1 00:00:00,160 --> 00:00:02,879 Hello, everyone. This is Erica Spicer Mason with 2 00:00:02,879 --> 00:00:03,859 Becker's Healthcare. 3 00:00:04,240 --> 00:00:05,599 Thank you so much for tuning in to 4 00:00:05,599 --> 00:00:07,700 the Becker's Healthcare podcast series. 5 00:00:08,160 --> 00:00:10,160 So today, we're going to talk about how 6 00:00:10,160 --> 00:00:13,299 integrating specialty pharmacy into EHR workflows 7 00:00:13,764 --> 00:00:17,144 can support strategic objectives like improving care coordination, 8 00:00:17,445 --> 00:00:19,704 patient outcomes, and operational efficiency. 9 00:00:20,404 --> 00:00:22,404 And joining me for this discussion is Jim 10 00:00:22,404 --> 00:00:25,464 Blondin, the senior director of digital product strategy 11 00:00:25,605 --> 00:00:27,544 at Accredo Specialty Pharmacy. 12 00:00:28,260 --> 00:00:30,179 Jim, welcome to the podcast. Thank you for 13 00:00:30,179 --> 00:00:32,899 being here today. Yeah. Thanks, Erica. Glad to 14 00:00:32,899 --> 00:00:33,560 be here. 15 00:00:34,020 --> 00:00:36,179 Just a little bit about myself. As you 16 00:00:36,179 --> 00:00:38,500 mentioned, I'm senior director of digital product at 17 00:00:38,500 --> 00:00:39,000 Accredo. 18 00:00:39,780 --> 00:00:41,460 I've been with the organization for about twenty 19 00:00:41,460 --> 00:00:43,695 years. I originally am a pharmacist, 20 00:00:44,475 --> 00:00:46,554 spent a number of years across our, 21 00:00:46,954 --> 00:00:49,695 more complex therapies running branch operations, 22 00:00:50,634 --> 00:00:52,234 and have been in a variety of roles 23 00:00:52,234 --> 00:00:54,394 across operations and strategy over the last several 24 00:00:54,394 --> 00:00:54,894 years, 25 00:00:55,600 --> 00:00:57,460 most recently in digital product. 26 00:00:57,840 --> 00:00:59,600 Our team is ultimately responsible for all of 27 00:00:59,600 --> 00:01:00,579 our digital tools, 28 00:01:01,520 --> 00:01:04,099 all of the client facing, patient facing, prescriber 29 00:01:04,159 --> 00:01:04,979 facing tools, 30 00:01:05,359 --> 00:01:08,180 as well as prior off product improvements 31 00:01:08,799 --> 00:01:10,500 from a specialty pharmacy perspective. 32 00:01:11,864 --> 00:01:14,525 Yeah. Fantastic. Jim, really appreciate the context. 33 00:01:15,064 --> 00:01:17,224 Super helpful to know. And so I know 34 00:01:17,224 --> 00:01:19,305 that EHRs really are kind of at the 35 00:01:19,305 --> 00:01:21,144 center of a lot of conversations in health 36 00:01:21,144 --> 00:01:24,619 care, whether that's digital transformation or or administrative 37 00:01:24,840 --> 00:01:27,239 burden. You know, e EHRs are oftentimes the 38 00:01:27,239 --> 00:01:29,159 center of a lot of initiatives that health 39 00:01:29,159 --> 00:01:31,719 systems are deploying right now. But from your 40 00:01:31,719 --> 00:01:34,219 perspective, how are health care leaders' expectations 41 00:01:34,599 --> 00:01:37,179 changing when it comes to EHR functionality, 42 00:01:37,704 --> 00:01:40,504 especially in supporting more complex areas like specialty 43 00:01:40,504 --> 00:01:41,004 pharmacy? 44 00:01:41,864 --> 00:01:44,185 Yeah. Great great question. Yeah. Yeah. Due to 45 00:01:44,185 --> 00:01:46,584 the complexity of the specialty meds, there were 46 00:01:46,584 --> 00:01:48,905 a lot of required data elements to support 47 00:01:48,905 --> 00:01:49,405 care 48 00:01:49,704 --> 00:01:52,329 that go above and beyond the the ERX 49 00:01:52,469 --> 00:01:54,329 transaction or standard e prescription. 