Miranda discusses how integrated technology solutions can be used at critical moments in the patient’s journey to increase access, affordability, and adherence to therapies.
To learn more about CoverMyMeds’ prescription decision support tools for the entire care team, visit CoverMyMeds at HIMSS22.
Read on for Miranda’s insights.
Technology Enables Patient Medication Access Support at Critical Touchpoints
By Miranda Gill, MSN, RN, NEA-BC Vice President of Network, CoverMyMeds
There’s no silver bullet to overcoming all access barriers—but there are multiple opportunities within healthcare technology to improve medication access. Patients now receive care through different interfaces and from many locations, creating a need for options to better understand and access their medications at every step of their journey. Available technology solutions from the point of prescribing to the pharmacy provide opportunities for patients to help improve their access to needed medications on time and affordably.
Throughout this article, we’ll review how technology can help optimize patient choice at critical touchpoints in the medication access journey at their preferred health systems and pharmacy. With role-specific tools and data availability, care team members including pharmacists can help patients find the right path to medication access, affordability and adherence.
Most patients faced medication delays in 2021, with 25% of delays related to insurance processes and 10% due to delays in provider communication. More patients also arrived at the pharmacy and found out their prescription cost more than expected —79% compared to 67% last year.
Accessible data through integrated technology solutions could not only help care teams and pharmacists surface affordability options and get ahead of access barriers—it could also provide improved continuity of care in a more diversified healthcare ecosystem.
POINT-OF-PRESCRIBING TOOLS TO IMPROVE PATIENT ACCESS
Upstream in the patient journey, real-time prescription benefit technology with direct payer and PBM connections can help providers surface patient-specific information to help them overcome barriers related to their medications. In fact, patient-specific benefit information is the most-valued piece of information that 75% of providers don’t have access to today. In-workflow prescription decision support solutions give providers accurate data at the point of care, enabling transparent conversations with their patients about clinically appropriate and affordable options. By holding these empowering conversations early in the patient journey, providers can help patients get ahead of sticker shock or delays that can lead to abandonment. In fact, in one study, with a real-time prescription benefit (RTPB) tool in place, 77% of prescriptions were available at the pharmacy within 1 hour and 82% of all prescriptions were available at the pharmacy within the 24 hours. (RelayHealth Partners data, 2022)
Health system solutions for care team members managing prior authorization (PA) can further help ensure patients receive their intended prescriptions. In one study, 82% of providers said PA can lead to treatment abandonment at least some of the time. The burden of PA management can also add weight to already overloaded care teams inside health systems. Teams can average almost two full workdays per week completing PAs and 88% of physicians describe the PA burden as high or extremely high.
Electronic PA (ePA) solutions, integrated within electronic health records (EHR), can help replace manual processes for care teams, freeing up time for higher value tasks. Further, RTPB tools can indicate if medications require a PA, helping eliminate unnecessary PA submissions and giving back time. Solutions that can surface options such as cash price or alternative affordability options at the point of care can also provide alternative routes to dispense, expediting time to therapy and overcoming patient affordability issues.
Having point-of-prescribing options within workflow can help patients can pick up their medications sooner — from the pharmacy or their doorstep. Additionally, these same data elements can also help pharmacists in their workflow.
OVERCOMING BARRIERS TO MEDICATION WITH PHARMACY SOLUTIONS
While opportunities upstream with providers can help smooth the process to medication access, patients still lean on pharmacists most when their prescription costs more than expected or requires a PA. Most PA requests are still started at the pharmacy. For these reasons, pharmacists need full data sets within their pharmacy system to pull the patient journey over the finish line.
Only 36% of pharmacists have patient-specific benefit information within their system, and 75% said they’re spending a significant amount of time helping patients understand their coverage. Surfacing data on demand, and even applying discounts automatically, can help solve access and affordability challenges faster, ideally reducing the number of patients abandoning medications or paying more than expected. Over 50% of patients in the last year often had to choose between their therapy or important life essentials, like groceries and bills.
Role-specific solutions tailored to each care team member—inclusive of pharmacists—can help best serve patients in getting their medication. While features and functions should vary to best serve each role, the fundamentals of healthcare technology remain true—real-time, accurate, patient-specific data is required to hold effective shared decision-making conversations with patients.
CoverMyMeds provides prescription decision support tools for the entire care team, throughout the patient journey. To learn more about critical touchpoints throughout the medication access journey and care team solutions, visit us at HIMSS22.
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