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Introducing Specialty Care Close to Home | TWIRx · Pharmacy Podcast Network

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Speaker 1: You are listening to the global network of podcasters dedicated
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Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
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Speaker 2: Specialty pharmacy is becoming one of the most important access
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Speaker 2: points in modern healthcare, especially for patients managing complex, chronic, rare,
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Speaker 2: and high cost conditions. As therapies advance and patient needs
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Speaker 2: become more sophisticated, health systems are rethinking how specialty pharmacy
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Speaker 2: can improve access, continuity of care, clinical outcomes, affordability, and
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Speaker 2: the overall patient experience. Specialty Care Close to Home is
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Speaker 2: a new Torque special series from the Pharmacy Podcast Network
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Speaker 2: examining how hospitals and health systems are building, supporting, and
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Speaker 2: scaling specialty pharmacy services within both health system and community
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Speaker 2: based care models. The special This Week in Pharmacy episode
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Speaker 2: features doctor Laura Mark, vice president of Pharmacy at Alleghany
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Speaker 2: Health Network, Alison Arran, senior vice president with clear Way Health,
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Speaker 2: and Chris Corsi, CEO of Cassie and RX. Together, they
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Speaker 2: will explore why health system specialty pharmacy expansion matters, what
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Speaker 2: makes these programs successful, where the greatest operational and strategic
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Speaker 2: challenges exist, and how collaboration can improve patient access and
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Speaker 2: therapy management. Future episodes will examine accreditation, payer access, manufacturer relationships,
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Speaker 2: patient engagement, clinical workflow, technology, data reporting, community access, and
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Speaker 2: long term sustainability, while inviting pharmacy leaders from health systems
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Speaker 2: across the country to share how they are delivering specialty
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Speaker 2: care closer to Home.
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Speaker 3: Hey, welcome to the Specialty Care Close to Home, a
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Speaker 3: special This Week in Pharmacy series from the Pharmacy Podcast Network.
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Speaker 3: I'm the founder of the Pharmacy Podcast Network in two
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Speaker 3: thousand and nine, releasing the first episode about our profession,
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Speaker 3: the first podcast about our profession, digging into the mind
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Speaker 3: share of so many of you who have over seventeen
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Speaker 3: years giving me so much information that we've shared, and
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Speaker 3: it's led us to sectors of pharmacy that need more
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Speaker 3: attention and need more dialogue. And today we're exploring how
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Speaker 3: health systems are expanding specialty pharmacy services to improve access,
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Speaker 3: strength and continuity of care, supporting better therapy outcomes, and
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Speaker 3: building trust models of pharmacy excellence inside the communities they serve.
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Speaker 3: And when you put that on top of what complexities
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Speaker 3: there are in specialty and the stress that is placed
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Speaker 3: on the patient, the patient's family, the care team, the insurances.
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Speaker 3: We have something to really open up and talk about today.
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Speaker 3: I'm so excited about our panel of experts who really
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Speaker 3: know they have hearts that are all about specialty pharmacy.
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Speaker 3: I want to introduce doctor Laura Mark. I would like
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Speaker 3: to bring doctor Mark and a fellow pittsburgher and just
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Speaker 3: welcome you to the series.
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Speaker 4: Thanks for inviting me and so happy to be here
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Speaker 4: with this panel. Laura Mark, I'm vice president of pharmacy
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Speaker 4: Alleghany Health Network in servicing Western PA. We're very excited
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Speaker 4: about the specialty pharmacy growth that we've had and being
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Speaker 4: able to really be an extension and of the care
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Speaker 4: team for our providers and then servicing our patients in
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Speaker 4: Western PA.
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Speaker 3: So thank you, thank you for being here, Laura. We
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Speaker 3: are excited about Alison Arant here. She's the senior vice
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Speaker 3: president for Clearway Health. Very excited that you're part of this.
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Speaker 3: Very excited to have you here, Alison, because you've already
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Speaker 3: taught me that there is gaps in many attempts and
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Speaker 3: efforts to build out profitable and sustainable especially pharmacies throughout
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Speaker 3: the nation and our health systems. Yeah, I introduce yourself
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Speaker 3: to the listeners. Let us know more about you.
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Speaker 5: Todd.
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Speaker 6: Thanks, it's great to be here with Chris and Laura.
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Speaker 6: I'm excited to be a part of the series. I
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Speaker 6: am Alison Arian. I am senior vice president at Clearway
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Speaker 6: Health and lead growth for our organization.
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Speaker 7: And primarily what that means is we are building.
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Speaker 6: New client partnerships with hospitals and health systems across the country.
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Speaker 6: And Todd, you talked about understanding the gaps. No matter
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Speaker 6: how hard some hospitals try to build these specialty pharmacy
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Speaker 6: programs because they are wildly complex and an incredibly changing
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Speaker 6: landscape with disparate technologies and fights happening between different organizations
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Speaker 6: all around them, and it is incredibly hard, and we
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Speaker 6: try to quiet that noise and find ways to focus
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Speaker 6: on helping hospitals build sustainable, successful specialty pharmacy programs. And
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Speaker 6: so Clearweight Health is owned by Boston Medical Center Health
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Speaker 6: System and for more than a decade, Boston Medical Center
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Speaker 6: has been providing specialty pharmacy services to incredibly underserved patients
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Speaker 6: on their side of Boston, and we have become an
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Speaker 6: extension of that legacy in the ways that we partner.
