Latest / Becker’s Healthcare Podcast / Breaking Barriers to Medication Access: Accelerating Therapy Starts with Integrated EHR Solutions

Transcript

Breaking Barriers to Medication Access: Accelerating Therapy Starts with Integrated EHR Solutions · Becker’s Healthcare Podcast

• 0:00
  Hi, everyone. This is Lucas Voss with Becker's
• 0:02
  Healthcare. Thanks so much for tuning in to
• 0:04
  the Becker's Healthcare podcast series. It's fantastic
• 0:08
  to have you. Today, we're talking about why
• 0:10
  accelerating therapy starts with integrated EHR solutions. And
• 0:13
  I'm so excited to have two wonderful guests
• 0:16
  for today's discussion. David Ward, he's the vice
• 0:18
  president of business development at CoverMyUpMed,
• 0:20
  and Molly Brady, she's the director of customer
• 0:23
  success at ONTADA. David and Molly, thanks so
• 0:26
  much for being here today and taking some
• 0:27
  time for us. It's great to have you.
• 0:29
  Thanks, Lucas. Good to be here. Thank you.
• 0:32
  Well, David and Molly, thanks so much for
• 0:33
  being here today. It's great to have you.
• 0:35
  For those that might not know you yet
• 0:37
  at least, I do wanna start us off
• 0:38
  with introductions here today.
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  David, we'll start off with you. Can you
• 0:42
  just share a little bit about yourself and
• 0:43
  and your work in health care? Yeah. Thanks,
• 0:46
  Lucas. Really happy and excited to be here
• 0:48
  with you today. So I I've been in
• 0:50
  health care really, my entire career, twenty plus
• 0:52
  years,
• 0:54
  seeing, you know, different parts of the health
• 0:56
  care industry. For the last, four years almost,
• 0:59
  I've been here with CoverMyMeds,
• 1:01
  working in, you know, various roles in product,
• 1:03
  product strategy, and business development.
• 1:05
  And it's really given me the opportunity to
• 1:08
  see things, you know, from that provider lens
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  and that, health system and and clinical perspective,
• 1:14
  of of things in health care. And then,
• 1:16
  you know, prior to my time,
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  at CoverMyMeds,
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  I I saw things from the the pharmaceutical
• 1:21
  industry and and that perspective where
• 1:24
  I I spent my time doing market access
• 1:26
  and commercialization
• 1:27
  consulting, you know, working with,
• 1:30
  branded pharmaceutical manufacturers
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  on launching their drugs.
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  On the personal side, I'm I'm based in
• 1:36
  Columbus, Ohio where we have the headquarters of
• 1:39
  Cover My Meds
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  and live here with my wife who is
• 1:42
  actually a health care practitioner
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  and my two small children.
• 1:46
  Yeah. Molly, same same question for you. It's
• 1:48
  great to have you. Can you share a
• 1:49
  bit about yourself and and your work in
• 1:51
  health care? You bet. Thanks.
• 1:53
  I'm an oncology nurse by trade, and I
• 1:55
  began my relationship with McKesson as a customer
• 1:58
  in 2003.
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  I worked in a community oncology practice in
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  Nebraska
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  for ten years
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  prior to coming to work for McKesson.
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  I helped take our practice live
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  from paper to InoMed EHR and then the
• 2:12
  transition from InoMed EHR,
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  to InoMed generation two as we know it
• 2:17
  today.
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  Shortly after our go live to generation two,
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  I went to work for McKesson.
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  And there, I've I've worked,
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  as an account manager,
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  a product manager, and now I'm the director
• 2:30
  of customer success team.
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  And my team of 10 support
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  a 119
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  community oncology practices,
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  both part of the US Oncology Network and
• 2:41
  open market.
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  I'm based in Omaha, Nebraska,
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  living my best life with my husband and
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  our Bernadoodle
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  scout.
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  We're busy with our three adult kids and
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  their spouses
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  and our three very busy grandchildren.
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  This partnership with iNoMed
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  generation two and and CoverMyMed is so important.
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  And I've seen firsthand
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  the real time benefits of this functionality,
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  and I'm excited for this opportunity.
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  Let's start with an overview of CMM.
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  Yeah. Thanks, Molly. So, you know, just to
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  give everybody a little more background, CoverMyMeds
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  is is one of the kind of pillars
• 3:16
  of McKesson Corporation along with Ontata.
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  And our focus really is on, medication access,
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  helping patients get the medications they need to
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  live, to live healthier lives.
