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Loreen M. Brown discusses how technology has influenced how healthcare teams function, from leveraging and delivering care to interacting with patients throughout the patient journey.
From text messaging to Skype, social networks to email, technology impacts how we connect with each other every day. The healthcare industry has certainly not been immune to these changes – in fact, technology has influenced how healthcare teams function, from leveraging and delivering care to interacting with patients throughout the patient journey.
An increased desire for and reliance on information has led to an ever-increasing demand from pharmaceutical manufacturers for easily accessible, real-time data that reliably works in patients’ and providers’ workflows and lifestyles without losing the personal elements of care. Patient support programs exist at this intersection of data and human interaction. High-tech - or advanced and innovative programs run by technologically - and high-touch – or programs that maintain a close personal connection – must be effectively combined to deliver the highest quality of care. The right patient support program will provide the data manufacturers, providers and patients need without sacrificing the personal care patients rely on and providers deliver, which ultimately increase both speed to therapy and adherence.
A host of technologies exist that can make aggregating and accessing data quick, easy and convenient for manufacturers, providers and patients. However, implementing the correct high-tech solutions is not a simple matter. A number of factors need to be considered when evaluating the addition of technology into patient access and adherence programs, including the impact on various stakeholders. Here are a few tips to consider when blending high-tech into high-touch programs:
Technology Should be Relevant for the Healthcare Provider
Whether a solution is geared toward delivering patient education through an internet portal or co-pay assistance via online adjudication, it must fit in with the workflow of the healthcare provider. Providers are incredibly busy, and need solutions that streamline their workflow, not add to it. Turnkey solutions that fit into the everyday process work of providers are of paramount importance. No innovation should be so cumbersome it requires end users to change their business operations. This is a challenge many service providers face when it comes to adapting their solutions.
Ensuring the program meets meaningful use standards and protected health information (PHI) compliance allows for relevant and significant data capture that can be used for a more prescriptive and personalized patient experience. For example, service delivery systems that incorporate elements such as electronic provider and patient authorization, electronic enrollment for medication processing, triage and dispensing, electronic benefit verification and electronic prior authorization not only cut down on the amount of paperwork processed daily in provider offices, they help to keep patient records all in one place and simplify organizational flow.
Automation is Essential
Technology as an impetus for reducing time to fill is, and already has been, promising. Data indicates patients whose enrollments are submitted via e-services technology have a significantly higher likelihood of initiating treatment, as well as a shorter time to therapy initiation. This is driven by factors such as the elimination of missing information and providing a platform for the office staff and their reimbursement counselor to communicate in real-time to solve any outstanding issues. Additionally, the enrollment is received and transmitted in a format that allows for sharing the data with necessary third parties, such as specialty pharmacies.
Patient- and provider-facing activities can also be automated. When providers have instant access to patient education, a product is more likely to stay top-of-mind. And some tools, such as those that allow payers to provide prior approval online, increasingly automate processes on the provider end to further reduce time before initiating treatment. After the first fill, automatic appointment and refill reminders - available through many service providers’ patient outreach offerings - have been proven to keep patients on therapy. Automation systems can include interactive voice recognition technology, live web chat capabilities, texting and multi-language capabilities, which help to ease communication between patient, payer and provider.
Solutions Should be Scalable
Even when solutions are designed to integrate smoothly with day-to-day medical office practices and patients’ lives, there will be those who will not or cannot adapt to new technologies. Rather than leaving them behind, the most innovative service providers offer end-to-end solutions. Consider multiple communication methods with your patients, supporting both high-tech solutions like text messaging and web chat along with personal phone calls and letters. Introduce innovative solutions as the market develops an infrastructure to support e-solutions, and support provider adoption of electronic tools and practice interfaces while partnering with providers and patients to transition to an electronic interface. In designing a scalable solution that integrates high-tech and high-touch, it’s important to note that the best technology does not replace face-to-face communication. Instead, it helps to foster and grow relationships through channels such as reminder text messages and emails, live chats with nurses and patient portals for increased education.
Utilize a Care Management Approach
Technology utilized within adherence programs should focus on patient experience, engagement and empowerment. A care management approach, which is an evidence-based, integrated plan created by collaboration from the patient and the provider, can combine technology and face-to-face interaction in a meaningful way that assists the patient through each stage of their journey. Utilizing a care management approach helps to maximize the patient journey through a thorough understanding of the root causes of non-adherence. The best programs actively engage the patient using an individually-focused, goal-oriented communication approach to empower patients to address barriers to adherence holistically as delivered based on their preferences. For example, live chat can supplement in-person office visits, and phone calls can follow up on emails. Using a personalized care management approach with technological support encourages patients to self-manage and provides the opportunity to collect robust patient-supported insights.
Use Field Support to Navigate Reimbursement Challenges
For the brand and reimbursement teams who must develop commercial strategies for the biopharmaceutical industry’s most innovative specialty products, declining reimbursement and increased payer management are not new challenges. Stakeholders across the healthcare continuum are continuously tasked with finding ways to combat shrinking payments. And when it comes to billing for drugs dispensed in a practice setting, healthcare providers are facing very specific obstacles to overcoming coding errors and receiving the appropriate reimbursement from payers. The ramifications of the Affordable Care Act, from Electronic Health Records requirements to increased focus on how providers bill for their services, mean the threshold for billing and coding errors is now lower than ever. Complicating the reimbursement landscape even further is the fact that providers have a limited understanding of the programs available to assist them with mitigating the risk of errors. Navigating support programs, plus managing patient cost-share issues, ultimately takes the focus away from patient care by increasing the administrative burden on the practice.
High-tech solutions can help to simplify this incredibly complex landscape. With proper training for those using them, support programs for automated coding and billing can dramatically decrease the margin of error and speed patient access to therapy. Additionally, programs can provide real-time analytic information regarding service flow, volume and account segmentation. The chart below presents an example of support program-provided analytics to better distribute office workflow.
However, high-tech solutions cannot exist alone. Without a high-touch, human element, the data is nearly meaningless. Highly qualified reimbursement professionals, such as field reimbursement specialists, supplement support programs in two critical ways: education and issue resolution. As trained experts with more than a decade of industry knowledge and detailed training on billing and coding, field reimbursement specialists understand how practices operate and leverage that knowledge to educate providers and their staff on the most effective use of manufacturer portals and programs. A combination of high-tech analytics and high-touch specialists can uniquely improve practice efficiency, speed to therapy and duration of therapy.
As technology continues to progress, it is up to the industry to decide how to best employ it to support patients. By providing a mix of high-tech and high-touch in patient adherence programs, pharmaceutical manufacturers are proving there is a place for cutting-edge ideas in the healthcare field, while ensuring the highest quality patient care.
Loreen M. Brown, MSW, Senior Vice President of Product Management and Not-for-Profit Operations, Lash Group, a part of AmerisourceBergen.