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Speaker 7: With hospitals and health systems.
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Speaker 6: So truly understanding because we've lived it the experience of
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Speaker 6: navigating how hard it is to build a program that
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Speaker 6: serves patients and then is a good steward of the
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Speaker 6: dollars of the three forty B program and then reinvest
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Speaker 6: them back into the community and the ways that they're
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Speaker 6: able to.
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Speaker 7: Serve their patients.
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Speaker 6: Really excited about the concept of specialty care close to home.
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Speaker 6: Clear Way Help believes that a hospital is the very
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Speaker 6: best provider of pharmacy services to patients, and so there
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Speaker 6: are a lot of different players in this landscape that
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Speaker 6: all have incredibly important roles, but the one that the
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Speaker 6: hospital or health system should play is serving their patient
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Speaker 6: and providing fulfillment and specialty pharmacy services to their patients.
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Speaker 6: So really excited to get to have this conversation and
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Speaker 6: thanks again.
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Speaker 5: For having me.
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Speaker 3: Thank you for being here, Alison. This is exciting and
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Speaker 3: to have those resources that you'll be able to bring
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Speaker 3: to the series is also exciting. Chris Corsi, CEO of
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Speaker 3: Cassie and RX. The technology that's mi nerdyness coming out,
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Speaker 3: because that's how I entered pharmacies was the technology systems
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Speaker 3: that we're helping to run our pharmacies. Chris, introduce yourself
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Speaker 3: to our listeners.
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Speaker 8: Thanks Tod. I'm excited to be here with this great
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Speaker 8: group that we have. Chris Corsi, CEO of Cassie and RX.
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Speaker 8: I actually started at Cassian as well about a decade ago,
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Speaker 8: and our mission was pretty simple and still is pretty simple,
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Speaker 8: to really take some of that weight off of the
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Speaker 8: specialty patients and their families.
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Speaker 5: And we believe technology can do so much of that.
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Speaker 8: What we've learned over that last decade is really that
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Speaker 8: specialty pharmacy was never built to work as one full
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Speaker 8: connected system with all those different stakeholders and patients, and
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Speaker 8: those care teams really end up getting stuck in the gaps, right.
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Speaker 8: You think about all those times where we hear about delays,
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Speaker 8: patients that didn't end up getting their refill, all those
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Speaker 8: different problems that occur. So really, at Cassian we support
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Speaker 8: a wide cross section of this industry, not only those
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Speaker 8: integrated delivery networks and health systems that we're talking about,
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Speaker 8: but also independent pharmacies help service providers and vertically aligned
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Speaker 8: pharmacies as well.
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Speaker 5: So I'm excited to be here with the group.
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Speaker 8: Talk a little bit about technology and how we can
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Speaker 8: help those patients and their caregivers have success with those treatments.
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Speaker 3: Chris can't wait nerd out with you and get into
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Speaker 3: the bits and the bites. So this is important to
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Speaker 3: have you as a part of this series. All right,
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Speaker 3: So listeners, you are in the trenches. You know what's
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Speaker 3: going on. Our pharmacy technicians are pharmacists, people in administration
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Speaker 3: these enormous hospital systems and the complexities that are part
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Speaker 3: of that. And the extra element that health system pharmacies
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Speaker 3: are facing in comparison to maybe a community pharmacy or
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Speaker 3: a more controllable long term care pharmacy, or even specially
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Speaker 3: pharmacy that isn't part of a health system per se,
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Speaker 3: and that is the stress. You think about the families,
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Speaker 3: you think about the patients that come to a hospital,
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Speaker 3: what eight out of ten times, I'm just throwing numbers out,
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Speaker 3: but there's probably something happening in their lives that's disastrous,
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Speaker 3: that's a horrible experience. The height and elevation of stress.
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Speaker 3: It's a whole other element that we're going to kind
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Speaker 3: of pour into. We're going to be in vitating a
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Speaker 3: psychologist to our series to really talk about the impact
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Speaker 3: of sickness and having to deal with sickness and where
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Speaker 3: specialty kind of is an extra special place for pharmacists
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Speaker 3: to fill in care gaps and health systems are uniquely
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Speaker 3: positioned to integrate our specialty pharmacies into that broader care
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Speaker 3: journey and creating a safe place with education and handholding
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Speaker 3: through every one of these processes. My first question, I
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Speaker 3: really want to open up to, Laura, because you're the
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Speaker 3: one that is experiencing so many sides of all of
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Speaker 3: this in the complexity, and we could tell a whole
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Speaker 3: other story about alleg any Health network and talk about
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Speaker 3: bringing hospitals all together, and it'll be another podcast. But today,
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Speaker 3: especially if pharmacy has become one of those most important
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Speaker 3: areas of modern pharmacy care, people know that there's a
10:01
Speaker 3: difference now they're being educated. Sometimes they don't, but there's
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Speaker 3: very intelligent consumers out there. From your perspective, Laura, why
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Speaker 3: is now such a critical time for health systems to
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Speaker 3: invest in specially pharmacy services.
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Speaker 4: Well, I think Allison said it too that not only
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Speaker 4: is it hard to build these these or wildly complex
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Speaker 4: and hard, but this is wildly complex and hard for
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Speaker 4: patients and providers to figure this out. You know, when
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Speaker 4: we go home, we built a meds to beds program,
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Speaker 4: a discharge prescription program where patients go home with their medications.
