DIGITAL TRANSFORMATION is advancing industries, altering consumer behavior, and reinventing society at every level. Digital disruption and big data are shifting the way businesses interact with consumers and accelerating change at a frenetic pace. As businesses from every sector learn to streamline and synergize advancements in technology with consumer experience, one industry consistently remains behind: health care. A recent study placed health care a decade behind other industries that have embraced digital transformation to better serve their consumers. The industry charged with safeguarding life itself is outpaced by retail and banking in terms of digital maturity.1

It was just over a decade ago that the federal government passed the Health Information Technology for Economic and Clinical Health Act as sweeping legislation seeking to force the health care industry to embrace technological change. Legislation compelling the health care industry to close the digital gap has continued. In March 2020, the Department of Health and Human Services passed new rules focused on data interoperability in line with initiatives laid out by both the current and previous administrations.2

Health care legislation achieving bipartisan agreement is just one indicator of how far behind the health care industry has fallen in terms of digital maturity.

As the government continues to legislate the industry, specialty pharmacies have seen an everincreasing demand for data from payers, prescribers, pharmaceutical partners, and accreditation agencies. To meet these demands, specialty pharmacies large and small have worked diligently to hone copious amounts of data into sleek dashboards and actionable reports providing insight into treatment efficacy, patient adherence, and process-outcome parameters measuring change throughout the patient journey.

Collecting, analyzing, acting upon, and sharing data as appropriate are important ways in which specialty pharmacies demonstrate the value of their services. Yet, as they continually seek to streamline, standardize, and organize data on the back end, they must not lose sight of an emerging opportunity to engage with and collect meaningful data from their most important stakeholders: patients.

Specialty pharmacies must leverage patients’ increasing digital competency and changing perspectives regarding data sharing to meet digital expectations, enhance the patient journey, and improve health outcomes. This article explores the efficacy of digital health interventions, examines the changing attitudes and expectations that patients have regarding digital health, and provides advice for specialty pharmacies looking to expand digital engagement with their patients.

Digital Interventions Work
Digital health interventions can be effective tools that promote better health. Common digital health interventions include those that encourage healthy behaviors, provide management tools for long-term and chronic conditions, or facilitate access to services that improve patient outcomes.3 Each of these has significant implications for specialty pharmacy.

Numerous studies have linked the use of mobile health apps to improved medication adherence for patients with chronic health conditions.4 Apps have also been found to be effective and appropriate for patients managing their health in a home setting.5 Reducing hospital admissions by keeping patients healthy is one way specialty pharmacies help control the cost of health care. One hospital system significantly cut their hospital readmission rates for congestive heart failure by providing patients with an app with customized medication instructions and self-care videos.6 Another large, randomized, controlled trial confirmed that pharmacist-assisted telemedicine is a powerful tool to help control hypertension. There was significant improvement in blood pressure for patients who received pharmacistassisted telehealth interventions.7

Digital health interventions can be as simple as a standard SMS text message. A recent systematic literature review examined studies that featured SMS-led interventions. Positive outcomes as a result of text messages were identified in 77% of the studies reviewed.8 Whether promoting healthy behavior, providing management tools, or facilitating access to care, digital health interventions provide pharmacists with a substantial resource for increasing patient engagement, reducing costs, and improving health outcomes.

Increased Expectations, Changing Perspectives
The past decade has seen a rapid expansion in technology adoption. As of January 2020, 4.54 billion people around the globe were active internet users.9 The rise in popularity of the smartphone has also significantly contributed to our growing digital footprint. According to the Pew Research Center, in 2011, only 35% of Americans owned a smartphone. Today, 96% of the US population owns a mobile device, with 81% owning a smartphone.10 The rise in digital engagement spans generations. Although millennials continue to lead the pack, baby boomers and the silent generation have recently shown a significant uptick in their digital adoption and use.11

In addition to greater technology adoption, companies such as Netflix, Uber, and Amazon have significantly boosted consumer expectations regarding digital experiences. Consumers today anticipate a high level of digital sophistication from the businesses they interact with, including health care providers. Recent research shows that almost 60% of patients expect their digital health care customer experience to mirror that of their retail.12 As such, patients are more willing to choose (or abandon) health care providers based on their digital capabilities.13

Fifty-four percent of patients would like to engage with health care providers using their smartphones. 14 At the same time, there has been a proliferation of mobile health care apps and personal monitoring devices. The use of wearable health and fitness technology increased from 9% in 2014 to 33% in 2018, and this trend is expected to continue.15 As technology advances and its adoption rises, patients are becoming more interested in using digital tools to track their health and communicate with providers.16

Bridge the Gap
Whether or not your organization has a proprietary app, patient portal, or other digital health tool, take steps to ensure your digital capabilities are in line with current trends and expectations. Patients engage more with systems that are aesthetically pleasing, simple, and intuitive.17 They want a platform that facilitates communication, provides capabilities to track treatment, and streamlines processes such as medication refills or payments.18 If your system has not achieved a satisfactory level of patient engagement, it may be time to examine an overhaul in line with current patient expectations.