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  And through our technology and our CoverMyMeds
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  platform, we really are reinventing
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  how patients are accessing their medications,
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  you know, through, where we've historically had success
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  within
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  electronic prior authorization, but really moving beyond that
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  to other parts of that patient and prescriber
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  journey. Again, with that that, that goal of
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  helping patients get on the medications that they
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  need to to live healthier.
• 3:52
  Yeah. It's great to have you both on.
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  I think, again, you've mentioned a couple of
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  important points here. Both have of you have
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  mentioned,
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  a couple of important aspects to this. And,
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  again, I'm so excited to to have you
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  both.
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  You've talked about the the shortages piece, quite
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  a bit, and and we certainly still see
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  a lot of pricing pressures and and administrative
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  complexity complexity
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  in the space itself.
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  And and medication access is a major challenge.
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  We we know that for both patients and
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  and care teams certainly.
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  From your perspective, and, David, I'd love to
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  start off with you on this, what is
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  sort of the most most critical workflow issue
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  that needs improvement
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  today
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  and and why?
• 4:31
  Yeah. It's a great question. And, you know,
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  in our experience,
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  you know, working with our health care provider
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  customers within our network, you know, the biggest
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  thing we really see is the fragmentation
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  that exists across health care,
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  particularly,
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  you know, from a workflow perspective
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  that that, health care providers and their staffs
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  are are working in. So, you know, in
• 4:54
  our research,
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  it's not uncommon that we've seen that, you
• 4:57
  know, these users and these, health care providers
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  are sometimes going across nine different digital tools,
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  and that's not including, you know, the old
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  ways of doing things like phone and fax,
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  just to complete these access steps to get
• 5:12
  patients onto therapy.
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  And, you know, there's a lot that this
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  fragmentation
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  creates. So, you know, number one is just
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  increasing
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  administrative tasks, particularly around duplication
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  of data, where a lot of we see
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  a lot of our customers and our users
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  looking into their electronic health record system and
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  then copying that information over into a prior
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  authorization
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  form or into a benefits investigation.
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  And these things, you know, can create, you
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  know, gaps in in data and information
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  and, you know, contribute to a lot of
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  the clinician burnout that we all hear
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  about. You know? And I think, really, the
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  unlock to a lot of this is, you
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  know, starting with that electronic health record system
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  where, you know, we could we could really
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  unlock and and make things simpler by having
• 6:01
  that integration directly into that electronic health record
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  for all types of medications, both pharmacy and
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  medical benefit, to kinda remove that
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  that contact switching, that chair swivel that are
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  that users are experiencing,
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  improving a lot of, of the quality of
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  data,
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  and really giving both, you know, practices and
• 6:21
  patients cleaner and faster paths to start therapy.
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  So, you know, we're really excited to be
• 6:27
  here today and share how our new CoverMyEd's
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  platform
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  will help solve these barriers and really be
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  a game changer in the industry. And we'll
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  be talking a lot more about it, at
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  HIMSS this year.
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  Mhmm. Yeah. You know you have a problem,
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  David, when in 2026,
• 6:43
  you still talk about facts. Right?
• 6:45
  Yeah. Of course. How does the facts work?
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  What is a fax machine? Some people might
• 6:49
  not know that. But, yes, you you do
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  know. Molly, I I wanted to ask you
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  the same question too,
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  specifically since you're so close to some of
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  the workflow pieces, etcetera.
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  What's that most critical workflow piece that that
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  needs improvement today for you?
• 7:04
  Yeah. And I'm gonna start with giving a
• 7:05
  little bit of background about Antata
• 7:08
  for our listeners.
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  ONTADA is a specialized
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  oncology data insights and technology business housed
• 7:16
  within McKesson.
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  We're I like to call it kind of
• 7:19
  a stripe, if you will, of McKesson.
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  And our mission is to advance cancer research
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  and care so we can help transform the
• 7:28
  fight against cancer.
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  Something I I just, as an oncology nurse,
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  like, live and breathe every day.
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  We enable real world evidence. We support oncology
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  providers and strengthen life science partnerships
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  through that those advanced analytics and point of
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  care technology.
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  So
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  I can
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  totally echo David what David said.
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  When various
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  steps
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  of the medication access
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  sit inside the electronic health record,
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  it's it's a win for both providers and
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  most importantly, the patient.
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  When treatment plans and drug orders immediately
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  trigger prior auth and benefits investigation
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  at that point of ordering,
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  this totally avoids delays and and status visibility
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  aligns with with scheduling.