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Speaker 4: They go home with their medications, but they might not
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Speaker 4: go home with a specialty medication because that's coming from
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Speaker 4: a mail order or another place where that's where they're
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Speaker 4: preting provided with those medications. So I think it's confusing
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Speaker 4: for patients but also providers, like I send the prescription in,
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Speaker 4: when do I get it? When while I hear from somebody,
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Speaker 4: I can't necessarily from a patient perspective, go up and
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Speaker 4: walk and talk.
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Speaker 9: To somebody like I would normally prescription.
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Speaker 4: So I think that's where it's really complex for patients
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Speaker 4: and providers. By being in a health system, it really
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Speaker 4: does help by we're having pharmacists talk to those patients,
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Speaker 4: we're calling and doing a follow up right after their
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Speaker 4: discharge to as well when we get those prescriptions.
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Speaker 9: So there's a connection.
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Speaker 4: We just have to make that connection differently for our
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Speaker 4: patient and providers.
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Speaker 9: Luckily for us too.
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Speaker 4: With our providers and our patients is that our pharmacy
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Speaker 4: are interconnected with our electronic health record, so providers will
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Speaker 4: see any time and point where that prescription is in
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Speaker 4: the process, they can see that. But then patients also
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Speaker 4: have that access through like my chart or messages that
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Speaker 4: we can connect with them, so it's all in one
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Speaker 4: place for them. So making it easier for patients and
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Speaker 4: provider is really what our objective is, Laura.
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Speaker 6: I think one of the things you said about making
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Speaker 6: it easy is so interesting. I years and years ago
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Speaker 6: worked for another organization that was owned by a health
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Speaker 6: system and they went through a major rebrand and one
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Speaker 6: of the big focuses in taglines was easy for me.
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Speaker 7: But easy for me did not.
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Speaker 6: Mean Allison or the other people who worked there. It
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Speaker 6: meant easy for me the patient to make sure that
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Speaker 6: they had the most successible way to receive care. And
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Speaker 6: so your points about connecting technology and then education is
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Speaker 6: so important. We spend so much of our time with
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Speaker 6: our hospital and health system clients talking about two pathways
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Speaker 6: for education patients and providers. Providers are very used to
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Speaker 6: dropping down to the preferred pharmacy that the patient has
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Speaker 6: gone to forever and ever in the EHR and then.
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Speaker 7: Sending a script that.
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Speaker 6: Ultimately that pharmacy on the corner really probably can't fill
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Speaker 6: because it's a special that has all of these other
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Speaker 6: complexities required, and so having the conversation that's really about
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Speaker 6: change management to help them understand there is an option
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Speaker 6: within the.
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Speaker 7: Four walls of the health system. Here is how we
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Speaker 7: can help you.
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Speaker 6: Not only do we have the technology connectivity, but we
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Speaker 6: also have the people to help you navigate it.
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Speaker 7: So we're providing, like.
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Speaker 6: You have the pharmacists, the liaisons inside of the clinics
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Speaker 6: who are really intercepting all of the things that are
13:28
Speaker 6: kind of getting pitched over to the wrong place to say, hey,
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Speaker 6: next time, if you have this prescription, here's how you
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Speaker 6: can help educate your patient on the right to choose
13:38
Speaker 6: to have it built here in a place where they're
13:40
Speaker 6: already comfortable and confident receiving care. For the patients, we've
13:45
Speaker 6: talked even in this group about the hard parts of
13:48
Speaker 6: becoming so largely virtual and remote that patients are losing
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Speaker 6: that personal connection in touch, and so the people that
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Speaker 6: we're putting in touch with them, the liaisons and the pharmacist,
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Speaker 6: are really they're navigators in this really hard specialty pharmacy process.
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Speaker 7: And so it's that connection point of education and change
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Speaker 7: management that I think.
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Speaker 6: Is so important, and it gets back to Todd's question,
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Speaker 6: which is why why are hospitals looking to do this
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Speaker 6: work now? And I think oftentimes people find themselves in
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Speaker 6: this hard place between is it too late? But also
14:22
Speaker 6: we have to start now because the longer wait, the
14:25
Speaker 6: more compounding loss you have in the ability to drive
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Speaker 6: some pretty sustainable financial resources back into the organization.
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Speaker 8: Yeah, and going off of that, Laura, even just from
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Speaker 8: a technology standpoint and visibility standpoint, a lot of those
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Speaker 8: patients end up getting lost and don't even know what's
14:42
Speaker 8: going on with their script for you know, it could
14:44
Speaker 8: be weeks, it could be maybe a month at a
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Speaker 8: certain point, right, So giving them that visibility into where
14:50
Speaker 8: they at, what actually is a PA, what is required
14:53
Speaker 8: to get your insurance and payer to cover this medication,
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Speaker 8: and giving them that visibility from the beginning of when
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Speaker 8: that's script is written all the way through when it
15:01
Speaker 8: actually gets filled. We've ran countless programs for countless entities
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Speaker 8: trying to give those patients that increase visibility and support
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Speaker 8: line right to be able to call in or even
15:11
Speaker 8: just get a status update by texting into the web
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Speaker 8: application that is supporting their pharmacy to get a status
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Speaker 8: update on where their medication is at, if there's any
15:20
Speaker 8: actual activities that need to be completed on the patient
15:23
Speaker 8: side or even the physician side, so they could reach
15:25
Speaker 8: out to the physician to help move that script along.
