Asembia 2021: Enabling Stakeholders Who Support the Patient
As the education sessions continued Thursday at Asembia 2021, presenters focused on opportunities around specialty — including telehealth and pharmacy’s rising profile for enabling providers to support patients more effectively. Key themes centered on forward-thinking innovations that lead to improved tools, processes and therapies.
Session: "Evolving Role of Telehealth & Pharmacy”
Summary: What was discussed
Few anticipated the struggles thrust on healthcare by the COVID-19 pandemic.
As discussed in Wednesday’s recap, patients canceled or delayed many elective procedures and routine visits during the pandemic, often leaving acute and preventive care unaddressed.
However, through those challenges and uncertainty, many future-planned technologies were pushed forward as a result.
In the session, “Evolving Role of Telehealth & Pharmacy,” Heather Bonome, Pharm.D., URAC’s director of pharmacy, and Jennifer Richards, Pharm.D., J.D., product development principal at URAC, discussed trends in telehealth and the intersection with pharmacy and the specialty pharmacy.
Telehealth care witnessed an uptake during the pandemic — offering convenience, speed and safety by eliminating the need to travel to an appointment, sit in a waiting room and risk exposure.
Likewise, the role pharmacists play in managing patient health also evolved.
The outcomes of the last 18 months illustrate that when a patient need exists, pharmacies — and particularly specialty pharmacies — step up to meet those needs.
Key takeaway: What you should know
When people think about telehealth, they might picture a live video with two-way interaction.
But the Centers for Medicare & Medicaid Services (CMS) also recognizes the following forms of telehealth and tele-pharmacy:
- E-visits without face-to-face patient interaction
- Remote patient monitoring
- Telephone, or audio-only interactions
- Mobile health — offers a mobile review of personal health information
- Case-based teleconferencing — often involves a collaboration among multiple providers on behalf of advancing the patient’s care
As specialty pharmacy started as a remote practice, the industry has provided virtual care — primarily via phone — for years.
However, prior to the pandemic, there was relatively low utilization of telehealth across the ecosystem.
However, once the pandemic started to spread across the country, stakeholders across healthcare, technology and government realized telehealth was critical to be able to keep providing care to patients.
According to medical claims data analysis, telehealth use rose nearly 4,000 percent from pre-pandemic levels in April 2020, while office visits simultaneously dropped 65 percent. Monitoring the Impact of COVID-19 on the Pharmaceutical Market, IQVIA, 2020
Even after falling from peak levels once office visits resumed, telehealth use remained significantly higher than ever, suggesting it has a prominent role in today’s patient-centered model of care.
Seventy percent of patients surveyed said they used telehealth appointments to reduce the spread of COVID-19, but more than half also appreciated the convenience factor. CoverMyMeds Patient Survey, 2019
However, social equity will also play a role in the ongoing adoption of telehealth as it relates to patient preferences and ability to use the technology to support that patient encounter.
For example, low broadband capabilities may prevent some remote patients from participating.
In one study, rural counties with high broadband availability saw 34 percent more telehealth visits per capita compared with counties where there was low broadband availability. Association Between Broadband Internet Availability and Telemedicine Use, Wilcock, Rose, Busch, 2019
We don’t want to compromise the quality of care being provided. The care provided through a telehealth platform should be of equal value to what the patient would experience in person. That doesn't mean the same exact care. That means they’re going to get the same value out of the care provided.
Jennifer Richards, PharmD, JD, URAC, “Evolving Role of Telehealth & Pharmacy,” Asembia 2021
Next steps: What can you do now?
While the pandemic drove broad adoption of telehealth, what are we going to see after?
Are regulators and payers going to tighten restrictions on its use again or — as suggested by curbside and drive-through pick-up in retail pharmacy — are some of these policies going to remain to support patient preference and convenience?
Another key concern among specialty pharmacies is the ability to bill for services provided remotely.
For years, pharmacists across all care settings have been advocating for provider status and enhanced billing capabilities.
There was progress during the pandemic as pharmacies were able to bill for testing and vaccine services, but broader payment structures should be pursued.
