Specialty Pharmacy: Connecting Healthcare Silos

Editor's Notes

1. OPPORTUNITY TO KICK OFF AMCP SPECIALTY CONFERENCE – GREAT 2 DAYS OF PRESENTERS HIGHLIGHTING SRX AS ONE OF THE GREAT CONNECTORS OF HEALTHCARETHINKING ABOUT OTHER EXAMPLES OF USING CONNECTIONS TO IMPACT THE HUMAN EXPERIENCE– THE IPOD – YOUR MUSIC EVERYWHERE, IN ANY VENUE, FOR ANY OCCASION TO MEET YOUR UNIQUE NEEDSSTEVE JOBS GENIUS WAS USING DIVERSE EXPERIENCES TO POINT TO NON-LINEAR SOLUTIONSCOMPANIES THAT THRIVE WILL INCORPORATE BROAD VISION & FOCUS ON HUMAN EXPERIENCESWHAT DRIVES MY PERSPECTIVES? LONGEVITY = DIVERSITYCOMMUNITY & ACADEMIC TEACHING HEALTHCARE SYSTEMSTAX EXEMPT, PUBLICLY TRADED & PRIVATE EQUITY BACKED COMPANIESPHYSICIAN NETWORKSSPECIALTY & RETAIL PHARMACYDRUG WHOLESALE, DISTRIBUTION, GPO & 3PLPBMSSPEECH AS THE QUINTESSENTIAL CONNECTOR EXPERIENCECardinal – Meghan Fitzgerald, Bruce Feinberg, Jeff Hawes; AIM – Mike Backus; Navigating Cancer – Gena Cook; Frameworks MI – Danielle Lydon; PRM – Gene Eavy
2. GROUPS WITH UNIQUE & IMPORTANT ROLES BUT WITH LIMITED ‘CONNECTION’PLANS & PBMS CONNECT NETWORKS OF PROVIDERS, MORE & MORE LOOKING FOR DECISION TREE SUPPORT FOR BEST PRACTICESPHARMACEUTICAL COMPANIES CONNECT DRUG WITH PATIENTS THROUGH PATIENT ASSISTANCE PROGRAMS & SERVICES
3. DATA CONTINUES TO GROW EXPONENTIALLY BUT WITHOUT CONNECTIVITY, GAPS IN MEANINGFUL, ACTIONABLE INSIGHTSUNIVERSITY OF CHICAGO FACULTY PRACTICE PLAN – LOTS OF DATA BUT NO INFORMATION
4. Providers and patients are actively adopting new technology. The “connectors” will need to leverage data and technology solutions to create real-time, mobile solutions. AVELLA prescribers on average 75% still use faxmore than 50% of the Michigan Med Oncs use paper not EMRCPT CodingBilling & Collections “Cheat Sheets”Access to Hospital and other Provider Healthcare RecordsProcessing Patients within Healthcare Silo’s
5. Watson (by IBM as a predecessor to DeepBlue) – famous for winning Jeopardy! in years past. Even beating Ken Jennings.
6. NOW, this is what Watson is being used for…..
7. The explosive growth makes it even more challenging to have the sort of broad vision necessary to connect the industry.53 of the current FDA phase 3 drugs are specialty.
8. UBER IS ANOTHER TAKE ON REVOLUTIONIZING A SIMPLE HUMAN EXPERIENCE BY CREATING NOVEL CONNECTIONS BETWEEN USERS AND SERVICE PROVIDERS. CUSTOMER EXPERIENCE IMPROVED DRAMATICALLY AND AN INDUSTRY WAS TRANSFORMED.
9. Can thesilo’d industry of healthcare become “connected”? We believe specialty pharmacies are uniquely positioned with the touchpoints, knowledge and data to “connect” the industry.
10. PHYSICIAN EXAMPLE OF DOSE TITRATION WITH ORAL IN REAL WORLD VERSUS CLINICAL TRIALSPAYOR EXAMPLE OF BENEFITS DESIGN PAIRED TO CPBS COMPARED TO EXPECTED COSTSPHARMA – CLINICAL TRIAL VERSUS REAL WORLD; HEAD TO HEAD WITH COMPETITORS
11. CHRONIC DISEASES – THROUGH CLINICAL INNOVATION & SUCCESSFUL PATIENT MANAGEMENT HIV, MS and RheumatologyHIGH COST/LOW POPULATION OF PATIENTS IDENTIFIED MOLECULARLY 1) Rapidly expanding Arsenal of very costly, highly precision tools2) Increasing in scope, with the increasing understanding of the biology of cancer – the more NEW APPROACHES WILL REQUIRE SOME HIGHLY SPECIALIZED SPECIALTY PHARMACIES THAT HAVE CLINICAL COMPETENCIES THAT CAN INTEGRATE TO OTHER PROVIDERS; ALSO ACO’S AND HOSPITAL SYSTEMS ARE SEEKING THIS COMPETENCYCLOSED LOOP, REAL TIME, INFORMATION SHARING
12. It took 50 years to introduce 27 oral compounds; yet the same number (27) was approved in the last 9 years
13. Radiology Benefit Management effectiveness is greatly overstated.  Act as a sentinel effect, not really compelling as a savings model.
14. One repository for all things specialty, making data user defined and easily obtainable!Gain insight into a number of variables, in Data Virtualization Cubs – Volumes, Outcomes, Contract Compliance – replacing silos of data making the business of pharmacy repeatable, predictable, for better outcomes
15. WIZMO?REIMBURSEMENT INFORMATIONCOMPLIANCE BY MD, PATIENT, PAYOR, PHARMAPERFORMANCE SCORECARDS RELEVANT TO ALL PROVIDERS
16. PATIENT CONVENIENCEEFFICIENCY & PRODUCTIVITY
17. nearly 1000 providers contracted, about 750 live, rest in integration/training 500,000 patients in database, 90,000 regularly using (still need providers to get email address for a large majority to invite them)
18. Benefits for physicians:Helps them meet at the patient centered care initiatives of health care reform (HITECH Meaningful Use, patient centered medical home, payor initiatives around patient satisfaction, ACO initiatives, 2015 Commission on Cancer standards)
19. Glowcaps data points--adherence
20. Avella participated in an NIH-funded adherence study in collaboration with the University of Arizona, published in the American Journal of TransplantationAdherence is a prime example of how Specialty Pharmacies can serve as a connector and impact outcomes.
21. Multiple tools used (based on the patient needs). Not a “one-size fits all”.
22. Oncology / Rheumatology MPR – vs. Nation –