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Speaker 8: So from a technology standpoint, I think that there's so
15:30
Speaker 8: much that now in twenty twenties, we're able to support
15:34
Speaker 8: a patient so much more than we were maybe in
15:36
Speaker 8: the twenty tens with what's available from a technology standpoint.
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Speaker 4: Awesome, Allison, I think you make a great point too,
15:44
Speaker 4: and Chris making it easy for me.
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Speaker 9: And Chris brought up the prior authorization piece.
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Speaker 4: That piece alone, people are confused about what do you
15:55
Speaker 4: mean I have to wait for a couple of days.
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Speaker 9: What does that mean? Like, am I going to get it?
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Speaker 9: What if I'm not a proved So I think.
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Speaker 4: That that piece is really from an education you know,
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Speaker 4: we we want to make sure that we close that
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Speaker 4: gap for them and there's some assurance that we do
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Speaker 4: reach out to them to say we're working on this
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Speaker 4: and we're processing this, so they have that you know,
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Speaker 4: it's coming in the next twenty four hours forty eight hours. However,
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Speaker 4: we can get that prior authorization quickly for them too
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Speaker 4: as well.
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Speaker 8: Yeah, and Laura, I joke when I say this sometimes,
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Speaker 8: but I always compare a you know, starting something very
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Speaker 8: serious right, like oncology medication or an MS or automune medication.
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Speaker 8: It's very serious medication to someone walking into a restaurant
16:38
Speaker 8: the first time. If you walk into the restaurant and
16:40
Speaker 8: you see a rat running around and the floor is
16:43
Speaker 8: dirty and it's just gross, like you want to walk out.
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Speaker 8: I don't want to, I don't want to do this right,
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Speaker 8: But same kind of experience if I start and I'm
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Speaker 8: getting no attention, I'm not covered.
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Speaker 5: It's taking a long time.
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Speaker 8: Like from from a compliance adherence perspective of that patiently
17:00
Speaker 8: going to want to stick on that drug because they
17:02
Speaker 8: just had such a bad start, right, and giving them
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Speaker 8: an increase visibility, helping them understand and educate them on
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Speaker 8: what the process is is a lot of the work.
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Speaker 5: To make sure that patient has a good outcome long term.
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Speaker 8: And I think in community pharmacy and the integrated delivery networks,
17:16
Speaker 8: they do such a great job of helping educate that
17:18
Speaker 8: patient right they're there in person, they're walking them through
17:22
Speaker 8: that they're having that high touch of care that maybe
17:25
Speaker 8: at you know, some other pharmacy settings you're not getting.
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Speaker 8: So I think that they're playing a really good role
17:29
Speaker 8: in helping improve some of those outcomes and adherence as well.
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Speaker 7: Chris, I agree.
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Speaker 6: I think the patient satisfaction part is hugely important to
17:38
Speaker 6: make sure you have the VP customers you know, so
17:41
Speaker 6: to speak in the commercial space. And Laura, your point
17:44
Speaker 6: about prior authorizations in turnaround is so so well received
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Speaker 6: and understood because you know, Chris ended with, and it
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Speaker 6: drives the adherence in the outcomes. You have to have
17:55
Speaker 6: patients who want to come back. If you think about
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Speaker 6: how hard it is to educate it patient on their
18:00
Speaker 6: right to choose to change the pharmacy that they have
18:03
Speaker 6: been using for a very long time. That takes sometimes
18:06
Speaker 6: a significant amount of work. If you get that first
18:10
Speaker 6: bill but you don't get the refill, you have lost
18:13
Speaker 6: so much momentum and.
18:14
Speaker 7: You're starting all over again.
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Speaker 6: So it's not just patient acquisition, it's patient retention and
18:20
Speaker 6: making sure that you're navigating and using all of the
18:23
Speaker 6: services you possibly can to ensure that they're receiving high
18:26
Speaker 6: quality care. They want to choose to fill their refill
18:29
Speaker 6: again at that hospital, pharmacy. The other side of it, though,
18:33
Speaker 6: is time to met in hand, and that gets Laura
18:36
Speaker 6: to the PA turnaround piece where you know, sometimes industry
18:39
Speaker 6: averages are well above seven days. We have had many
18:43
Speaker 6: partners who were in the twenty and thirty day turnaround,
18:46
Speaker 6: depending on which specialty met and the complexity that it required.
18:51
Speaker 6: I am really proud to say that we consistently deliver
18:55
Speaker 6: under two days, often under one for those prior offs
18:59
Speaker 6: and it was no one's fault that it was taking
19:02
Speaker 6: so long the first time, because it is so hard.
19:04
Speaker 6: You have nurses in mas who are running ragged ensuring
19:08
Speaker 6: that their patient service eving the best care.
19:10
Speaker 7: They don't have.
19:11
Speaker 6: Time to sit on hold with insurance companies for days
19:14
Speaker 6: and days on end after denial after denial after denial,
19:18
Speaker 6: and so knowing how to navigate that process is so
19:20
Speaker 6: important so that we can make sure that that prior
19:23
Speaker 6: off comes around quickly, the patient has their ned and
19:26
Speaker 6: they're starting the therapy that they need as quickly as
19:29
Speaker 6: they possibly can.