Ultimately, according to Richards, tele-pharmacy is a mode of providing care and pharmacy services.
It’s not a different kind of care or a change in care. It’s simply a change in how the care is being delivered. Digital technologies and platforms will be used to enhance communication among patients and providers.
As pharmacists continue to play a larger role in providing care and supporting patients through telehealth, they will need tools to effectively field patient questions and problem solve when access and affordability issues come up.
By supporting specialty pharmacies with patient support services dashboards, healthcare technology can help centralize and standardize specialty medication orders and enrollments.
Additionally, these technologies can allow specialty pharmacists more time for value-added services and serve care roles for patients beyond dispensing.
Especially since these roles and services can be particularly impactful, as patients can lack face time with their provider, where they can ask more detailed questions.
Specialty therapies are often the hardest to access for patients due to process complexity and affordability challenges. To learn more about specialty medication access and specialty pharmacies, download the 2021 Medication Access Report: Complex Care & Specialty Edition.
Session: "Don’t Overlook the Prescriber Journey”
Summary: What was discussed
This session reviewed the complexity of the prescriber journey when supporting patients’ access to therapy, with a particular emphasis on the role of Electronic Health Records (EHR) in that journey.
Under development since the early 1970s, EHRs are in use in 99 percent of hospitals today, compared to 31 percent in 2003. ASHP National Survey of Pharmacy Practice in Hospital Settings: Prescribing and Transcribing—2016
And as EHR adoption has increased, so has e-prescribing, which is rapidly becoming the preferred method for prescribers and is required in many states.
E-prescribing provides benefits like increased legibility, comprehensiveness and easier access to information.
E-prescribing also supports point-of prescribing solutions, including electronic prior authorization (ePA) and intelligent pharmacy workflows designed to help solve more patient access and affordability challenges.
The real advantage of an EHR is that information can be created and managed and shared across one health organization.
Anita Dopkosky, “Don’t Overlook the Prescriber Journey,” Asembia 2021
Key takeaway: What you should know
The EHR is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are:
- Patient demographics
- Progress notes
- Problems
- Medications
- Vital signs
- Past medical history
- Immunizations
- Laboratory data
- Radiology reports
As it relates to specialty pharmacy, the EHR is designed to automate and simplify the clinician’s workflow to take care of and diagnose a patient and ultimately prescribe a specialty medication by e-prescribing.
Panelists demonstrated the use of an existing EHR to support a specialty medication, showing the complexity of oncology prescribing journey and patient management.
Oncology care teams are involved in the design of comprehensive treatment plans, patient education, adherence support and ongoing treatment management.
Multiple people across the care team need access to patient information through the EHR to coordinate care, monitor patients and document outcomes.
This complexity underscores why it’s important to understand how providers are engaging with the solution.
For example, when accessing a specialty hub, the provider may prescribe and check benefits via the EHR, but they will also need to engage with at least one other platform related to the hub program before they can enroll in other access activities.
Requiring the provider to have multiple logins and platforms to access support for one patient in one program is an ineffective use of time and cuts into their ability to deliver clinical care.
Improving the provider experience by equipping them with tools and support that simplifies the process not only enhances the patient experience, but also supports accelerating the patient’s speed to therapy.
Next steps: What can you do now?
Using a centralized platform where all patient support services can be accessed has many benefits.
By leveraging technology that simplifies repetitive tasks while enabling connectivity, providers can use one location to start and track all access activities.
In solutions like this, visibility into the full patient journey is accessible through a patient case view.
This enables the provider and care team to quickly and easily understand what actions need to happen next so the patient can move forward to therapy access most efficiently.
Since the provider is the closest proxy to the patient, making things easier for them ultimately makes things easier for the patient.
Specialty therapies are often the hardest to access for patients due to process complexity and affordability challenges. To learn more about specialty medication access and specialty pharmacies, download the 2021 Medication Access Report: Complex Care & Specialty Edition.
Editor: Information from Asembia 2021 was obtained from a third-party source.
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