Practice Management
Relieving inventory control headaches
Inventory systems reduce counting and waste while increasing billing accuracy.
BY RENÉ LUTHE, CONTRIBUTING EDITOR
As expensive injectable medications became a staple of retinal practices, staff members immediately faced a daunting level of time and effort. They needed to keep track of the medications, rotate inventory so the drugs did not expire, bill them correctly to the patients’ insurance carriers, allocate them to the appropriate physician, and maintain the necessary supply.
Fortunately, retina practices now have a powerful tool in the form of automatic inventory systems. They allow clinicians and designated staff to monitor medication inventory in the practice and incoming inventory. They know which vials are about to expire and the date for when they assigned the drug to specific patients.
“I can go to any computer, log on to the portal, and pull up and know exactly how much I have in the refrigerator at that moment,” says Aundrea Borelli, COT, lead technician at Vitreo-Retinal Associates, Worcester, MA, which has used an automatic inventory system for more than a year.
Experienced users discuss the three inventory systems currently used in retina practices.
How they work
These retina-friendly automatic inventory systems — the Physician Office Drug Inventory System (PODIS), CubixxMD and USRetina — monitor a practice’s drug supply, but they all operate a little differently, specifically in how they identify the product that enters or exits the inventory.
PODIS uses bar codes that are attached to the packaging for each vial of medication. Each code, matched to information in the PODIS system, allows practices to track the vial. When a new drug arrives at the practice, staff scans the vial with the code reader (included with the system) to transfer that code to the practice’s system. When a vial is used, they scan the bar code again and the system updates the records. In addition to a USB-compatible scanning wand, PODIS comes with a bar code printer and a user interface portal that is accessible from any computer with an Internet connection.
CubixxMD and USRetina track drugs with radio-frequency identification (RFID) tags — again, each vial of drug bears one as its unique identifier. The systems read the RFID tags automatically when drugs are put into, or removed from, the refrigerated and/or non-refrigerated cabinets included in both systems. The system “knows” the door has been opened and a transaction has occurred; once the cabinet door closes again, the cabinet automatically scans the contents and updates the system.
The three systems interface with practice management systems and integrate with some EMR systems.
Sure and secure access
In addition to “knowing” how many of which medications the practice has on hand at all times, the inventory systems ensure stock is available only to appropriate staff. Kathy Pignio, operations director at South Jersey Eye Physicians, Moorestown, NJ, says that new retina technicians receive unique access codes, and she can access the user interface portal from any computer with an Internet connection. The CubixxMD system features a control pad on the front of each cabinet; authorized users punch in a PIN to access it. For USRetina, designated staff members receive a secure RFID badge that opens the cabinet when swiped.
“[The inventory management system] is going to have a record of who took it out, when they took it out, what was taken out,” says Matt Love, business office manager of Southern Vitreoretinal Associates, Tallahassee, FL.
Each tracking method has its proponents. “It takes time to enter the medication info into the computer system, but it is a better tracking system for where medications are going, whose patients are getting which medications, lot numbers, etc.,” says Melanie Woods, clinic manager at Charles Retina Institute, Memphis, TN, which has used PODIS for more than three years.
Mr. Love prefers the RFID system (his practice uses USRetina). “If someone misses scanning something, medication can fall through the cracks,” he says. “Once the shipment is received and associated in our system, it’s placed in our cabinets, which are RFID-monitored. Once that medication is removed from the cabinet, it doesn’t matter if someone scans it or not; it’s going to have a record of who took it out, when they took it out, what was taken out.”
In stock and up to speed
In addition to knowing how much drug you have in stock and to which patient it’s prescribed, these systems warn you if vials near their expiration dates. “The administrator of the program at our practice gets a pop-up on her computer to notify us of expirations,” says Ms. Pignio.
Ms. Borelli, who works with the CubixxMD system, says that the number of vials practices keep track of is increasingly difficult. “On average, I need to order hundreds of medications monthly, including Eylea, Lucentis, and Avastin.”
Alerts warn when a drug’s inventory is low. When these inventory levels fall, all three systems offer an ordering feature, contacting pharmaceutical distributors and pharmacies for the practice. In the USRetina system, for instance, a practice sets up an order with its supplier(s), indicating the amounts of each drug the practice wants to keep in stock. As soon as a practice falls below its stated amount, the drug supplier automatically sends what is needed.
CubixxMD operates in a similar fashion: Based on current inventory and user-defined par levels, the system transmits replenishment orders directly into Besse.com, where orders are fulfilled. Products arrive pre-tagged and lot-tracked with RFID tags.
Inventory system vendors
CubixxMD Inventory Systemwww.besse.com/pages/CubixxMD.aspx
(800) 543-2111
Physician Office Drug Inventory Systemwww.podis.org
(877) 382-8894
USRetina Inventory Systemwww.usretina.com
(865) 696-4825
Clinical lessons as well
The tracking capabilities provide information that’s valuable from a clinical perspective, too.
“We’ve seen a shift in the medications we use,” says Ms. Woods. “We can track medications by physician, we can tell what physicians are using for each patient; we can tell how much to order based on how our physicians are assigning medications. We can tell which medications the physicians are using for which diagnoses.”
Better billing
Before automatic inventory systems, Mr. Love says that it took the full-time efforts of two to three employees to ensure accurate billing. When each dose of medication costs nearly $2,000, practices can’t afford mistakes.
“It was a massive effort [to correct errors in billing] and it was very time-consuming, because you don’t want to send something out and get a denial. That denial doesn’t arrive until 30 days later, and then once you resubmit, it’s another 30 days before you get paid, and we already put out the expense of the medication,” Ms. Pignio says.
With the automatic inventory systems, the clinical staff reviews a report on the system administrator’s website each evening to make sure that every medication removed from the cabinet has been administered to a patient in the practice’s clinical application, Mr. Love says. Once charges integrate into the practice management system the next morning, billing staff confirm that the drugs billed match what was used according to the cloud report. The system interface also lists date of birth with each patient’s name in the system interface to help ensure correct billing.
No-brainer training
Users report that all three systems are easy to learn. Even a new technician could “pick it up in an hour,” says Mr. Love of the USRetina touch-screen interface. “All you do is look at the application, choose your patient, and then it just has four criteria that you have to fill out: which eye you’re doing, which drug, which diagnosis, and which procedure code.”
Training for administrative tasks on the CubixxMD portal requires “perhaps only an hour at most,” says Ms. Borelli.
Should users run into a problem, customer support is responsive. “If I have an issue, I just call them on the phone, and they address it,” says Ms. Pignio. “I would never go back to hand calculating again.” OP