19:31
Speaker 4: And Alison, I think you brought up a good point
19:33
Speaker 4: about customer service and even how we're hiring into these
19:37
Speaker 4: positions to support specialty pharmacy or our technicians and our pharmacies,
19:41
Speaker 4: the customer service piece, and that empathy is so important.
19:46
Speaker 4: They have to be a unique sort of individual that
19:49
Speaker 4: can manage that sort of fear. But I'm going to
19:53
Speaker 4: have you want to make it easier for you for
19:54
Speaker 4: the patient, but then also on the back end understanding
19:58
Speaker 4: from a prior authorization and all of that pieces to
20:02
Speaker 4: work through that take that prescription from the electronic health
20:06
Speaker 4: record and really following it through the whole way. So
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Speaker 4: I think that that is a really unique.
20:12
Speaker 9: Individual that we really seek to hire two as well.
20:16
Speaker 5: Odd we could probably talk for another five hours on this.
20:20
Speaker 3: Yes, all right, So I have a question for Alison,
20:26
Speaker 3: and it's really around operations. I want to let the
20:30
Speaker 3: listeners know we are going to be breaking up this
20:34
Speaker 3: series into very specific subjects. We're going to be talking
20:39
Speaker 3: about operations, technology, operations, and workflow. Actually we're going together
20:46
Speaker 3: re embarrassment, insurance issues, fundraising three point forty B. But
20:52
Speaker 3: in opening, in kind of this intro episode, Alison, and
20:58
Speaker 3: you're the one that actually to to come clean to
21:02
Speaker 3: the listeners. It's Alison that got me thinking that this
21:06
Speaker 3: was a necessary series. I searched for operational demystifying of
21:13
Speaker 3: what's happening in our health system. Hospital pharmacies out there
21:16
Speaker 3: could find zero topics talking about it. So I want
21:20
Speaker 3: to thank Allison for getting me to think about the
21:22
Speaker 3: series overall, but just operational realities. Let's focus on that
21:27
Speaker 3: for just a second, and that is how do you
21:31
Speaker 3: how do you get health systems to really understand what
21:34
Speaker 3: they're wanting to do. Laura runs this well oiled machine
21:41
Speaker 3: serving the patient population in that building, on that premise,
21:45
Speaker 3: on that campus, and the technicians and the pharmacists that
21:49
Speaker 3: are serving the nurses, and the nurses that are coordinating
21:52
Speaker 3: with the physicians and the bedside delivery and the whole
21:55
Speaker 3: thing in the robots sometimes that are going down the hallways,
21:59
Speaker 3: that is, that is the SOPs of that whole operation.
22:02
Speaker 3: Pretty hey, we got it, we know exactly what's going on. Now.
22:06
Speaker 3: You inject specialty pharmacy into that operations like, that's not
22:10
Speaker 3: the same animal of serving the internal per se of
22:15
Speaker 3: what happens when you say, okay, it's time to go
22:18
Speaker 3: to specialty. So what are the operational realities that should
22:21
Speaker 3: that the other health system leaders really need to understand.
22:25
Speaker 6: I'll start by saying, organizations like alig Any Health Network
22:30
Speaker 6: are so fortunate to have people.
22:31
Speaker 7: Like Laura Mark doing this work because having.
22:34
Speaker 6: People who have experience an exclusive focus on pharmacy and
22:39
Speaker 6: specialty pharmacy in the outpatient care setting is just so
22:42
Speaker 6: important for the success of a program like this, and
22:46
Speaker 6: for organizations that don't have a Laura Mark, it is
22:49
Speaker 6: it is hard, and that's why we have the partnerships
22:53
Speaker 6: that we have with health systems across the country. Pharmacy
22:57
Speaker 6: for a very long time has been so inpatient focused,
23:00
Speaker 6: and so even when it started looking at an outpatient
23:03
Speaker 6: care setting, specialty was still a straggler and still is
23:07
Speaker 6: for many hospitals across the nation. So operationally, there is
23:11
Speaker 6: so much that you have to consider first. If you
23:13
Speaker 6: have it yet, you are shifting the concept of an
23:16
Speaker 6: inpatient service line to an outpatient service line for the
23:19
Speaker 6: first time.
23:20
Speaker 7: There is a.
23:21
Speaker 6: Significant financial shift when the mindset goes from a cost
23:25
Speaker 6: center to a margin generator, because when you think about
23:29
Speaker 6: specialty pharmacy, especially in a three P fourty B environment,
23:33
Speaker 6: you are now looking at ways to provide what I
23:37
Speaker 6: think is an incredibly hard trifecta to find. You are
23:40
Speaker 6: now delivering clinical, financial and operational value in one single
23:46
Speaker 6: service line, tell me what other service line does that
23:49
Speaker 6: in the way the specialty pharmacy does. So when hospitals
23:53
Speaker 6: start this journey, there are so many different operational components
23:56
Speaker 6: to consider.
23:57
Speaker 7: I'll start with data.
23:59
Speaker 6: Every every engagement starts with understanding the data, which is
24:03
Speaker 6: the prescribing patterns of the providers who are writing specialty
24:07
Speaker 6: pharmacy prescriptions for patients being cared for by that help system.
24:11
Speaker 7: The data is there, but being.
