How Technology is Changing More Than Just Prehistoric Systems in Specialty Pharmacy

Specialty pharmacies and their patients now require technology systems that are more sophisticated in nature than the basic functions used in the past.

Specialty pharmacy has enormous potential when it comes to technological enhancements. The possibilities are endless, such as replacing archaic systems, managing big data, applying predictive analytics, and engaging digitally with patients and prescribers. Adding more technological solutions to our daily processes can only improve the specialty pharmacy experience.

Internally, the use of technology can help to streamline workflow and eliminate monotonous tasks, giving us more time to spend with patients. Externally, technology can boost our ability to reach patients and providers through multiple platforms and beyond the traditional means of manual phone calls. Behind the scenes, capturing and sorting through mountains of data and tracking trends can help us to evolve into better business models and deliver unique services to patients.

Updating Outdated Systems

Pharmacy in general is notorious for having outdated computer systems and platforms. For decades, pharmacies have gotten by with computer systems and software that only perform the basic functions required: data entry, drug utilization review, prescription verification, and adjudication. However, today’s specialty pharmacies and their patients require systems that are more sophisticated in nature.

In addition to basic pharmacy functions, specialty systems need to be able to handle referral information, medication effects, adverse effects, and contain flexibility that allows for updating dosages, performing drug/disease and risk evaluation and mitigation strategy counseling, and capturing responses to clinical assessments.

Due to the rigid constraints of traditional legacy systems, many specialty pharmacies have been forced to use multiple platforms and applications in day-to-day processes in order to accommodate this. Although each application accomplishes necessary tasks, it results in inefficient workflows that are disjointed and time consuming.

Navigating multiple systems also introduces greater potential for human error and gaps in care. Not to mention, it can also result in duplication of efforts across departments. This is currently a major pain point for specialty pharmacy staff and becomes even more complicated as clinical programs are introduced to manage high-touch therapies.

These antiquated systems will not suffice forever. Customizable workflow and integration of systems is critical to managing complex disease states that require unique monitoring and intervention.

Furthermore, technology can help deliver standardization so that all patients on a given therapy receive the same level of care. If your organization is focused on quality programs and accreditation, creating uniform and streamlined processes that standardize care for every patient is imperative.

As health care moves away from fee-for-service payments and more towards value-based models that are dependent on the quality of care rather than the quantity of interactions, integrated systems will be essential in order to track outcomes. Although there doesn’t seem to be a comprehensive one size fits all pharmacy system yet, today’s specialty pharmacy software vendors are developing solutions that target the precise needs of specialty pharmacy.

These needs include capturing adherence metrics and adverse drug reactions, patient outcomes monitoring, paperless management, inventory tracking, and user-friendly queue-based dashboard and reporting tools. As software platforms allow for further customization and integration, the specialty pharmacy process and the patient experience will improve exponentially.

Adding Automation

In larger organizations, cumbersome workflow processes get a boost from automation. When servicing thousands of patients, bottlenecks that occur due to high volume, rate limiting, and manual processes are amplified.

Some newer systems may incorporate aspects of automation that are systematically built-in, while other more basic systems have the potential to introduce automation at specific points. Adding automation to workflow can result in increased efficiencies and overall accuracy not to mention a reduction in turnaround time to get an order out the door.

Whether the functionality is built in—such as automated faxing/calling or savvier new age technologies such as robotics process automation (RPA) or other artificial intelligence capabilities are introduced to enhance more primitive systems—larger pharmacies can cut down on repetitive, manual, low-value tasks and shift employees to work that requires deeper reasoning.

There is a common misconception and fear that the use of automation will replace humans and ultimately eliminate jobs. However, automation can be used as a beneficial tool and that can actually, “take the robot out of the human.”

For example, RPA is a software application that can carry out systematic, repetitive, and routine tasks more accurately and vigorously than a human. This allows people to focus their work on more strategic tasks that require judgement, critical thinking, decision making, emotional intelligence, and customer or patient interaction.

Health Information Exchange

Nationwide efforts are currently underway to make health information exchange (HIE) possible. According to HealthIT.gov, “Electronic health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically—improving the speed, quality, safety and cost of patient care.”

There are 3 types of HIE: directed exchange, query-based exchange, and consumer mediated exchange. Directed exchange may be used by health care providers to send patient information such as discharge summaries or lab reports quickly and securely to other providers.

