPI was more current and its unique architecture, allowing classification by anywhere from 2 to 14 alphanumeric digits, "really serves our needs."

HighFiveRx seeks to "normalize" drug lists to overcome problems created by different spellings and lexicons from different providers. "When you have a group of different drugs, the only way to compare them is to get them all on the same list," Streckenbach says. What used to be a tedious manual process of looking up the RxNorm code for every NDC is made simpler with the help of the Medi-Span GPI.

He further explains that the GPI is ideal for assisting with medication reconciliation, in which medications need to be grouped as identical, similar (same ingredient, different "sigs"), or unique. The GPI structure helps his application identify more duplications and gaps in therapy. "You need to look at sub-groups, which is where Medi-Span, in my view, beats everyone else," he says. "It helps you find twice as many drug errors – errors that would lead to readmission – in half the amount of time."

By switching to Medi-Span data, he found his application returned results more quickly. "I cut out four iterative steps in the algorithm," he explains, and searching functionality improved from taking around 60 seconds to return results, to returning results in sub-one second.

"Now I get to an optimized medication list sooner," Streckenbach says. "Could I do it without Medi-Span? No. I could get close. But close isn't good enough."

Unmatched Customer & Implementation Support

"My development team is mostly off-shore," Streckenbach says, "so Medi-Span implementation support helped save me one month in speed to market and about $10,000 in development costs."

Streckenbach describes Medi-Span customer service as "top-shelf. The team is very responsive. They got back to us, if not the same day, then in a reasonable time. And we got troubleshooting and problem-solving. It wasn't just, ‘Go to this page in this manual.' It was collaborative problem-solving. I love that!"

The Results

HighFiveRx was able to achieve:

  • 60X faster searching functionality
  • Four steps cut from algorithm
  • Twice as many drug errors identified in half the time
  • Speed to market one month faster with $10,000 saved

HighFiveRx is a community medication management application with operations based
in Madison, Wisconsin, and an office in Chicago, Illinois. Learn more at http://highfiverx.com/.

Quotes

  • "I cut out four iterative steps in the algorithm," Streckenbach explains, and searching functionality improved from taking around 60 seconds to return results, to returning results in sub-one second.

    Keith Streckenbach, CEO, HighFive Health

  • Medi-Span "helps you find twice as many drug errors — errors that would lead to readmission — in half the amount of time."

    Keith Streckenbach, CEO, HighFive Health

  • "Medi-Span implementation support helped save me one month in speed to market and about $10,000 in development costs."

    Keith Streckenbach, CEO, HighFive Health