If your pharmacy does not currently use a portal or proprietary app, there are many other ways to engage patients around digital health. Research digital health tools that are relevant and effective for your patient populations. Try different mobile health apps and determine how they can streamline self-reported patient data, complement your current clinical assessments, or lead to actionable insights improving patient care. Most importantly, start a conversation with patients about digital health. Research indicates that patients encouraged by their health care provider were twice as likely to access their online patient portal.19

Escalating rates of technology adoption, changing patient expectations regarding digital competencies, and rising interest in digital health to track and share data have significant implications for specialty pharmacies. Taking steps to ensure your organization’s digital competencies are in line with current expectations can increase levels of patient engagement and overall satisfaction while facilitating the exchange of data, leading to better health outcomes.
 
Marc Stranz, PharmD, is chief clinical officer at BioMatrix Specialty Pharmacy.

JUSTIN LINDHORST, MBA, is marketing director at BioMatrix Specialty Pharmacy.



REFERENCES
 
  1. Landi, H. (2018). Study: Healthcare lags other industries in digital transformation, customer engagement tech. Healthcare Innovationhttps://www.hcinnovationgroup.com/population-health-management/news/13030021/study-healthcare-lags-other-industries-in-digital-transformation-customer-engagement-tech
  2. Crouch, Hanah. (2020). US passes interoperability rules giving patients more data control. Digital Healthhttps://www.digitalhealth.net/2020/03/us-interoperability-rules-passed/
  3. Murray, E., Hekler, E. B., Andersson, G., Collins, L. M., Doherty, A., Hollis, C., Rivera, D. E., West, R., & Wyatt, J. C. (2016). Evaluating Digital Health Interventions: Key Questions and Approaches. Am J Prev Med51(5), 843–851. https://doi.org/10.1016/j.amepre.2016.06.008
  4. Kruse CS, Argueta DA, Lopez L, Nair A. (2015). Patient and provider attitudes toward the use of patient portals for the management of chronic disease: A systematic review. J Med Internet Res 2015;17(2):e40. DOI: 10.2196/jmir.3703
  5. Pérez-Jover V, Sala-González M, Guilabert M, Mira JJ. (2019). Mobile apps for increasing treatment adherence: systematic review. J Med Internet Res. 21(6):e12505. DOI: 10.2196/12505
  6. Mottl, Judy. (2015). Mobile health tools cut readmissions for congestive heart failure patients. Fierce Pharmahttps://www.fiercehealthcare.com/mobile/mobile-health-tools-cut-readmissions-for-congestive-heart-patients
  7. Green BB, Cook AJ, Ralston JD, et al. (2008). Effectiveness of home blood pressure monitoring, web communication, and pharmacist care on hypertension control: A randomized controlled trial. JAMA. 2008;299(24):2857–2867. doi:10.1001/jama.299.24.2857 
  8. Kannisto KA, Koivunen MH, Välimäki MA. (2014). Use of mobile phone text message reminders in health care services: A narrative literature review. J Med Internet Res 2014;16(10):e222. DOI: 10.2196/jmir.3442
  9. Statista. (2019). Global digital population as of January 2020. https://www.statista.com/statistics/617136/digital-population-worldwide/
  10. Pew Research Center. (2019). Mobile fact sheet. https://www.pewresearch.org/internet/fact-sheet/mobile/ 
  11. Vogels, E. (2019). Millennials stand out for their technology use, but older generations also embrace digital life. Pew Research Center https://www.pewresearch.org/fact-tank/2019/09/09/us-generations-technology-use/ 
  12. NTT data study finds nearly two-thirds of consumers expect their healthcare digital experience to be more like retail [news release]. Las Vegas, NV; March 5, 2018: NTT Data Services. https://www.businesswire.com/news/home/20180305005288/en/NTT-DATA-Study-Finds-Two-Thirds-Consumers-Expect  
  13. Deloitte. (2019). A consumer-centered future of health. https://www2.deloitte.com/us/en/insights/industry/health-care/global-health-care-trends-survey.html
  14. Accenture. (2015). Losing patience: Why healthcare providers need to up their mobile game. https://www.accenture.com/t20160118T135036__w__/us-en/_acnmedia/Accenture/Conversion-Assets/DotCom/Documents/Global/PDF/Dualpub_24/Accenture-Losing-Patience.pdf 
  15. Phaneuf, Alicia. (2020). Latest trends in medical monitoring devices and wearable health technology. Business Insider. https://www.businessinsider.com/wearable-technology-healthcare-medical-devices
  16. Rock Health. (2019). Digital Health Consumer Adoption Report 2019https://rockhealth.docsend.com/view/i6j4ieu
  17. Lazard, A., Mackert MS., Shalev, H., Stephens, KK., Mackert, MS., Watkins I., Xie, B. (2015). Design simplicity influences patient portal use: the role of aesthetic evaluations for technology acceptance. J Am Med Inform Assn. 23(1), 157-161. https://academic.oup.com/jamia/article/23/e1/e157/2379907
  18. Accenture. (2019). Digital health consumer survey. https://www.accenture.com/t20190208t144039z__w__/us-en/_acnmedia/pdf-94/accenture-2019-digital-health-consumer-survey.pdf#zoom=50 
  19. The Office of the National Coordinator for Health Information Technology. (2018). ONC Data Brief No. 40. https://www.healthit.gov/sites/default/files/page/2018-03/HINTS-2017-Consumer-Data-Brief-3.21.18.pdf