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  And since I Inomed is an oncology specific
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  electronic health record,
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  developed by Ontata,
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  it's designed specifically for oncology and hematology practices
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  supporting that high quality evidence based cancer care.
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  And the result,
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  with of this partnership between CoverMyMeds and InaMed
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  is fewer delays, fewer faxes, there's that that
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  word, and more predictable chair utilization and positive
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  patient experience.
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  We're we're excited about the collaboration between Ontata
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  and CoverMyMeds
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  and the promise we've seen,
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  from the pilot work thus far.
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  Certainly, the, the big piece here is integration
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  and just the the ease of workflow through
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  integration in itself.
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  And, David, when you're thinking about all these
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  challenges and you've highlighted some of this already
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  here in your previous answer, but what are
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  some of those tools and and approaches,
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  initiatives, etcetera that you're seeing that that really
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  make a difference and, more importantly, that you
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  are encouraged by right now that you think,
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  okay. This is actually working. We're making a
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  difference here.
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  Yeah. Let me let me maybe take a
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  little step back, and let's kinda walk through
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  a scenario on this and see how it
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  plays out. And I think that'll kinda better
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  help, kinda illustrate and show how this works
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  in practice. So imagine,
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  you know, a a a new cancer patient
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  starting a very complex,
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  treatment plan
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  and, and therapy plan. There are gonna be
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  significant barriers to getting that patient through that
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  treatment plan. Some of these things, are, you
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  know, delays in getting prior authorizations
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  done,
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  uncertainty of coverage from either the health plan
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  or the pharmacy benefit manager on the drug
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  side,
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  fragmented communication
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  along all of the different people who are
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  part of that patient journey. So this isn't
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  just the provider's office. This could be different
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  lab labs. This could be a specialty pharmacy.
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  And this can also be the the health
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  plans and payers as well. And, you know,
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  just think about how challenging that is just
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  from a real world situation. You know, these
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  these patients are already very sick. These are,
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  you know, life and death situations in a
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  lot of cases, and it's placing, you know,
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  a lot of emotional strain
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  on top of just the difficulty of that
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  treatment journey. So, you know, when an oncology
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  practice, you know, like where Molly came from
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  and works with every day, you know, lack
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  a lot of those integrated and real time
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  tools and access to clinical information, benefits information,
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  and and authorization information at the point of
• 10:51
  care. You know, this is where the, the
• 10:53
  the office staff, the nurses, the physicians, the
• 10:56
  support staff are having to get on those
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  phones. They're having to check that fax machine.
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  They're reentering data, and they're doing it across
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  multiple portals
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  and multiple systems where it's hard to
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  really see the complete status of that treatment
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  plan
• 11:12
  at that patient level.
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  And so when you ask, you know, what
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  am I encouraged by right now? It is
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  it is things like the partnership that we
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  have, but with CoverMyMeds and our platform
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  and ONTADA and the InoMed
• 11:24
  electronic medical record system where we can really
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  put all these things in workflow connected to
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  that data
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  to help make this journey, you know, just
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  a little bit easier. You know, Molly, you
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  know, is this a story that, you know,
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  resonates with you? I'm sure you have a
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  lot of experience,
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  with this in your in your clinical experience
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  as well.
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  David, 100%.
• 11:44
  I mean, the time spent in clinic, I've
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  seen it firsthand, and I still see it
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  today.
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  Trying to gain approval for therapies ordered or
• 11:52
  validating
• 11:53
  payer coverage
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  is absolutely enormous,
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  and it's very time consuming. And, unfortunately, the
• 11:59
  patient is is, as you said, directly affected
• 12:02
  by these delays.
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  We work so closely with the largest network
• 12:06
  of community oncology providers, and we have a
• 12:09
  clear understanding of of their challenges and workflow.
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  And this is such a a great solution.
• 12:15
  We built InnoMed based on that clinician workflow.
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  So continuing to provide,
• 12:21
  the tools that make their jobs more efficient
• 12:23
  is something we we just
• 12:26
  are continually looking to integrate.
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  We're trying to,
• 12:31
  address the challenge of medication access
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  and the standardized,
• 12:35
  oncology workflows.
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  So this absolutely, I can
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  100%
• 12:40
  relate.
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  And I I wanna shift the focus a
• 12:43
  little bit too because we've talked about this
• 12:45
  in in in sort of the administrative processes
• 12:47
  piece, right, and and make and technology playing
• 12:50
  a larger role in streaming
• 12:52
  the process in itself
• 12:54
  too. I do wanna talk a little bit
• 12:56
  about the pharmacy and medication access space here
• 12:58
  because, certainly, technology is making a difference there
• 13:01
  as well.