50 00:01:54,869 --> 00:01:57,989 This ultimately results in delays and starts of 51 00:01:57,989 --> 00:01:58,810 care because 52 00:01:59,430 --> 00:02:00,950 as a pharmacy, you tend to get the 53 00:02:00,950 --> 00:02:01,450 prescription, 54 00:02:01,750 --> 00:02:04,634 but the supporting documentation isn't always there. So 55 00:02:04,634 --> 00:02:05,994 there's a lot of back and forth between 56 00:02:05,994 --> 00:02:07,935 the pharmacy and the prescriber to obtain 57 00:02:08,555 --> 00:02:09,055 labs, 58 00:02:10,155 --> 00:02:11,775 high way procedures, 59 00:02:12,875 --> 00:02:14,875 and and ultimately progress notes as well to 60 00:02:14,875 --> 00:02:17,294 support the therapy and clinically manage those patients. 61 00:02:18,000 --> 00:02:20,819 Between health information exchange connections, direct 62 00:02:21,199 --> 00:02:24,340 EHR connections, and other connections to intermediaries, 63 00:02:25,039 --> 00:02:26,959 EHR data become in a critical piece of 64 00:02:26,959 --> 00:02:27,780 the care continuum, 65 00:02:28,479 --> 00:02:30,959 specifically for specialty pharmacy. And by leveraging this 66 00:02:30,959 --> 00:02:33,824 data, specialty pharmacy can improve the processing 67 00:02:34,365 --> 00:02:36,844 of the prescription, reducing start to, 68 00:02:37,324 --> 00:02:39,425 care time, as well as reducing 69 00:02:39,805 --> 00:02:41,724 what we call gaps in care for existing 70 00:02:41,724 --> 00:02:44,219 patients when they might have a prior auth 71 00:02:44,379 --> 00:02:47,040 that is due when their their renewal prescription 72 00:02:47,099 --> 00:02:47,759 is ready. 73 00:02:48,460 --> 00:02:49,199 And, ultimately, 74 00:02:49,580 --> 00:02:52,159 leveraging this data can reduce the prescriber abrasion. 75 00:02:53,180 --> 00:02:56,540 Yeah. Prescriber abrasion. It's such a good term, 76 00:02:56,540 --> 00:02:59,094 Jim, and it's actually something I wanted to 77 00:02:59,094 --> 00:03:00,875 go a little bit deeper on here. 78 00:03:01,335 --> 00:03:02,775 You know, you mentioned some of the ways 79 00:03:02,775 --> 00:03:03,275 that 80 00:03:03,575 --> 00:03:04,955 that EHRs can 81 00:03:05,415 --> 00:03:07,814 certainly become more more complex when it comes 82 00:03:07,814 --> 00:03:09,419 to specialty pharmacy. But 83 00:03:09,819 --> 00:03:12,479 what role does EHR integration play in reducing 84 00:03:12,539 --> 00:03:16,379 friction across specialty pharmacy workflows, and how does 85 00:03:16,379 --> 00:03:19,280 that translate into improved patient and provider experiences? 86 00:03:20,219 --> 00:03:23,840 Yeah. Oftentimes, especially meds have many clinical requirements 87 00:03:23,979 --> 00:03:26,985 such as weight or indication based dosing, 88 00:03:27,605 --> 00:03:29,145 titration based dosing 89 00:03:29,444 --> 00:03:31,444 to to make sure the patient's tolerant and 90 00:03:31,444 --> 00:03:32,905 response to therapy is correct. 91 00:03:33,365 --> 00:03:35,925 Labs and test results are typically needed to 92 00:03:35,925 --> 00:03:36,824 support therapy. 93 00:03:37,219 --> 00:03:39,699 A lot of times DME or the pumps, 94 00:03:39,699 --> 00:03:40,199 orders, 95 00:03:40,819 --> 00:03:43,060 ancillary meds, and home nursing orders are all 96 00:03:43,060 --> 00:03:44,759 all needed to start therapy. 