Latest / Becker’s Payer Issues Podcast / Integrating Specialty Pharmacy into Electronic Health Record Workflows: Unlocking Enhanced Value

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Integrating Specialty Pharmacy into Electronic Health Record Workflows: Unlocking Enhanced Value · Becker’s Payer Issues Podcast

• 0:00
  Hello, everyone. This is Erica Spicer Mason with
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  Becker's Healthcare.
• 0:04
  Thank you so much for tuning in to
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  the Becker's Healthcare podcast series.
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  So today, we're going to talk about how
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  integrating specialty pharmacy into EHR workflows
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  can support strategic objectives like improving care coordination,
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  patient outcomes, and operational efficiency.
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  And joining me for this discussion is Jim
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  Blondin, the senior director of digital product strategy
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  at Accredo Specialty Pharmacy.
• 0:28
  Jim, welcome to the podcast. Thank you for
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  being here today. Yeah. Thanks, Erica. Glad to
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  be here.
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  Just a little bit about myself. As you
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  mentioned, I'm senior director of digital product at
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  Accredo.
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  I've been with the organization for about twenty
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  years. I originally am a pharmacist,
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  spent a number of years across our,
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  more complex therapies running branch operations,
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  and have been in a variety of roles
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  across operations and strategy over the last several
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  years,
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  most recently in digital product.
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  Our team is ultimately responsible for all of
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  our digital tools,
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  all of the client facing, patient facing, prescriber
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  facing tools,
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  as well as prior off product improvements
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  from a specialty pharmacy perspective.
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  Yeah. Fantastic. Jim, really appreciate the context.
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  Super helpful to know. And so I know
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  that EHRs really are kind of at the
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  center of a lot of conversations in health
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  care, whether that's digital transformation or or administrative
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  burden. You know, e EHRs are oftentimes the
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  center of a lot of initiatives that health
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  systems are deploying right now. But from your
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  perspective, how are health care leaders' expectations
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  changing when it comes to EHR functionality,
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  especially in supporting more complex areas like specialty
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  pharmacy?
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  Yeah. Great great question. Yeah. Yeah. Due to
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  the complexity of the specialty meds, there were
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  a lot of required data elements to support
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  care
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  that go above and beyond the the ERX
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  transaction or standard e prescription.
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  This ultimately results in delays and starts of
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  care because
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  as a pharmacy, you tend to get the
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  prescription,
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  but the supporting documentation isn't always there. So
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  there's a lot of back and forth between
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  the pharmacy and the prescriber to obtain
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  labs,
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  high way procedures,
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  and and ultimately progress notes as well to
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  support the therapy and clinically manage those patients.
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  Between health information exchange connections, direct
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  EHR connections, and other connections to intermediaries,
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  EHR data become in a critical piece of
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  the care continuum,
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  specifically for specialty pharmacy. And by leveraging this
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  data, specialty pharmacy can improve the processing
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  of the prescription, reducing start to,
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  care time, as well as reducing
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  what we call gaps in care for existing
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  patients when they might have a prior auth
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  that is due when their their renewal prescription
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  is ready.
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  And, ultimately,
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  leveraging this data can reduce the prescriber abrasion.
• 2:53
  Yeah. Prescriber abrasion. It's such a good term,
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  Jim, and it's actually something I wanted to
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  go a little bit deeper on here.
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  You know, you mentioned some of the ways
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  that
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  that EHRs can
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  certainly become more more complex when it comes
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  to specialty pharmacy. But
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  what role does EHR integration play in reducing
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  friction across specialty pharmacy workflows, and how does
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  that translate into improved patient and provider experiences?
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  Yeah. Oftentimes, especially meds have many clinical requirements
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  such as weight or indication based dosing,
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  titration based dosing
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  to to make sure the patient's tolerant and
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  response to therapy is correct.
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  Labs and test results are typically needed to
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  support therapy.
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  A lot of times DME or the pumps,
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  orders,
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  ancillary meds, and home nursing orders are all
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  all needed to start therapy.
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  And many of these, are require a form
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  from the prescriber,
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  in in current state.
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  Those forms come in the form of prior
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  auth forms,
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  referral forms,
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  REMS forms,
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  HIPAA consents,
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  patient assistant forms. So there's a variety of
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  documents that pharmacies tend to get.
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  And Surescripts recently cited a study that that
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  says prescribers spend about three hours per week
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  filling out paperwork to get patients started on
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  a specialty med, while their nurses, roughly 50%
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  of those nurses spend about ten additional hours
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  per week on what on top of what
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  the prescriber is doing to get a patient
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  on therapy or get patients on therapy.
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  And many of these fields on the forms
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  are already present,
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  present in the prescriber EMR,
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  And,
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  it's really a duplication of effort from the
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  prescriber perspective as well as the pharmacy
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  if you have access to that record.
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  Therefore,
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  you know, by obtaining access, you can reduce
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  the friction and, again, reduce time to start
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  a therapy and improve clinical management of these
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  patients.
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  Mhmm.
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  Yeah. And I know as health systems are
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  looking at any opportunity
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  that they can to reduce
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  administrative burden for their team. So it sounds
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  like certainly that duplication of forms is a
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  a key area
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  that you've identified.
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  And I know that EHR capabilities,
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  they are expanding. You know, we're seeing,
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  some providers add, you know,
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  AI and other functions to EHRs. And then
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  at the same time, specialty pharmacy is growing
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  very quickly in the health care ecosystem. So
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  what strategies or tools or even new models
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  are emerging
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  to better support access adherence and care continuity?
