The Johns Hopkins ACG System includes many features that highlight key health concerns for individuals. In this blog, we discuss one critical feature – the inclusion of pharmacy data.

Pharmacy data provides ACG System users with many opportunities to better understand their population by looking at population health management through a pharmacy-specific lens. Pharmacy data in the ACG System allows users to see all medications patients have been prescribed and uncover any medication adherence issues within a population. Pharmacy data can be run through the ACG System alone, or in alongside other data types, such as medical diagnoses, lab data and other supplementary file types. Read more to find out how this information is important to the overall care of your population.

Why is pharmacy data important?

Pharmacy data provides critical information about patients and, when available, is important to include in health care data analyses.

A pharmacy file contains data on the medications prescribed, dispensed and used by patients. This information can be used to identify trends and patterns in medication use, assess the effect of a medication and evaluate health care utilization and costs.

One important use of pharmacy data is identifying and tracking patients who take multiple prescriptions, known as polypharmacy. These patients require careful management and oversight to avoid problematic health events. For example, individuals with multiple medications for chronic conditions can potentially experience adverse reactions and confusion over their medications and dosing schedules. Patients also run the risk of inappropriate polypharmacy, which is the use of unnecessary medications that cause more harm than good.

The ACG System provides a unique view into a patient’s medication history, so users can provide high-quality care and avoid adverse health events as a result of polypharmacy.

Features and Benefits of Pharmacy Data

Using the ACG System to analyze pharmacy data allows health care organizations and researchers to monitor adherence to medication regimens, detect potential medication errors, discover chronic conditions, detect chronic opioid users, reveal those with complex medications or regimens and optimize health care utilization.

Health systems and providers are the first line of defense against inappropriate medication use. Using pharmacy data, providers can also see if a patient is taking medications for a condition that has not been recorded and explore which patients are on medications that inherently have more risk (those with complex medication regimens and/or high medication complexity). This can allow for interventions to preserve the health of the patient.

ACG System users who use pharmacy data solely for analysis can utilize a wide range of outputs from the System. Pharmacy data allows users to assess medication adherence rates through medication possession ratio (MPR), proportion of days covered (PDC) and continuous, single-interval measure of medication availability (CSA). It also allows users to explore gaps in care and detect untreated conditions. These measures can empower users to see gaps in medications, see how well the medication is working for the patient, observe whether patients are taking their medications correctly and identify potential issues with a prescription.

A notable benefit of using the ACG System is its proprietary Medication Complexity Score. This patient-level score shows the level of challenges tied to certain medications, a medication regimen of multiple prescriptions, if some medications have conflicting or similar instructions and other requirements. The higher the score, the more complications a patient could experience. This includes medication gaps, opioid dependence, unplanned readmissions and a higher annual medication cost.

Pharmacy Data also helps providers and health systems identify inappropriate opioid use. Users are grouped into three categories:

1. The first is a chronic user, someone who is at high risk for complications stemming from these drugs.
2. The second is a concomitant user. This individual takes both opioids and prescribed benzodiazepines, including Valium or Xanax. Using these drugs together increases the risk of overdose and death.
3. The third type of user is opioid-dependent. The pharmacy data files on these individuals show back-to-back refills and prescriptions from more than one provider.

This critical ACG System feature identifies problems with opioid use and can potentially save lives.

Predictive Models

The ACG System also develops predictive models to identify those at the highest utilization risk of health services, classifying patients at low, medium or high risk for several adverse outcomes. Through these pharmacy-based predictive models, patients who are on the path to becoming a persistent high-utilizer, or those at risk of sentinel events (such as avoidable hospital admissions, additional treatments and a higher cost compared to other patients), can be identified.

Pharmacy Data is an important tool to use in population health. The ACG System shows users how many prescriptions a person has received in a specified time. It also looks at a patient’s disease burden in terms of the number of prescriptions they take and can identify trends of polypharmacy within a population based on a number of unique subgroups – a unique functionality not available in other population health management tools that allows users to identify and intervene at a population or individual level, when social determinants, health need or external factors are affecting their patients’ health.

Understanding pharmacy data is a critical part of the whole-person care approach. This data gives users information that can’t be obtained through other methods. The ACG System uses pharmacy and claims data to more accurately fill the gaps in a patient’s health record.

To learn more about Pharmacy Data and the ACG System, visit HopkinsACG.org, email acginfo@jh.edu or contact your account manager.