97 00:03:45,219 --> 00:03:48,180 And many of these, are require a form 98 00:03:48,180 --> 00:03:49,080 from the prescriber, 99 00:03:49,780 --> 00:03:51,080 in in current state. 100 00:03:51,735 --> 00:03:53,974 Those forms come in the form of prior 101 00:03:53,974 --> 00:03:54,715 auth forms, 102 00:03:55,175 --> 00:03:56,235 referral forms, 103 00:03:56,775 --> 00:03:57,754 REMS forms, 104 00:03:58,694 --> 00:03:59,594 HIPAA consents, 105 00:04:00,135 --> 00:04:02,555 patient assistant forms. So there's a variety of 106 00:04:03,254 --> 00:04:05,754 documents that pharmacies tend to get. 107 00:04:06,180 --> 00:04:08,979 And Surescripts recently cited a study that that 108 00:04:08,979 --> 00:04:11,800 says prescribers spend about three hours per week 109 00:04:12,180 --> 00:04:14,180 filling out paperwork to get patients started on 110 00:04:14,180 --> 00:04:17,459 a specialty med, while their nurses, roughly 50% 111 00:04:17,459 --> 00:04:19,939 of those nurses spend about ten additional hours 112 00:04:19,939 --> 00:04:22,134 per week on what on top of what 113 00:04:22,134 --> 00:04:23,975 the prescriber is doing to get a patient 114 00:04:23,975 --> 00:04:26,154 on therapy or get patients on therapy. 115 00:04:26,535 --> 00:04:28,694 And many of these fields on the forms 116 00:04:28,694 --> 00:04:29,595 are already present, 117 00:04:30,134 --> 00:04:32,154 present in the prescriber EMR, 118 00:04:33,029 --> 00:04:33,430 And, 119 00:04:33,990 --> 00:04:36,310 it's really a duplication of effort from the 120 00:04:36,310 --> 00:04:38,250 prescriber perspective as well as the pharmacy 121 00:04:38,710 --> 00:04:40,569 if you have access to that record. 122 00:04:41,110 --> 00:04:41,610 Therefore, 123 00:04:42,310 --> 00:04:44,629 you know, by obtaining access, you can reduce 124 00:04:44,629 --> 00:04:46,764 the friction and, again, reduce time to start 125 00:04:46,764 --> 00:04:49,004 a therapy and improve clinical management of these 126 00:04:49,004 --> 00:04:49,504 patients. 127 00:04:50,285 --> 00:04:50,785 Mhmm. 128 00:04:51,404 --> 00:04:53,324 Yeah. And I know as health systems are 129 00:04:53,324 --> 00:04:54,545 looking at any opportunity 130 00:04:55,085 --> 00:04:57,264 that they can to reduce 131 00:04:57,725 --> 00:04:59,964 administrative burden for their team. So it sounds 132 00:04:59,964 --> 00:05:02,569 like certainly that duplication of forms is a 133 00:05:02,569 --> 00:05:03,750 a key area 134 00:05:04,689 --> 00:05:05,670 that you've identified. 135 00:05:06,529 --> 00:05:08,069 And I know that EHR capabilities, 136 00:05:08,370 --> 00:05:10,389 they are expanding. You know, we're seeing, 137 00:05:10,770 --> 00:05:12,870 some providers add, you know, 138 00:05:13,584 --> 00:05:15,904 AI and other functions to EHRs. And then 139 00:05:15,904 --> 00:05:17,904 at the same time, specialty pharmacy is growing 140 00:05:17,904 --> 00:05:20,644 very quickly in the health care ecosystem. So 141 00:05:20,944 --> 00:05:23,764 what strategies or tools or even new models 142 00:05:23,985 --> 00:05:24,724 are emerging 143 00:05:25,104 --> 00:05:28,164 to better support access adherence and care continuity? 144 00:05:29,129 --> 00:05:32,350 Yeah. It's HR capability expands or automation capabilities 145 00:05:32,410 --> 00:05:34,589 such as EHR data ingestion, 146 00:05:35,370 --> 00:05:38,410 parsing technology to help distill the relevant information 147 00:05:38,410 --> 00:05:39,790 out of that chart, 148 00:05:40,170 --> 00:05:41,389 to support the therapy. 