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