1. Pharmacy Informatics Workgroup Pharmacy Inventory Informatics Group Update

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

3. Pharmacy Informatics Workgroup 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. Pharmacy Informatics Workgroup Main Objective How to accurately track products to within 5% variance using VA software or other tools available to facilities.

5. Pharmacy Informatics Workgroup 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 Which can means it is usually out of date.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. Pharmacy Informatics Workgroup 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. Pharmacy Informatics Workgroup 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. Pharmacy Informatics Workgroup 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. Pharmacy Informatics Workgroup 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. Pharmacy Informatics Workgroup 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. Pharmacy Informatics Workgroup Future Objectives Create a check list. Finish national reporting SharePoint site Begin working on best inventory practices guidance.