Pharmacy technology and the healthcare ecosystem: How technology can improve patient outcomes
Medication therapy is not being optimized in the United States, a problem that is negatively impacting patient care and placing a major strain on the U.S. healthcare ecosystem. Each year, non-optimized medication therapy is linked to more than 275,000 avoidable patient deaths and adds upwards of $500 billion in costs, representing 16% of all healthcare expenditures. Non-optimized medication therapy is a cyclical process that begins with patients either not receiving the right medication/dosage or not adhering to their prescribed medication regimen, which leads to adverse events and potential health problems, and ultimately results in increased healthcare costs.
As the shifting healthcare landscape places increasing emphasis on both cost efficiency and patient outcomes, breaking this cycle of non-optimized medication usage dramatically could lower costs and improve patient care. Pharmacists are uniquely positioned to be a key player in this effort and, with the right technology solutions at their disposal, they will be empowered to become even better advocates for their patients and help drive down healthcare costs.
Why pharmacists are uniquely placed for an expanding role
While the role of the pharmacist has been vastly underutilized in the past, the evolution of pharmacy into more clinical operations, as well as their position among patients as a trusted and accessible provider, places them in a central role to optimize medication therapy and engage with patients to help prevent nonadherence. In Gallup’s 2019 Honesty and Ethics survey, pharmacists ranked second overall — just below nurses and ahead of medical doctors — in their list of most trusted professions. This high level of trust indicates that pharmacists have opportunities to motivate patients toward behavioral change, whether by conducting a medication review to address some of the main challenges of non-optimized medication therapy or by providing clinical advice and support. Pharmacists also are highly accessible to patients and interact with them more frequently than other providers. Commonwealth Medicine notes that nine in 10 Americans live within 5 miles of a community pharmacy, and other research has shown that patients visit their pharmacists up to eight times more frequently than their primary care provider. Because of their overall accessibility to patients, pharmacists are well suited to serve as a central connector between key stakeholders across the healthcare ecosystem, from payers to providers to manufacturers.
The expansion of the pharmacist’s role into clinical services in recent years has led to increased cohesion and efficiency in the healthcare system. An example of this expansion is the development of collaborative practice agreements, or CPAs. According to Commonwealth Medicine, a pharmacist and primary care physician collaborate through a CPA to enable the pharmacist to provide additional direct patient care services to their clients, such as ordering and interpreting laboratory tests, prescribing, changing or discontinuing medications, screening and treating patients for minor ailments, and developing care plans. As of 2011, 44 states had allowed for the development of CPAs.
Pharmacists are also playing a major role in advanced medication management. Health Datix reports that overusing, under-using or misusing medications costs the American healthcare system around $300 billion a year, but when pharmacists take on a more involved role with patients and manage their medications, the cost of nonadherence inevitably will decrease, and simultaneously improve patient outcomes.
Payers are particularly interested in the expanded role of the pharmacist, as the Centers for Medicare and Medicaid Services reimburses based on performance. State administrators of these programs can demonstrate how they are able to differentiate and better administer health plans, and the benefits of improved adherence for all stakeholders across the healthcare ecosystem. This is an area in which pharmacists can add significant value and help other stakeholders reach the shared goal of improved outcomes at a lower cost.
Why Technology is Critical for Enabling Clinical Capabilities
The expansion of the role of pharmacists as key players in connecting stakeholders across the healthcare ecosystem, as well as their role in advanced medication management and adherence, clearly shows they can successfully address the issue of non-optimized medication therapy. However, having the right technology solutions at their disposal is critical in order for pharmacists to expand into these areas. Currently, many pharmacies are managing several disconnected systems that make it difficult to track clinical opportunities and delegate priorities. Ideally, pharmacists should seek out a scalable patient-focused clinical care suite of advanced technology solutions that allows them to digitally manage their workflow, drive efficiencies, engage with patients and connect with payers, providers and manufacturers.
Medication therapy management tools can be integrated into the pharmacy management system, connecting pharmacists with payers to access targeted, payable patient care opportunities and centrally document them. Additionally, they can enable pharmacists to provide health education, improve medication therapy compliance and assess medication side effects. As states continue to expand the provider status of pharmacists, enabling them to screen patients for diseases like flu and strep throat and prescribe treatments, pharmacies will require technology solutions to document and bill for these clinical services.
Digital communication tools can also be integrated into existing systems for direct patient engagement, streamlining patient communication workflows and driving efficiencies through automated reminders, on-demand messaging, pre-fill alerts and medication delivery management. By helping pharmacists maintain a high-touch, personal relationship to patients, they can improve adherence and retention while adding a convenient, modernized patient experience.
Telepharmacy solutions should also be a core component of a pharmacy technology portfolio. These solutions enable pharmacists to expand their operation and capture more prescriptions in a cost-effective manner, as well as load balance between locations. During the current COVID-19 pandemic, these tools are especially useful for counseling patients remotely in a secure, HIPAA-compliant manner.
When their capabilities are fully leveraged and they have the technology tools needed to efficiently optimize medication therapy, pharmacists can help patients live healthier lives and reduce the overall cost of care. From their unique position in the healthcare ecosystem, pharmacists’ ability to connect to manufacturers, payers and providers can add significant value.
Brent Stutz is senior vice president of commercial technologies at Cardinal Health