149 00:05:41,925 --> 00:05:43,225 Prior auth automation, 150 00:05:43,605 --> 00:05:45,925 which sometimes includes AI, as you had mentioned, 151 00:05:45,925 --> 00:05:47,625 to improve benefit investigation, 152 00:05:48,245 --> 00:05:51,365 as well as enhanced partnerships with prescribers to 153 00:05:51,365 --> 00:05:54,084 leverage that EHR data, as well as the 154 00:05:54,084 --> 00:05:56,824 AI to facilitate prior auth requests more efficiently. 155 00:05:57,589 --> 00:06:00,150 And when we have EHR data, we're seeing 156 00:06:00,150 --> 00:06:02,170 about a three to four day improvement 157 00:06:02,550 --> 00:06:04,490 in turnaround time for pharmacy 158 00:06:04,949 --> 00:06:05,850 prior auth 159 00:06:06,629 --> 00:06:09,189 and up to about seven day improvement in 160 00:06:09,189 --> 00:06:09,689 turnaround 161 00:06:10,354 --> 00:06:12,615 for prior auths related to medical 162 00:06:13,074 --> 00:06:13,975 covered therapies 163 00:06:14,435 --> 00:06:15,574 in our most complex 164 00:06:16,274 --> 00:06:16,774 therapy, 165 00:06:17,475 --> 00:06:19,414 groups when they're infused. So, 166 00:06:19,875 --> 00:06:22,055 we have that EHR data. We can significantly 167 00:06:22,194 --> 00:06:24,454 reduce turnaround time. And, again, that that 168 00:06:24,790 --> 00:06:27,689 that's the back and forth between the prescriber 169 00:06:28,550 --> 00:06:31,430 obtaining data that we we we tend to 170 00:06:31,430 --> 00:06:34,170 have access to already within that EHR flow. 171 00:06:34,470 --> 00:06:36,410 So it's it's a much better experience. 172 00:06:37,110 --> 00:06:37,610 Mhmm. 173 00:06:38,004 --> 00:06:39,225 Yeah. Thanks, Jim. 174 00:06:39,605 --> 00:06:41,285 And I know that we've we've touched on 175 00:06:41,285 --> 00:06:43,464 prior authorization just a little bit already. 176 00:06:43,925 --> 00:06:46,725 But can you elaborate on how enhanced EHR 177 00:06:46,725 --> 00:06:49,524 integration can help health plans improve the prior 178 00:06:49,524 --> 00:06:52,579 auth process efficiency and also reduce some of 179 00:06:52,579 --> 00:06:55,399 that admin burden for both patients and providers? 180 00:06:56,500 --> 00:06:59,539 Yeah. You know, I represent this this specialty 181 00:06:59,539 --> 00:07:01,939 pharmacy. This response is is kinda from my 182 00:07:01,939 --> 00:07:03,879 perspective and what I've seen in the market. 183 00:07:04,235 --> 00:07:06,634 But really through EHR data integration, the health 184 00:07:06,634 --> 00:07:07,535 plan can develop 185 00:07:07,995 --> 00:07:10,314 insights in the patient's clinical journey. They better 186 00:07:10,314 --> 00:07:12,634 understand a complete picture of the pharmacy and 187 00:07:12,634 --> 00:07:15,754 medical claims data to support care. And by 188 00:07:15,754 --> 00:07:17,834 leveraging this info, many of the required PA 189 00:07:17,834 --> 00:07:20,500 elements can be automatically answered such as questions 190 00:07:20,500 --> 00:07:21,160 related to 191 00:07:21,620 --> 00:07:22,120 prescriber, 192 00:07:22,660 --> 00:07:25,319 especially the diagnosis for that therapy. 193 00:07:25,779 --> 00:07:28,339 Have they tried and failed therapies? Are they 194 00:07:28,339 --> 00:07:30,740 on concurrent therapies? And then as well as 195 00:07:30,740 --> 00:07:32,279 progress on therapy questions. 