Embedding Into the Provider’s Workflow is Key to a Specialty Drug’s Success

Today’s guest post comes from Nasir Ali, Chief Product Officer at CareMetx.

Nasir reviews the cumbersome processes that affect providers’ preferences when prescribing a specialty drug to their patients. He believes that embedding the specialty drug initiation process into the provider’s workflow will benefit both patients and prescribers.

Learn more by downloading CareMetx’s new 2024 Patient Services Report: Revealing Manufacturer Priorities: Patients Naturally Take Center Stage.

Read on for Nasir’s Insights.

Embedding Into the Provider’s Workflow is Key to a Specialty Drug’s Success
By Nasir Ali, Chief Product Officer, CareMetx

Patients who are prescribed a specialty therapeutic for a complex or rare condition can face significant hurdles in accessing the drug. The providers who strive to help them overcome those challenges often find the process time-consuming and burdensome, even in a digital world.

Despite the proliferation of technology, initiating a script often requires significant manual work on the part of the provider and their staff. Ensuring the patient can get on therapy in a timely way is only one of the issues providers face. Providers also need to manage financial risk, especially when prescribing buy-and-bill drugs or those covered under medical benefits.

Unfortunately, this process typically involves a host of “swivel-chair” activities that take time and attention away from serving patients. Many specialty drug manufacturers offer support that remains call center-based, requiring providers to use slow, inefficient methods like phone and fax to interact with payers and hubs. While some manufacturers offer drug-branded portals that handle certain activities in the process, these vehicles still require the provider to step out of their native workflow and interact with a separate system.

The process often requires duplicate data entry, increasing the risk of errors that further slow time to therapy or create data quality problems downstream. The proliferation of single drug portals has providers toggling between their systems and a multitude of portals. It has become unsustainable, especially for practices that prescribe a variety of specialty therapies.

With many providers struggling to handle a high patient load without sufficient staff, few have the time or tolerance for unnecessary steps that take their focus away from patients and hamper their practice’s growth. Even when providers perceive that a drug is efficacious and appropriate for their patients, if the process is burdensome they might not make their preferred clinical decision.

THE SOLUTION: EMBEDDING INTO THE PROVIDER’S WORKFLOW

Given the considerable impact that provider perceptions can have on a new therapeutic’s adoption, it’s vital to break down barriers that discourage providers from prescribing the drug of their choice.

One of the most effective ways is to empower providers to manage the script initiation process and subsequent activities within the electronic medical records (EMR) or practice management systems in which they do much of their daily work. These activities can include getting the patient enrolled in the drug program, obtaining patient consent, conducting a benefit verification, submitting a prior authorization, and triaging the patient to the appropriate provider (when the prescribing physician and administering physician aren’t the same).

Equipping providers to manage these critical steps within the systems they already use to manage patients’ clinical records yields significant benefits, such as:

• The streamlined, automated process eliminates redundant work and reduces administration, accelerating time to therapy and supporting better health outcomes.

• The data needed to enroll the patient, verify their benefits, or submit a prior authorization can automatically be pulled from the provider’s EMR or practice management system, improving data quality.

• Embedding the therapy initiation process into the provider’s native workflow helps facilitate revenue cycle management: The faster the therapy is initiated, the sooner the claim can be submitted and reimbursed.

• In CareMetx’s experience, practices have achieved 70-80% time savings on patient support enrollments using embedded technology. (Source: Time Savings Report, PX Technology, July 31, 2024.)

BRINGING ALL THE RIGHT COMPONENTS TOGETHER

Embedding the specialty drug initiation process into the provider’s native workflow requires several key enabling components: a full suite of electronic hub services designed to handle every activity in the process, APIs that allow those services to “plug-and-play” within the provider’s existing workflow, and deep integrations into EMR and practice management systems.

As the trusted partner of premier specialty drug manufacturers, CareMetx has made significant investments in these components to facilitate the therapy initiation process and meet providers where they are. The combination of robust e-services and several dozen EMR and practice management integrations support a frictionless, brand-neutral workflow that places key activities right at the provider’s fingertips.

Additionally, the use of AI-enabled processes and robotics automation simplifies data capture, eliminates duplicate data entry, and makes key information readily available within the provider’s existing workflow. This end-to-end process can even give providers improved visibility across the entire patient journey to ensure drug adherence and persistence, which is especially valuable when a different provider will be administering the treatment.

Moving away from a call center-centric approach to the use of e-services embedded into the provider’s native workflow benefits providers, patients, and drug manufacturers alike. It minimizes administrative work and reduces friction, enabling providers right where they are. It gets patients on life-altering medications faster. And it removes barriers to provider adoption.

The 2024 Patient Services Report provides more insights on the importance of prioritizing the provider experience to ensure exceptional patient care, along with a comprehensive look at the patient services landscape. Download the full report for details.

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