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  Yeah. It's HR capability expands or automation capabilities
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  such as EHR data ingestion,
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  parsing technology to help distill the relevant information
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  out of that chart,
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  to support the therapy.
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  Prior auth automation,
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  which sometimes includes AI, as you had mentioned,
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  to improve benefit investigation,
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  as well as enhanced partnerships with prescribers to
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  leverage that EHR data, as well as the
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  AI to facilitate prior auth requests more efficiently.
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  And when we have EHR data, we're seeing
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  about a three to four day improvement
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  in turnaround time for pharmacy
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  prior auth
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  and up to about seven day improvement in
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  turnaround
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  for prior auths related to medical
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  covered therapies
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  in our most complex
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  therapy,
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  groups when they're infused. So,
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  we have that EHR data. We can significantly
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  reduce turnaround time. And, again, that that
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  that's the back and forth between the prescriber
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  obtaining data that we we we tend to
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  have access to already within that EHR flow.
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  So it's it's a much better experience.
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  Mhmm.
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  Yeah. Thanks, Jim.
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  And I know that we've we've touched on
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  prior authorization just a little bit already.
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  But can you elaborate on how enhanced EHR
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  integration can help health plans improve the prior
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  auth process efficiency and also reduce some of
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  that admin burden for both patients and providers?
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  Yeah. You know, I represent this this specialty
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  pharmacy. This response is is kinda from my
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  perspective and what I've seen in the market.
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  But really through EHR data integration, the health
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  plan can develop
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  insights in the patient's clinical journey. They better
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  understand a complete picture of the pharmacy and
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  medical claims data to support care. And by
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  leveraging this info, many of the required PA
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  elements can be automatically answered such as questions
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  related to
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  prescriber,
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  especially the diagnosis for that therapy.
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  Have they tried and failed therapies? Are they
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  on concurrent therapies? And then as well as
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  progress on therapy questions.
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  All those things can be automated leveraging the
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  EHR data. So that that's a much improved
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  process for us going back and forth to
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  the prescriber to get that information or having
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  the pharmacy
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  intermediary.
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  And again, this reduces,
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  the burden we talked about earlier as well
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  as improves the patient's experience.
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  Mhmm.
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  Yeah. Thanks, Jim.
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  And I know that we've already talked a
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  lot about the data capabilities within the EHR.
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  What role does EHR data transparency
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  play in helping payers make more informed decisions
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  around specialty drug management and care coordination?
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  Yeah. Again, this is from the pharmacy lens.
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  But although EHR data transparency could be instrumental
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  or can be instrumental in supporting care for
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  specialty drug management and care coordination.
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  There's still plenty of work to do for
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  payers to have more access to data and
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  leverage.
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  In conception with the right connections, payers could
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  help guide the clinical journey more proactively by
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  approving care paths,
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  associated therapies for those care paths at or
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  before the time of prescribing versus the current
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  state, which is typically retrospectively
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  after the prescription is written.
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  So it guides the prescriber through the the
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  care journey,
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  versus stopping stopping the process.
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  Additionally, there's significant opportunity, as you mentioned, to
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  leverage AI to improve the process.
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  We're aware of several tech companies. They're experimenting
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  with embedding AI products into the EHR.
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  These products
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  tend to interpret the EHR data.
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  They have ingested
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  payer policies, and they can essentially embed
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  the clinical data into the prior auth question
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  set itself,
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  essentially teeing it up for the prescriber to
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  to submit.
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  And in future state, payers could really harness
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  these AI products to capture these required data
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  elements and guide guide care like I had
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  mentioned earlier.
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  And even if they can't guide care proactively,
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  they certainly could automatically
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  approve these PAs
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  to improve care coordination.
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  Yeah.
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  And, Jim, I really appreciate the insights that
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  you've shared today. It sounds like there are
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  so many opportunities
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  within the EHR to really streamline a lot
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  of these processes and specialty pharmacy, get patients
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  the the treatments that they need more efficiently.
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  And I can only imagine
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  down the line the outcomes that could produce,
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  in terms of care outcomes
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  and costs. So thank you again so much
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  for all the insights today. Before we wrap,
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  is there anything that we missed or any
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  other final
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  cusp of of really
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  connecting the dots on EHR connectivity across the
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  industry. There's a lot of stumbling blocks to
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  them. There's certainly some
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  competitive strategies that are out there. But, ultimately,
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  the the more that we can connect data
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  to the pharmacy,
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  to the health plan,
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  you you you can really improve the clinical
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  journey for our patients and prescribers. So,
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  really excited about where some of this stuff
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  goes including,
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  as we talked about earlier, where AI will
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  take us in the future.
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  Yeah. Thanks, Jim. Really sounds like connectivity is
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  key here.
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  So thank you again for the time that
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  you spent with us today and for all
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  of your insights. Really appreciate it. Thanks very
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  much.
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  And we'd also like to thank our podcast
• 10:49
  sponsor for today, Accredo Specialty Pharmacy. Accredo is
• 10:53
  a specialty pharmacy that serves patients with complex
• 10:55
  and chronic health conditions,
• 10:57
  including cancer, hepatitis c, HIV, bleeding disorders, and
• 11:01
  multiple sclerosis.
• 11:03
  Accredo understands the complexity of these conditions and
• 11:06
  treatments, and their specialty trained pharmacists and nurses
• 11:09
  are available to provide personalized care to patients.
• 11:12
  Listeners, you can tune in to more podcasts
• 11:14
  from Becker's Healthcare by visiting our podcast page
• 11:17
  at beckershospitalreview.com.