196 00:07:32,894 --> 00:07:35,295 All those things can be automated leveraging the 197 00:07:35,295 --> 00:07:38,014 EHR data. So that that's a much improved 198 00:07:38,014 --> 00:07:39,855 process for us going back and forth to 199 00:07:39,855 --> 00:07:41,774 the prescriber to get that information or having 200 00:07:41,774 --> 00:07:42,355 the pharmacy 201 00:07:42,735 --> 00:07:43,235 intermediary. 202 00:07:44,254 --> 00:07:45,314 And again, this reduces, 203 00:07:45,935 --> 00:07:48,069 the burden we talked about earlier as well 204 00:07:48,069 --> 00:07:49,930 as improves the patient's experience. 205 00:07:50,629 --> 00:07:51,129 Mhmm. 206 00:07:51,670 --> 00:07:52,810 Yeah. Thanks, Jim. 207 00:07:53,270 --> 00:07:55,670 And I know that we've already talked a 208 00:07:55,670 --> 00:07:58,490 lot about the data capabilities within the EHR. 209 00:07:59,430 --> 00:08:01,850 What role does EHR data transparency 210 00:08:02,389 --> 00:08:05,564 play in helping payers make more informed decisions 211 00:08:05,564 --> 00:08:08,464 around specialty drug management and care coordination? 212 00:08:09,724 --> 00:08:12,384 Yeah. Again, this is from the pharmacy lens. 213 00:08:12,524 --> 00:08:15,245 But although EHR data transparency could be instrumental 214 00:08:15,245 --> 00:08:17,084 or can be instrumental in supporting care for 215 00:08:17,084 --> 00:08:19,370 specialty drug management and care coordination. 216 00:08:19,910 --> 00:08:21,270 There's still plenty of work to do for 217 00:08:21,270 --> 00:08:23,270 payers to have more access to data and 218 00:08:23,270 --> 00:08:23,770 leverage. 219 00:08:24,550 --> 00:08:27,129 In conception with the right connections, payers could 220 00:08:27,189 --> 00:08:29,910 help guide the clinical journey more proactively by 221 00:08:29,910 --> 00:08:31,210 approving care paths, 222 00:08:31,735 --> 00:08:34,774 associated therapies for those care paths at or 223 00:08:34,774 --> 00:08:37,334 before the time of prescribing versus the current 224 00:08:37,334 --> 00:08:38,955 state, which is typically retrospectively 225 00:08:39,414 --> 00:08:40,955 after the prescription is written. 226 00:08:41,815 --> 00:08:44,330 So it guides the prescriber through the the 227 00:08:44,330 --> 00:08:44,970 care journey, 228 00:08:45,450 --> 00:08:47,549 versus stopping stopping the process. 229 00:08:48,250 --> 00:08:50,490 Additionally, there's significant opportunity, as you mentioned, to 230 00:08:50,490 --> 00:08:52,350 leverage AI to improve the process. 231 00:08:52,889 --> 00:08:56,110 We're aware of several tech companies. They're experimenting 232 00:08:56,169 --> 00:08:58,750 with embedding AI products into the EHR. 233 00:08:59,454 --> 00:09:00,195 These products 234 00:09:00,575 --> 00:09:02,754 tend to interpret the EHR data. 235 00:09:03,134 --> 00:09:04,434 They have ingested 236 00:09:05,134 --> 00:09:08,034 payer policies, and they can essentially embed 237 00:09:08,575 --> 00:09:11,615 the clinical data into the prior auth question 238 00:09:11,615 --> 00:09:12,355 set itself, 239 00:09:12,815 --> 00:09:15,269 essentially teeing it up for the prescriber to 240 00:09:15,670 --> 00:09:16,410 to submit. 241 00:09:16,950 --> 00:09:19,269 And in future state, payers could really harness 242 00:09:19,269 --> 00:09:21,590 these AI products to capture these required data 243 00:09:21,590 --> 00:09:23,750 elements and guide guide care like I had 244 00:09:23,750 --> 00:09:24,570 mentioned earlier. 