A Prescription for Success: Embedded Decision Support Improves Refill Timeliness and Saves $1.6M

Summary

Carle Health faced a challenge when the demand for medication refill support outpaced the capacity of its patient contact center, resulting in escalating costs due to the addition of staff. The organization implemented the Health Catalyst Embedded Refills™ application to successfully streamline, standardize, and scale automated medication refill workflows.

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THE CHALLENGE

Carle Health faced a challenge when the demand for medication refill support outpaced the capacity of its patient contact center, resulting in escalating costs due to the addition of staff. The organization needed a solution that would allow it to scale centralized medication refill support and contain costs.

THE SOLUTION

Carle Health implemented the Health Catalyst Embedded Refills™ application to streamline, standardize, and scale automated medication refill workflows. When a refill request is received, Embedded Refills reviews the EHR for patient data, compares the patient data with Carle Health’s customized, evidence-based refill protocols, and quickly identifies if the request is safe to refill. Summarized patient data and recommended next steps are presented to the patient contact center staff for completion. This improved workflow ensures staff can easily verify if refill requests align with protocol criteria and identify any care gaps, allowing proactive patient engagement to address gaps before processing the refill.

THE RESULT

Using Embedded Refills, Carle Health has scaled standardized and automated evidence-based refill management across the organization. This strategic initiative has led to a consistent increase in the number of providers and patients served, achieved without incurring additional costs and with a simultaneous reduction in overall expenses. It has improved care consistency and reduced risk—registered nurses and medical assistant refill work is standardized, ensuring each role practices within its defined scope of practice.

  • $1.6M cost savings over three years, the result of automating medication refills.
  • Refill protocols for more than 200 classes of medications—close to 400K refill encounters processed annually.
  • Nearly 30 percent of refill requests are completed on the same day the request is received. 80 percent are completed within three days.
"Health Catalyst Embedded Refills has enabled us to standardize and scale centralized refill management, improving the patient experience and removing $1.6M in cost from our system."
Christine Scroggins, MBA, CLHP, Director, Patient Contact Center, Carle Health

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