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  How is all of this translating
• 13:06
  to that space, to the pharmacy and medication
• 13:08
  access space? And what are some of the
• 13:11
  outcomes you're seeing for patients and practices right
• 13:14
  now out there? David, we'll start with you.
• 13:17
  Yeah. So, you know, you you hear a
• 13:19
  lot of, you know, buzzwords in the industry,
• 13:22
  particularly in health care now, around things like
• 13:24
  artificial intelligence
• 13:26
  and automation. And they really are making
• 13:29
  a lot of positive impact in health care
• 13:32
  already, even in these early days. But,
• 13:35
  you know, I do wanna make kind of
• 13:36
  a quick clarification here around, you know, automation
• 13:39
  and AI.
• 13:40
  You you hear these things used interchangeably
• 13:42
  quite a bit, but they're actually kind of
• 13:45
  very different things. And I think understanding those
• 13:47
  and the audience being able to understand that
• 13:49
  will really help see where kind of each
• 13:51
  one of these is making an impact. So
• 13:53
  let me start with automation.
• 13:55
  This is something that's actually not new in
• 13:58
  health care. We've been using it for many
• 14:00
  years to to streamline structured tasks.
• 14:04
  So, again, things like benefits verification,
• 14:07
  eligibility
• 14:08
  checks,
• 14:09
  and the more simple,
• 14:10
  prior authorization
• 14:11
  submissions.
• 14:13
  When we talk about automation, we're talking about
• 14:15
  building APIs with clear business rules
• 14:19
  and, you know, really focused on making a
• 14:21
  lot of repetitive tasks easier.
• 14:24
  And and that really does matter because, you
• 14:26
  know, even though most providers have adopted some
• 14:28
  form of electronic prior authorizations,
• 14:32
  that manual
• 14:33
  process, the phone calls and the fax machine,
• 14:36
  it it really does still persist. And and
• 14:38
  and this automation
• 14:40
  over time is really starting to make that
• 14:42
  electronic prior authorization process more efficient,
• 14:45
  simplifying it, and, you know, ultimately getting patients
• 14:48
  on therapy faster.
• 14:50
  The confusion between the two is definitely present
• 14:53
  across all of health care and certainly continues
• 14:56
  to be. And I think that the differentiation
• 14:58
  will be a a big difference in 2026
• 15:01
  and beyond. Molly, from an oncology perspective,
• 15:05
  how do you see this making the biggest
• 15:07
  difference?
• 15:09
  Yeah. There's several that come to mind. The
• 15:11
  medical benefit prior authorizations for the infusion therapies.
• 15:16
  AI helps match regimen and diagnosis
• 15:19
  to health plans
• 15:20
  and or pharmacy benefits criteria,
• 15:23
  and that just reduces the back and forth
• 15:25
  ordering
• 15:26
  and canceled infusion.
• 15:28
  And it ultimately leads to that which ultimately
• 15:31
  leads to treatment delays.
• 15:33
  And the patient,
• 15:34
  again, the patient is is directly affected.
• 15:38
  Oral oncolytics and specialty enrollment,
• 15:40
  that automated enrollment and benefit checks shorten the
• 15:43
  time to dispense and connects patients to the
• 15:46
  financial assistance that is often needed.
• 15:50
  The biomarker pathology alignment,
• 15:53
  ensuring the right clinical evidence is present
• 15:56
  at submission to prevent avoidable denials.
• 15:59
  And then the scheduling and visibility
• 16:01
  links prior auth status to infusion scheduling in
• 16:04
  InoMed,
• 16:05
  and that avoids the chair under underutilization
• 16:09
  and same day surprises.
• 16:11
  It also it it makes staffing more efficient.
• 16:14
  With smaller community teams, we often see, you
• 16:17
  know, shaving those minutes and eliminating
• 16:20
  faxes at each step adds up to meaningful
• 16:23
  capacity gains for those practices.
• 16:26
  And the ambient AI noting,
• 16:29
  willingness to leverage the advanced technologies
• 16:32
  and how this can be applied to other
• 16:34
  clinician workflows is huge.
• 16:37
  And, Molly, maybe to build on that too.