24:14
Speaker 6: Able to analyze it to understand the value of the
24:16
Speaker 6: specialty pharmacy service is really hard. It's hard because even
24:21
Speaker 6: if you understand your total market, it doesn't mean that
24:24
Speaker 6: you're going to have access to it right away, and
24:27
Speaker 6: so that gets into the other operational challenges, things like
24:30
Speaker 6: what accreditations will be required for the pharmacy. How do
24:35
Speaker 6: I gain access to the limited distribution drugs or ldds.
24:38
Speaker 7: That I need?
24:40
Speaker 6: How do I partner with the manufacturers to make sure
24:43
Speaker 6: that I get the drugs one formulary that I need
24:46
Speaker 6: for the hospital? How do I navigate three P forty
24:49
Speaker 6: B optimization and pressures in a compliant way that demonstrate
24:53
Speaker 6: how we're being investing those dollars back into the community.
24:57
Speaker 7: And that's all to.
24:59
Speaker 6: Suggest that you have a pharmacy to start doing the work.
25:01
Speaker 6: If you don't, we have to build one. So how
25:04
Speaker 6: do we find space to build the pharmacy. You can
25:07
Speaker 6: think about things like eligibility and managing the HOPD versus
25:11
Speaker 6: the clinics. You have three P FORTYV eligibility, you're balancing
25:15
Speaker 6: things like Medicare cost reports. It is so hard and
25:18
Speaker 6: it is so much, and so when you ask about
25:21
Speaker 6: the operational considerations, it's really tough. Clear My Health really
25:26
Speaker 6: breaks it into two buckets. We first start with how
25:29
Speaker 6: do we grow the program and accelerate the capture and
25:33
Speaker 6: the ways that we're serving patients and sitting alongside the.
25:36
Speaker 7: Providers and the care team to do the work.
25:38
Speaker 6: The second bucket is the management of dispensing and operating
25:42
Speaker 6: the pharmacy, and you have to have both.
25:44
Speaker 7: And so ultimately, as we.
25:46
Speaker 6: Get into more and more conversations about the operations of
25:49
Speaker 6: specialty pharmacy programs, the most exciting and complex thing is
25:55
Speaker 6: ensuring that you have so many multi parallel paths of
25:58
Speaker 6: growth that you can juggle all at once, Because if
26:02
Speaker 6: you wait and do one and then the next and
26:04
Speaker 6: then the next you're limiting your ability to grow and
26:07
Speaker 6: serve patients and drive you know that trifecta of clinical, financial,
26:11
Speaker 6: and operational outcomes.
26:13
Speaker 3: Operational outcomes, Chris, we can't have any of that if
26:18
Speaker 3: we don't have technology in place in order to keep
26:22
Speaker 3: up with a unique workflow. Tie into the EHR systems
26:28
Speaker 3: getting ready for the advent of more artificial intelligence that's
26:34
Speaker 3: now playing into the the decision making of insurance claims
26:40
Speaker 3: and battling that on the other side of the hospital system,
26:46
Speaker 3: that's that's fighting for their patient. So let's talk about technology. Well,
26:52
Speaker 3: what technology gaps slow down the specialty pharmacy programs.
26:59
Speaker 5: Yeah, that's a one, Todd.
27:00
Speaker 8: I mean, looking at it from operations, right, typically you
27:04
Speaker 8: have a lot of fragmented systems. Right, You're usually going
27:07
Speaker 8: to have your PMS, You're going to have probably your
27:11
Speaker 8: EHR if you're a health system. In some cases you
27:15
Speaker 8: might even have a clinical management platform as well. So
27:18
Speaker 8: in many cases there could be other supporting platforms too,
27:21
Speaker 8: like Digital Patient Engagement bold ons prior to the bold
27:26
Speaker 8: ons as well. I mean I've seen some pharmacies have
27:29
Speaker 8: a streamline of six, seven, eight different vendors from a
27:33
Speaker 8: technology perspective, when you start thinking about like telephony and
27:36
Speaker 8: things of that nature, right, pulling all those different systems together,
27:40
Speaker 8: and then I like to say, orchestrating it. Right, it's
27:43
Speaker 8: kind of like a dance. How do you make all
27:45
Speaker 8: of this work for that one patient's journey to end
27:49
Speaker 8: seamlessly without them knowing, Hey, it's actually ten different fragmented
27:54
Speaker 8: systems and five different people in the back end supporting
27:58
Speaker 8: this to make sure that this all goes through and
28:00
Speaker 8: you end up getting your medication on the other side
28:02
Speaker 8: and hopefully what is less than a few days, right,
28:06
Speaker 8: So technology plays a really big role, and what we've
28:09
Speaker 8: seen is is really trying to consolidate a lot of
28:11
Speaker 8: those different platforms down and have one orchestration platform that
28:18
Speaker 8: control sort of everything that goes.
28:20
Speaker 5: Along along the journey.
28:22
Speaker 8: So as opposed to having you know, a lot of
28:25
Speaker 8: different point solutions trying to integrate them together. Really, if
28:28
Speaker 8: you can have an integration layer or an organistration layer
28:31
Speaker 8: that pulls those point solutions together to work in tandem
28:35
Speaker 8: to drive the workflow autonomously, whether you're driving that with
28:39
Speaker 8: AI agents in some cases we've seen pharmacies starting the
28:42
Speaker 8: leverage now, or you know, just manual automation logic based
28:46
Speaker 8: of Hey, I've triggered this and I'm moving into the
28:49
Speaker 8: next status of the workflow. I mean, technology continues to
28:53
Speaker 8: evolve and continues to accelerate. Some of the cooler things
28:56
Speaker 8: I've seen on the technology for front from an operation
28:59
Speaker 8: side when we get in especially in the AI topic
29:03
Speaker 8: and maybe Alison or Lara, I've seen some of this too,
29:06
Speaker 8: but agentic voice voice spots where people are actually calling
29:10
Speaker 8: in processing a refill with that voice.
