Digital Transformation, Shift to Home Care Delivery Have Significant Implications for Specialty Pharmacies

Pharmacy Times Oncology Edition, August 2022, Volume 4, Issue 4

Oncology pharmacists must think critically about the digital experience they give patients.

In health care, digital transformation has quickly evolved from a corporate catchphrase to an operational necessity. A global pandemic, changing expectations, and growing research indicating the safety and efficacy of digital health technology are pushing health care to refine and advance digital capabilities.

Digital health represents a key component in helping patients safely manage therapy at home and in helping oncology-focused specialty pharmacies gather real-world data relevant to the interests of prescribers, pharmaceutical manufacturers, and payers. This article examines the rise of digital health, the changing site of health care in the United States, and the implications for oncology-focused specialty pharmacies.

The Rise of Digital Health and a Changing Site of Care
The digital health industry is booming. In 2021, digital health investments reached $29.1 billion—a 255% increase from 2019.1 The industry is projected to reach $650 billion by 2026.2 The proliferation of the smartphone, wearable devices, and the internet of things stands to significantly shape health care in the United States and around the world.

Patients have increasing digital health resources at their disposal. More than 350,000 digital health apps are availablefor download, 320 million wearable devices will ship globally this year, and 41.9% of US households are connected to smart home devices.3-5 More than ever, patients are using technology to monitor, measure, and manage their health.6 Although concerns about data and privacy linger, patients are increasingly willing to share digital health information with physicians, health insurers, and pharmacists to optimize their own care while increasing the ease of methods by which they receive that care.7

Health care is moving closer to home. During the next 3 years, nearly $265 billion in services for Medicare fee-for-service and Medicare Advantage patients could shift from health care facilities to the home.1 Research demonstrates that digital health apps, wearables, and other monitoring devices are effective resources for home management of chronic health conditions.8 Studies involving oncology patients demonstrated a reduction in symptoms and increased survival time by using remote monitoring devices in the home.9

Combining digital health with multidisciplinary support, hospital at home (HAH) programs seek to reduce length of hospital stays and unplanned hospital visits for patients with chronic health conditions. HAH oncology services are gaining traction in the United States, and research demonstrates oncology HAH support effectively improves treatment outcomes and lowers costs.10 Digital health and HAH programs will be a key tactic driving the site of care from the hospital to the home in years to come.

Digital Health and Specialty Pharmacy

Digital transformation and the changing site of health care delivery have significant implications for specialty pharmacies. Value-based contracting, digital companions for specialty drugs, and the expanding clinical role of pharmacists are among reasons why specialty pharmacies should evaluate, upgrade, and expand their digital health capabilities.

As health care moves toward value-based contracting and reimbursement models, digital health will play an increasingly important role in driving patient engagement, satisfaction, and the measuring of outcomes. In a value-based system, measurable outcomes and patient satisfaction both represent clinical quality measurements.

The digital revolution in communication, shopping,entertainment, and travel has set a high bar for thedigital experience patients expect from health care providers. If their digital experience with a healthcare app is not on par with that of Amazon, Uber, Netflix, and other digital giants, patient expectations likely are not being met. Patients increasingly decidewhether to keep or abandon a health care provider based on the provider’s digital capabilities.8 Specialty pharmacies not providing a digital experience in line with these expectations may see decreased patient engagement and satisfaction scores; such metrics are important in a value-based model of care.

In addition to overall digital experience, specialty pharmacies should prepare for the proliferation of digital companions and digital therapeutics. The next 5 years will see a growing number of specialty therapies targeting cancer reach the market.11 As new drugs are released, many pharmaceutical manufacturers are deploying digital companions to help patients manage complex therapies; these companions can also provide education and adherence support while collecting patient-reported outcomes related to therapy.12

Digital therapeutics work by deploying evidence-based interventions to help unique patient populations manage, prevent, or treat specific health conditions.13 There are 35 to 40 FDA-approved digital therapeutics used for a growing range of mostly chronic health conditions, including cancer.14 Along with oversight from board-certified oncology pharmacists, digital companions and therapeutics will play an increasing role in helping patients manage complex therapies from home.

The ways in which pharmacists support patients are evolving. Integrating digital support into oncology medication therapy management programs provides an opportunity for clinical pharmacists to engage with patients, provide effective tools for managing therapy, and facilitate collection of valuable real-world data. Oncology pharmacists, technicians, and support staff should identify and develop competency in the use of digital health apps, companions, wearables, and therapeutics that are effective in supporting patients with cancer. With more apps and devices available, pharmacists can help patients identify, evaluate, and execute a tailored digital health strategy.