• 16:39
  You know, those are a lot of the
• 16:41
  benefits that we're seeing with AI, right, and
• 16:44
  how that's different than automation and how it
• 16:46
  can really take
• 16:47
  the much more complex task and start making
• 16:50
  them simpler. But, you know, there there's one
• 16:53
  thing I always think about here too that
• 16:55
  that's key is, you know, still having that
• 16:57
  clinical oversight is really critical
• 17:00
  within that process. So, you know, having the
• 17:02
  AI to help support the decision making, but
• 17:05
  it it you know, not replacing it. Right?
• 17:08
  So still having
• 17:09
  clinicians and staff in the loop to ensure
• 17:11
  that the recommendations
• 17:13
  are safe and appropriate and really aligned with,
• 17:16
  you know, patient the the full patient contact.
• 17:18
  So, you know, when we're thinking about AI
• 17:21
  at CoverMyMeds,
• 17:22
  and as a as a technology company in
• 17:24
  health care, it's something we talk about every
• 17:26
  day,
• 17:27
  it's, you know, really why we we believe
• 17:29
  that AI is something that has to be
• 17:31
  done both in a responsible
• 17:33
  and very scalable way, again, to keep patient
• 17:35
  safety first and and keep that, those clinical,
• 17:39
  decision makers in the loop at all times.
• 17:41
  Absolutely. One of my favorite buzzwords is the
• 17:44
  human in the loop piece for, for health
• 17:46
  care right now. It's very, very important, especially
• 17:48
  in a clinical context.
• 17:49
  Well, again, it's so great to have you
• 17:51
  both on. As we close our episode here,
• 17:53
  I'd love to leave our our audience with
• 17:56
  some actionable take actionable takeaways as they head
• 17:59
  through 2026
• 18:00
  and beyond.
• 18:02
  As you are looking ahead from your perspective,
• 18:04
  how do you envision medication access evolving here
• 18:07
  in the next year or two? And and
• 18:08
  what's that one step, right, that one step
• 18:11
  leaders can take right now to prepare? David,
• 18:14
  we'll start off with you.
• 18:15
  Yeah. I mean, I I think it is
• 18:17
  moving, you know, faster than I than I
• 18:19
  have seen in the twenty plus years that,
• 18:22
  you know, I I've been in health care.
• 18:23
  And I know we talked about this a
• 18:25
  little bit earlier on,
• 18:26
  but everything in my mind really starts with
• 18:30
  that source of truth, which is the electronic
• 18:33
  health record systems
• 18:34
  that, healthcare providers and and practices are using.
• 18:38
  And that's why, you know, I'm I'm so
• 18:40
  excited about the CoverMyMeds
• 18:41
  platform that we've been building
• 18:44
  being really kind of a first of its
• 18:45
  kind EHR integrated solution that is, you know,
• 18:49
  unifying
• 18:50
  benefits investigations,
• 18:52
  prior authorizations
• 18:54
  of both medical and pharmacy benefit,
• 18:56
  and patient services
• 18:58
  enrollments into a single experience.
• 19:01
  You know, by centralizing all these access functions,
• 19:04
  it really unlocks insights for health system leaders,
• 19:07
  helps provide aggregated, de identified market insights that
• 19:11
  help life sciences companies understand access challenges,
• 19:14
  and ultimately is gonna help us in improve
• 19:17
  those time to initiation and time to therapy
• 19:19
  for patients. So, you know, this is this
• 19:21
  is really an exciting time, to be in
• 19:23
  right now with all these advances
• 19:25
  and, you know, really looking forward to see
• 19:27
  what's gonna be coming, in the next year
• 19:29
  or so. Thank you. Molly, same question for
• 19:32
  you here. What's what that one step that
• 19:34
  you would like leaders,
• 19:35
  to to take right now, and how are
• 19:37
  you seeing this evolve?
• 19:40
  Take the step.
• 19:41
  Take the plunge, and check us out for
• 19:43
  more information.
• 19:44
  It's as David said, it's it this is
• 19:46
  just
• 19:48
  such a valuable tool
• 19:49
  integrated directly into the the EHR.
• 19:53
  I'm excited about what's going on and what's
• 19:55
  to come.
• 19:56
  Well,
• 19:57
  Molly and David, it's so great to have
• 19:59
  you both on. We'll send you a fax.
• 20:02
  Right? That's how we'll do things.
• 20:04
  I wanna thank you both for your time
• 20:05
  and insights.
• 20:07
  It's so fantastic to have you, and we
• 20:08
  also want to thank our podcast sponsor, Cover
• 20:10
  My Meds. And you can certainly tune in
• 20:12
  to more podcasts from Becker's Healthcare by visiting
• 20:14
  our podcast page at beckershospitalreview.com.