245 00:09:25,269 --> 00:09:27,929 And even if they can't guide care proactively, 246 00:09:28,070 --> 00:09:29,290 they certainly could automatically 247 00:09:29,670 --> 00:09:30,730 approve these PAs 248 00:09:31,284 --> 00:09:32,664 to improve care coordination. 249 00:09:34,325 --> 00:09:34,825 Yeah. 250 00:09:35,205 --> 00:09:37,524 And, Jim, I really appreciate the insights that 251 00:09:37,524 --> 00:09:39,365 you've shared today. It sounds like there are 252 00:09:39,365 --> 00:09:40,345 so many opportunities 253 00:09:40,804 --> 00:09:43,605 within the EHR to really streamline a lot 254 00:09:43,605 --> 00:09:46,485 of these processes and specialty pharmacy, get patients 255 00:09:46,485 --> 00:09:48,480 the the treatments that they need more efficiently. 256 00:09:49,179 --> 00:09:50,240 And I can only imagine 257 00:09:50,620 --> 00:09:52,700 down the line the outcomes that could produce, 258 00:09:52,940 --> 00:09:54,240 in terms of care outcomes 259 00:09:54,620 --> 00:09:57,100 and costs. So thank you again so much 260 00:09:57,100 --> 00:09:59,419 for all the insights today. Before we wrap, 261 00:09:59,419 --> 00:10:01,419 is there anything that we missed or any 262 00:10:01,419 --> 00:10:01,875 other final 263 00:10:07,394 --> 00:10:08,855 cusp of of really 264 00:10:09,235 --> 00:10:12,034 connecting the dots on EHR connectivity across the 265 00:10:12,034 --> 00:10:13,875 industry. There's a lot of stumbling blocks to 266 00:10:13,875 --> 00:10:15,174 them. There's certainly some 267 00:10:15,820 --> 00:10:18,320 competitive strategies that are out there. But, ultimately, 268 00:10:19,179 --> 00:10:21,279 the the more that we can connect data 269 00:10:21,419 --> 00:10:22,320 to the pharmacy, 270 00:10:22,940 --> 00:10:24,079 to the health plan, 271 00:10:24,459 --> 00:10:26,860 you you you can really improve the clinical 272 00:10:26,860 --> 00:10:28,940 journey for our patients and prescribers. So, 273 00:10:29,615 --> 00:10:31,134 really excited about where some of this stuff 274 00:10:31,134 --> 00:10:32,034 goes including, 275 00:10:32,815 --> 00:10:34,894 as we talked about earlier, where AI will 276 00:10:34,894 --> 00:10:35,954 take us in the future. 277 00:10:36,815 --> 00:10:39,774 Yeah. Thanks, Jim. Really sounds like connectivity is 278 00:10:39,774 --> 00:10:40,514 key here. 279 00:10:40,975 --> 00:10:42,799 So thank you again for the time that 280 00:10:42,799 --> 00:10:44,279 you spent with us today and for all 281 00:10:44,279 --> 00:10:46,839 of your insights. Really appreciate it. Thanks very 282 00:10:46,839 --> 00:10:47,339 much. 283 00:10:47,639 --> 00:10:49,480 And we'd also like to thank our podcast 284 00:10:49,480 --> 00:10:53,320 sponsor for today, Accredo Specialty Pharmacy. Accredo is 285 00:10:53,320 --> 00:10:55,959 a specialty pharmacy that serves patients with complex 286 00:10:55,959 --> 00:10:57,259 and chronic health conditions, 287 00:10:57,794 --> 00:11:01,554 including cancer, hepatitis c, HIV, bleeding disorders, and 288 00:11:01,554 --> 00:11:02,534 multiple sclerosis. 289 00:11:03,475 --> 00:11:06,115 Accredo understands the complexity of these conditions and 290 00:11:06,115 --> 00:11:09,235 treatments, and their specialty trained pharmacists and nurses 291 00:11:09,235 --> 00:11:11,894 are available to provide personalized care to patients. 292 00:11:12,610 --> 00:11:14,370 Listeners, you can tune in to more podcasts 293 00:11:14,370 --> 00:11:17,169 from Becker's Healthcare by visiting our podcast page 294 00:11:17,169 --> 00:11:19,750 at beckershospitalreview.com.