Query-based exchange allows providers to search and access patient information, such as lab values and medication lists. Finally, consumer-mediated exchange allows patients to access their own health information and empowers them to track and manage their own health similar to how they would manage an online bank account.

In specialty pharmacy, HIE via electronic communication and provider portals may also help to drive faster speed to therapy. Many specialty medications require additional clinical data such as height and weight, diagnosis codes, and current lab values and immunizations.

HIE would give specialty pharmacists a window into the patient’s overall medical history, which eliminates the need for a portion of manual outreaches and lengthy attempts to obtain additional information or prescription clarifications.

Big Data

The term big data refers to an exorbitant amount of information, either structured or unstructured, that is either too large or too complex for traditional data applications to be able to process. Big data is usually summarized as the three V’s—volume, velocity, and variety, but can also include variability and complexity.

In health care, the scope of big data is quite large and can come from a variety of channels, including electronic health records, wearable devices, smartphone applications, medical and pharmacy claims, and genomics. Over the past several years, the buzz surrounding big data in health care has been on the rise.

The recent surge is being made possible by the increased use of electronic health records. By capturing patient information, medical, and diagnostic history electronically, we can now excavate these data to determine trends in health care that were never before quantifiable.

There is an ongoing shift from data storage and processing towards harnessing data mining to improve patient health and reduce costs.

Predictive Analytics

Predictive analytics is the means by which we can use big data to predict future events and influence patient health. By analyzing historical and current data, a variety of statistical methods can be engaged to use these data to our advantage. Data mining, machine learning, and predictive modeling are some of the techniques that predictive analytics uses to forecast otherwise unknown events.

In order to make the most of predictive analytics in health care, patient level data first needs to be cleansed and normalized to ensure that information is formatted consistently. Next, because these data often come from multiple sources, the data needs to be aggregated and unified at the patient level.

Additionally, it makes sense to track the origin of the data due to the duplication of certain types of information and also because certain types of data sets are better analyzed by algorithms that are designed and trained for those data sets. Patient data also needs to be de-identified in order to comply with HIPAA regulations.

The use of big data analytics can positively benefit specialty pharmacy in three important ways: deliver increased cost savings, enable faster and better decision making, and grant the insight required to analyze trends and gauge needs. By having this information, we can develop effective programs and services to target specific patients and enhance patient outcomes.

Digital Communication

Most of our patients or their caregivers are carrying around smart phones these days. It only makes sense that we evolve with the times in terms of the means by which we engage with our patients.

Although there will always be value in face-to-face interactions and phone calls, digital messaging offers another way for us to stay in contact with our patients. Not only is digital communication a powerful tool, but it can be customized to reach specific patients at critical points in therapy, such as when a particular adverse effect may arise.

Messaging tactics such as these can help provide pertinent information when the patient needs it the most and connect patients with their specialty pharmacy care team if additional support is needed. Digital communication is also the perfect platform for adherence programs. In fact, according to a recent study published in the Journal of Medical Internet Research, text messaging technology helped to increase medication adherence rates by up to 14% in older Medicare patients.

Patients were more likely to respond to refill reminder text messages and request a refill. Mobile applications put specialty pharmacy care literally at patients’ fingertips. Contact is simple, secure, and allows patients to engage with their specialty pharmacy care team when it is most convenient for them.

The Future of Specialty Pharmacy is Now

It is an exciting day and age to work in health care and specialty pharmacy. Right before our eyes, the landscape is changing from primitive to futuristic.

Pharmacy systems don’t have to go extinct to be upgraded. By using technology to augment our processes, we can achieve greater efficiency and free up humans to create a more enriching patient experience.

About the Author

Jacqueline Hanna earned her Bachelor of Science in Biological Sciences from the University of Pittsburgh before earning her Doctor of Pharmacy degree from Duquesne University in 2011. She recently received her Master of Science in Pharmacy Business Administration (MSPBA) program at the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines. Jacqueline has spent the last 4 years working in Specialty Pharmacy, initially as a clinical pharmacist and most recently working on a variety of high-profile Specialty Operations Projects. In her current role, she is able to channel her passion for patient care into innovation and process design while being part of a concerted effort to transform Specialty Operations and improve the patient experience.