29:14
Speaker 5: Agent, and we've done a decent amount of that.
29:16
Speaker 8: Type of work at CASSI and with some of our
29:18
Speaker 8: partner pharmacies, or whether that's just making simple updates over
29:22
Speaker 8: the phone as well to their profile metallergies, those types
29:25
Speaker 8: of profile updates as well. Some other really cool things
29:30
Speaker 8: with agents we've seen is building out specialized agents for
29:32
Speaker 8: different aspects of the care journey. Whether that's focused on
29:36
Speaker 8: just like the prior ofth and benefits aspect of it,
29:39
Speaker 8: or whether that's focused on processing that patient through the
29:44
Speaker 8: different clinical assessments, clinical interventions and driving those to the
29:50
Speaker 8: top and forefront to make sure that we're you know,
29:52
Speaker 8: risk stratifying those patients appropriately targeting those patients to make
29:55
Speaker 8: sure that they're getting.
29:56
Speaker 5: That high quality of care that they need.
29:58
Speaker 8: So AI is really, I think, paying a really big
30:00
Speaker 8: role in the future of pharmacy. I think it's going
30:03
Speaker 8: to help us identify where operations should go, where those
30:07
Speaker 8: patients that are struggling, where things getting held up in
30:11
Speaker 8: the queue, and how do we help drive that better
30:13
Speaker 8: outcome and better quality of life patient satisfaction for those patients.
30:20
Speaker 6: Chris, you talk about the technology elements in the patient
30:25
Speaker 6: engagement parts of it, and I think that is such
30:29
Speaker 6: an important part of where pharmacy is going. And it's
30:32
Speaker 6: almost like pharmacies catching up to where healthcare has been
30:35
Speaker 6: a little bit for a while related to patient engagement
30:38
Speaker 6: and consumerism.
30:39
Speaker 5: I would even go, well, there you go.
30:41
Speaker 8: I was going to even say consumerism and just commercial applications.
30:45
Speaker 8: Right at a certain point, healthcare, I feel like man
30:49
Speaker 8: was two decades behind. Maybe it's getting closer to five
30:53
Speaker 8: years behind now, you see it right with I mean,
30:57
Speaker 8: we even support a lot of direct to employer programs
31:00
Speaker 8: and direct to patient programs with some of our farmer partners,
31:04
Speaker 8: and through that, I mean you're just seeing like the
31:07
Speaker 8: push for higher quality patient applications higher quality user interfaces,
31:12
Speaker 8: understanding how this actually works, and helping that patient navigate it,
31:16
Speaker 8: whereas before it was like, hey, here's a message, click
31:19
Speaker 8: in and pretty much it's a dead end, right, and
31:21
Speaker 8: it's like call pharmacy, man. Why did I even click
31:23
Speaker 8: into the application in the beginning to go into my
31:26
Speaker 8: chart to say call pharmacy great?
31:27
Speaker 5: I could have just picked up the phone anyway.
31:29
Speaker 8: So I think some of that change on the pharmacide
31:32
Speaker 8: is also help accelerating that for some of those vertically
31:35
Speaker 8: aligned pharmacies and some of those independent pharmacies, and even
31:38
Speaker 8: just from a technology perspective as well, just all of
31:41
Speaker 8: those different synergies that we're getting. It's really helping us, say,
31:44
Speaker 8: elevate everyone, right, We're kind of raising the sea across
31:46
Speaker 8: the board as opposed to certain pockets of it.
31:49
Speaker 7: Yeah, I agree Chris completely.
31:52
Speaker 6: I also think it's interesting when you start the connectivity
31:55
Speaker 6: of things like the patient engagement to consumerism to other
31:59
Speaker 6: growth strategies within health systems, because when you have engaged
32:03
Speaker 6: patients who are receiving a service in a very consumeristic way,
32:08
Speaker 6: then you start to think about capture and reducing leakage,
32:12
Speaker 6: and there is not a single conversation that I have
32:15
Speaker 6: with a hospital or health system where the word capture
32:19
Speaker 6: or leakage or retention or market share does.
32:22
Speaker 3: Not come up.
32:24
Speaker 6: But often I think retention and leakage is looked at
32:28
Speaker 6: as more of an ambulatory concept and where patients are
32:31
Speaker 6: choosing to go to receive their ambulatory care. But not
32:35
Speaker 6: often does pharmacy come up in that same conversation. And
32:38
Speaker 6: so when we expand this consumerism outpatient care landscape to
32:44
Speaker 6: include pharmacy, that's where we're going to see some impactful
32:48
Speaker 6: change because.
32:50
Speaker 7: When you talk about leakage.
32:52
Speaker 6: We had a conversation recently with an organization who was
32:55
Speaker 6: looking to increase their capture rate for their outpatient oncology services.
