Specialty pharmacies are experts at dealing with the complex. Complex health conditions, complex drugs, and complex payment models are the cornerstones of the industry. However, when it comes to answering simple questions about the care patients are actually receiving, specialty pharmacies struggle. Answering simple questions requires visibility into a complex delivery model that includes distributors, physicians, caregivers, payers, and finally, patients.
Today, a solution that puts everyone on the same page is painfully absent.
Paper treatment plans and basic software applications provide only one-directional information about patient care. When it comes to creating better patient outcomes or providing manufacturers with information to improve their products, siloed, unactionable is of little help. Leading specialty pharmacies are looking for new technology solutions to differentiate their services to their payer and manufacturer partners. Unlocking new ways to stand out against the competition and improve the bottom line may require going back to basics.
Questions with a big impact for specialty pharmacies:
1. Did the drug get delivered?
When caregivers use a mobile app to track drug administration, doctors can see that the drugs they prescribed were actually delivered to the patient. This makes it easier to predict when refills will be needed and schedule the next round of treatment.
2. Were there side effects?
When caregivers or patients track side effects in a mobile application, data is instantly accessible to everyone. More data on side effects also helps physicians make better decisions about which drugs to prescribe. When care teams and patients know what side effects to expect, they can be better prepared for treatment.
Access to patient data is especially important as new drugs with unknown side effects enter the market. Patient data can be sent back to manufacturers. When manufacturers get patient data sooner, that data can augment their R+D process, helping to create drugs with reduced side effects.
3. Is the patient following their care plan?
When patients (or nurses who administer drugs in a home setting) track care in the mobile application, results are visible to administrators in real-time. This helps care managers direct their attention where it’s needed most. When specialty pharmacies focus on the most at risk patients, population outcomes improve.
4. Did a hospitalization or ER visit occur?
The average cost of just one emergency room visit is $2,1682. It’s no surprise that payers (and patients themselves) are eager to prevent unnecessary ER visits. When patients record side effects, symptoms and biometrics in an app, care teams can spot worrisome signs. This makes it possible to intervene before issues becomes serious enough to result in ER visits. If an ER visit does occur, administrators will be immediately alerted when care is recorded in the app.
Solutions for the specialty pharmacy industry face a unique set of challenges. They must be robust enough to securely manage and report on vast sets of data, yet easy enough for patients and caregivers to adopt. New legislation, new technologies and new drugs are impacting the specialty pharmacy industry at an increasingly rapid pace. It’s clear that companies that stand still will get left behind.
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Reference: “How Much Will I Get Charged For This?’ Patient Charges for Top Ten Diagnoses in The Emergency Department”, PLOS one, 2/27/13, http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055491