For a medical practice with a typical infusion program, it is generally understood that the procurement cost of drugs is the largest expense incurred by the organization.  With the high price tag of many biologics and other treatments, it is not unusual for a multi-provider rheumatology practice to accumulate annual drug purchases in amounts of several million dollars.  Considering increasingly large patient volumes and the frequent multiple dose infusion therapies that are administered over the course of a day, many medical practices consider the tracking of drug inventory and the verification of reimbursement to be an especially daunting task for a staff primarily concerned with delivering effective and compassionate healthcare. 

Nearly everyone is familiar with the small images of seemingly random vertical lines that are found on almost everything from supermarket items to mail to library books – the barcode has revolutionized the way businesses are run and items are tracked.  When decoded by an appropriate scanning device, the item in question can be rapidly identified by its reference number that is encoded in the sequence of lines and spaces.  This number in turn may be fed into a product database to gather countless details about the item.  Some medical applications have capitalized on this technology to streamline a number of operations to make their processes safer and more efficient – but with the ever expanding portfolio of biologic treatments available and with patient specific dosing protocols, how best could a medical practice make use of the benefits provided by automatic ID to better manage an infusion program?

Enter automated drug inventory tracking.  Through the use of individually barcoded vials and syringes, product can now be tracked in detail from the time it is received and put into storage until the time that the anticipated reimbursement is totally accounted for.  This complete lifecycle monitoring records all vital data at the individual dose level, including production lot number, expiration date, which patient received the dose, the attending provider, and many other key characteristics of the particular unit.

This new capability is welcome news to countless medical practices that administer dozens of drug doses per day, in many cases performing these services in multiple locations.  Considering the fast paced flow of a busy infusion program, any available method that can be employed to increase efficiency and lighten the load for office staff will be of significant value to the practice.

One such medical practice that is taking full advantage of these extensive drug tracking capabilities now available is Dayton Arthritis and Allergy Center, located in Dayton, OH.  Through a pilot program established to refine system capabilities to meet the specific needs of an infusion program, Dayton Arthritis and Allergy Center became acquainted with DoseTracer™ Inventory and Payment Tracking Software for Pharmaceuticals, a product of Custom PC Programming, LLC also located in Dayton. 

 “DoseTracer software has been a great addition to our multi-physician practice, allowing us to effectively track inventory and monitor payment status,” states Dayton Arthritis and Allergy Center Infusion Nurse Mary Zugelder.  “We have successfully transitioned from paper inventory tracking to an electronic method. DoseTracer has provided us with the tool we need to increase accuracy and efficiency.”

Created to track inventory and reimbursement of drugs and vaccines dispensed in the clinic or physician office, the capabilities of DoseTracer software go far beyond one dimensional inventory systems that are on the market. Through efficiency gains achieved by greatly facilitating much of the administrative process and record keeping, and by reducing the time required to assure billing accuracy and proper reimbursement, those medical practices using DoseTracer software report tangible improvement to the bottom line.

Through the collaborative efforts of Dayton Arthritis and Allergy Center and Custom PC Programming, the pilot program has provided an opportunity to fine tune the operation of DoseTracer software to address the particular needs of an allergy/rheumatology medical group.

"Since DoseTracer has been used for several years to assign and track patient doses, our single injection workflow functioned perfectly right out of the gate,” explains Ms. Zugelder.  “With our infusion process, things work a little differently, because a single patient will get several doses of the same drug during a single encounter.  We worked with the folks at Custom PC Programming to optimize the dose assignment process under these unique circumstances to where we can rapidly associate multiple doses to a single patient."

"We've now installed all of the major custom features that are of value specifically to an allergy and rheumatology group practice,” says Ms. Zugelder.  “We'll continue to enhance the service overall by identifying and implementing smaller modifications so that the day to day operation becomes even more efficient.  We'll also look to add some additional custom reporting capability to allow us to get an even better handle on our drug program."