Health care often falls behind other industries in terms of digital maturity.15 Regardless, specialty pharmacies need to think critically about the digital experience they provide patients. As the site of health care moves from hospital to home, the role of the oncology pharmacist will evolve. Specialty pharmacies should consider how to best deploy digital health resources throughout the patient journey to improve communication, reduce barriers, facilitate medication access, gather real-world data, and promote positive outcomes.

References
1. Bestsennyy O, Chmielewski M, Koffel A, Shah A. From facility to home: how healthcare could shift by 2025. McKinsey Insights. February 1, 2022. Accessed July 2, 2022. https://www.mckinsey. com/industries/healthcare-systems-and-services/our-insights/ from-facility-to-home-how-healthcare-could-shift-by-2025
2. Lovell T. What’s next for digital health in 2022? MobiHealthNews. December 29, 2021. Accessed July 2, 2022. https://www.mobihealthnews. com/news/emea/what-s-next-digital-health-2022-0
3. Olsen E. Digital health apps balloon to more than 350,000 available on the market, according to IQVIA report. MobiHealthNews. August 4, 2021. Accessed July 2, 2022. https://www.mobihealthnews.com/news/ digital-health-apps-balloon-more-350000-available-market-according-iqviareport#:~:
text=The%20number%20of%20consumer%20digital,health%20
apps%20available%20to%20consumers.
4. Bucaille A, Crossan G, Loucks J, Stewart D. Wearable technology in health care: getting better all the time. Deloitte Insights. December 1, 2021. Accessed July 2, 2022. https://www2.deloitte.com/us/en/insights/industry/ technology/technology-media-and-telecom predictions/2022/wearabletechnology- healthcare.html
5. Lis J. Smart home forecast 2021. eMarketer. December 21, 2021. Accessed July 2, 2022. https://www.emarketer.com/content/smart-home-forecast-2021

6. Betts D, Giuliani S, Korenda L. Are consumers already living the future of health? Deloitte Insights. August 13, 2020. Accessed July 2, 2022. https:// www2.deloitte.com/us/en/insights/industry/health-care/consumer healthtrends.
7. DeSilva J, Prensky-Pomeranz R, Zweig M, et al. Digital health consumer adoption report 2020. Rock Health. February 26, 2021. Accessed July 2, 2022. https://rockhealth.com/insights/digital-health-consumer-adoption-report 2020/
8. Lindhorst J, Stranz M. Opportunities and trends in digital health. Pharmacy Times®. June 18, 2020. Accessed July 2, 2022. https://www. pharmacytimes.com/view/opportunities-and-trends-in-digital-health
9. Dicker AP, Jim HSL. Intersection of digital health and oncology. JCO Clin Cancer Inform. 2018;2:1-4. doi:10.1200/CCI.18.00070

10. Mooney K, Titchener K, Haaland B, et al. Evaluation of oncology hospital
at home: unplanned health care utilization and costs in the Huntsman at Home real-world trial. J Clin Oncol. 2021;39(23):2586-2593. doi:10.1200/JCO.20.03609

11. IQVIA Institute for Human Data Science. The use of medicines in the US. IQVIA. 2021. Accessed July 2, 2022. https://www.iqvia.com/-/media/ iqvia/pdfs/institute-reports/the-use-of-medicines-in-the-us/iqi-the-use-of medicines-in-the-us-05-21-forweb.pdf
12. Ahmed A, Davis B, Elsner N, Miranda W. Personalized therapies in the future of health. Deloitte Insights. March 4, 2021. Accessed July 2, 2022. https://www2.deloitte.com/us/en/insights/industry/life-sciences/importanceof-
personalized-therapies.html
13. The role of digital drug companions in a digital therapeutics world. Medisafe. Accessed July 2, 2022. https://www.medisafe.com/ the-role-of-digital-drug-companions-in-a-digital-therapeutics-world/

14. Galvin G. COVID-19 accelerated use of digital therapeutics, but coverage issues and regulatory questions could slow their momentum. Morning Consult. June 15, 2021. Accessed July 2, 2022. https://morningconsult.com/2021/06/15/digital-therapeutics-use coveragepolling/#:~:text=About%2035%20to%2040%20digital,56%25%20said%20they%20are%20accurate
15. Landi H. Study: healthcare lags other industries in digital transformation, customer engagement tech. Healthcare Innovation. March 30, 2018. Accessed July 2, 2022. https://www.hcinnovationgroup.com/population-health management/news/13030021/study-healthcare-lags-other-industries-in-digital-transformation-customer-engagementtech

About the Author
Justin Lindhorst, MBA, is marketing director/regional care coordinator at BioMatrix Specialty Pharmacy in Plantation, Florida.