32:59
Speaker 6: Incredible competitive landscape like most hospitals face, and so we said, well,
33:04
Speaker 6: we have people who are talking to your patients every
33:07
Speaker 6: single day. How can we help And so together we
33:10
Speaker 6: put together this plan to say, when we're engaging patients
33:13
Speaker 6: and educating them on their specialty therapy, on their right
33:17
Speaker 6: to choose to have it filled here, let's talk about,
33:21
Speaker 6: you know, keeping them in network in ways that we
33:23
Speaker 6: can connect even to primary here and other parts of
33:25
Speaker 6: the organization that they haven't had before. So there is
33:28
Speaker 6: so much that drives a successful program that then touches
33:33
Speaker 6: so many other parts of the organization.
33:35
Speaker 5: Oh one hundred percent and other aspects of it.
33:38
Speaker 8: That also getting me super excited is when you start
33:40
Speaker 8: pulling in and thinking of the future of medicine and
33:43
Speaker 8: getting into precision medicine. Right, Like, I think it's seventy
33:46
Speaker 8: or eighty percent of medications now in the FDA pipeline
33:49
Speaker 8: or specialty meds, So that market share is just going
33:52
Speaker 8: to keep growing and eventually you know it's going to
33:55
Speaker 8: be personalized to you, your genome, et cetera. So when
33:59
Speaker 8: you start thinking about out introducing additional data sets on
34:02
Speaker 8: top of just what we're collecting from the pharmacy and
34:05
Speaker 8: then looking long term of like what is that patient's goal?
34:08
Speaker 8: Where do they want to go? Are they trying to
34:09
Speaker 8: make it to their son's wedding? Are they trying to
34:11
Speaker 8: have it? Hey, I'm trying to get to see my
34:13
Speaker 8: grand order that's due in three months. I have a
34:16
Speaker 8: trip coming up, right Where am I trying to go
34:18
Speaker 8: with my life? How do you start pulling in some
34:21
Speaker 8: of those other data elements, whether that's like genomic data,
34:24
Speaker 8: whether that's wearable data and correlating across all of that
34:27
Speaker 8: and kind of also elevating that experience holistically from a
34:31
Speaker 8: data perspective or real world evidence perspective, outcomes perspective, on
34:35
Speaker 8: top of even just hey, you know, capture, retention, leakage,
34:40
Speaker 8: all of those types of metrics that we care to
34:41
Speaker 8: health system but even looking at the outcome and it
34:44
Speaker 8: is that medicine working for the patient and driving them
34:47
Speaker 8: to the goal that they actually have. That's an area
34:50
Speaker 8: that also gets me super excited as you think about
34:52
Speaker 8: the pipeline and think about where medicine's going long term as.
34:54
Speaker 3: Well specialty care close to home. This is a special
35:02
Speaker 3: series from the Pharmacy Podcast Network. Buckle up listeners. We're
35:07
Speaker 3: going to dig into technology, We're going to go deep
35:10
Speaker 3: into operations. We're going to be talking about the financial
35:13
Speaker 3: side of this, building your specialty phar pharmacy from scratch,
35:18
Speaker 3: and we're going to have participation from people that are
35:20
Speaker 3: leading health systems, specially pharmacy throughout the nation. I would
35:25
Speaker 3: like to thank doctor Laura Mark. You're kind of the
35:28
Speaker 3: guinea pig of the opening of this wonderful series that
35:33
Speaker 3: we're so excited but Thank you so much, doctor Laura
35:36
Speaker 3: Mark for being part of this.
35:38
Speaker 9: Thank you, thanks for having me again.
35:41
Speaker 3: Oh Alison, thank you for spawning this entire idea and
35:46
Speaker 3: helping me to think this is important. This is very important,
35:50
Speaker 3: and like I said, there wasn't enough. There's not enough
35:53
Speaker 3: out there talking about specifically the special care, the special
35:57
Speaker 3: implementation that's necessary for our health system, especially pharmacies, to thrive.
36:02
Speaker 3: Thank you so much for being part of this, Allison.
36:05
Speaker 7: Thanks for making space.
36:06
Speaker 6: It's an important topic and a really important conversation.
36:09
Speaker 7: Thanks for having me.
36:11
Speaker 3: Chris Corsi with Cassie and RX, thank you so much
36:14
Speaker 3: for being part of this. We're going to be bringing
36:16
Speaker 3: you back for lots of tech talk and digging much
36:19
Speaker 3: deeper into the AI component of this. We have lots
36:23
Speaker 3: of questions and the listeners are very curious. Thank you
36:27
Speaker 3: so much for being part of this.
36:29
Speaker 8: Yeah, Tod excited to continue to talk about technology and
36:32
Speaker 8: how it's going to reshape the pharmacy world.
36:33
Speaker 5: So thank you.
36:36
Speaker 3: Be sure to subscribe on any of your podcasts favorite
36:40
Speaker 3: podcast platforms, Spotify, Apple, or even on YouTube just to
36:45
Speaker 3: get this information. Send us questions. Don't wait for the
36:48
Speaker 3: remainder of the series. There's going to be multiple parts.
36:51
Speaker 3: This is going to continue throughout twenty twenty six. You
36:54
Speaker 3: will have access to Chris, to Laura and to Alison's
36:59
Speaker 3: link Den profiles. It's going to be in the show notes.
37:03
Speaker 3: And with that, we thank you so much for listening
37:05
Speaker 3: to this Week in Pharmacy and our special episode, our
37:08
Speaker 3: special Specialty Care Close to Home series