Ease of use and responsiveness by the vendor are paramount to the successful implementation of any new software product into a medical office.  Marcie Wayne, Clinical Manager at Dayton Arthritis and Allergy Center states, "I was introduced to DoseTracer when I started as Clinical Manager here at Dayton Arthritis and Allergy Center last year. Mark, the company owner, sat down with me and explained the system to me and has worked with me every step of the way. They are great people to work with and are readily available to help and answer any questions we might have.  The system has been easy to learn and very user friendly.”

Since the pilot program began, the practice has realized efficiency improvements in many areas of the operation above and beyond accounting for every dose of an unlimited number of drugs.  What really drives home the value of the service, according to Ms. Wayne, is the tangible savings resulting from the identification of billing errors on all administered doses.  “Being an Arthritis practice that does infusions, we have some very expensive medications that makes it imperative we have a tracking system that will reconcile inventory and account for all our medications. Through DoseTracer software we can be assured that charges are billed and allocated correctly by running a report that identifies each dose scanned and the patient who received it.  We can then make sure there are no discrepancies, and not miss billing a drug.  We have already found missed revenue that we most likely would not have found without the use of DoseTracer.”

Through custom reporting available with DoseTracer software, C-level executives and providers have instant access to the financial state of the vaccine or drug administration program.  “Custom PC Programming has also created a report for us by working with our EMR so that we’re able to see reimbursement trends from insurance companies and individual plans”, states Ms. Wayne. “We can now help our physicians identify which medication to use according to a patient’s insurance coverage."  Per Kelly Eveleth, Infusion Services Coordinator for Dayton Arthritis and Allergy, “DoseTracer has greatly facilitated billing processes, enabling us to calculate usage of drugs and manufacturer rebates by physician."

 “Our company delivered our first barcode label printing program in 1988,” explains Mark Naples, President of Custom PC Programming, LLC, “and we evolved into a more fully integrated provider when we began developing and offering inventory solutions in 2002.  Our specialized drug inventory software has been used since 2010 and has scanned many tens of thousands of serialized barcodes that are affixed to each incoming drug dose administered by our client practices, resulting in extraordinary bottom line improvements for our users.  When we saw the complexities of the infusion process with variable dosing requirements for a large volume of patients, we knew there was an opportunity there to offer rheumatology practices and others a system that would transform the way drugs were tracked in the office, and we went right to work.” 

The key to how DoseTracer software operates resides in the custom interface that is developed to extract patient encounter and billing/reimbursement information from the practice PM system.  Reports generated by the PM system are picked up and processed each morning by DoseTracer software shortly after midnight.  DoseTracer databases are then updated with the information provided by the reports, resulting in extensive and concise one-touch status updates on the billing and reimbursement status of each individual dose.  “We’ve already successfully integrated with many of the major PM system suppliers, and we generally encounter very little difficulty when creating new interfaces,” says Mr. Naples.  “Our process has been refined to the point that preparing and completing a new installation is trivial.” 

DoseTracer software is actually 2 modules which act largely independently from each other – the inventory module and the billing/reimbursement module.  The product can track inventory on an unlimited number of products across an unlimited number of locations, and can maintain separate inventory counts for samples and free prescription programs.  And because DoseTracer software is also used by pediatric groups for tracking vaccines labeled with the 2D barcode, the system is already fully capable of processing the upcoming new identification scheme that is mandated by the Drug Supply Chain Security Act.  When the statute goes fully into effect, users will realize even greater benefit – manufacturers will have the ability to include product identification, expiration date, and lot number information within the code, allowing a specialized data collection system such as DoseTracer software to directly read and record this critical data.

It has become increasingly apparent to the medical community that the tracking of vaccines and drugs is no longer just a good idea, but rather a necessity to ensure that the organization is maximizing its profitability potential.  It is now understood that the implementation of an effective, flexible, and easy to use system is critical to the health of a practice engaging in a vaccine or drug administration program.  States Ms. Eveleth, "DoseTracer software has become an invaluable tool in our multi-physician specialty practice.   We are now able to inventory and track our infusion and injectable medications with greater ease and speed.”