Next week, Scott will be at the 2016 Armada Specialty Pharmacy Summit in Las Vegas. Email him at firstname.lastname@example.org to learn more about SamplifyRx’s technology and set up an in-person meeting.
Visit www.parxio.com for a cool demo that was created using the SamplifyRx API. (Free registration)
Digital Patient Adherence Digital Strategies for Specialty Pharmacy
By Scott Pribyl, CEO, mRx Ventures LLC
Taking a specialty patient from a new diagnosis to conquering their disease takes a care team utilizing interconnected portals and the latest in technology to navigate the four main phases:
- Get the patient on drug: Prior authorization
- Get the patient drug delivered: Inventory management
- Keep the patient on drug: Adherence
- Treat the patient to a goal: Quantify
Portal vs. Hub
Understanding the difference between a portal and hub is essential to understanding the real workflow:
- Portal: Allows access to patient-centric record with permissions
- Hub: Consolidated group of data
The New Standard: API and OAuth2.0
An Application Program Interface (API) connects the backend database to the user interface. Using an API – typically in the RESTful JSON format – will message directly with the backend database without worrying about any changes to the frontend interface. Instead of full “hard coded” integrations with a legacy system, using an API can speed up the time to connect different care team portals.
Technology in specialty is shifting towards the use of an API for retrieving data but HIPAA still requires permissions for patient data. Patients must be able to opt-in and opt-out of sharing patient data. One standardized option is the use of OAuth2.0 for granting permissions using tokens.
The token allows access to protected resources securely. For example, if a patient app wants to connect with Fitbit data, first the two apps must be connected with an API. Then, the patient must enter the OAuth2.0 token to give permission to share data from the Fitbit device with the patient app, which only takes seconds. API plus OAuth2.0 protocols are being used by:
- Fast Healthcare Interoperability Resources (FHIR) HL7 specification
During the Prior Authorization (PA) phase, there are two different pathways required for PA approval:
- Electronic claims or adjudication software (including the switch and D.0 transaction) determines the patient’s benefits and eligibility.
- Clinical pharmacist approval determines if the drug prescribed is medically appropriate and necessary.
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An API allows everyone to keep their workflow with the switch but remain connected to a standardized platform to expedite the PA approval. Utilizing an API with portal access for prior authorizations allows any care team member to use the SamplifyRx RapidPA electronic library to find a dynamic PA form by entering any of the following search criteria:
- Specialty Pharmacy
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Engaging the Patient
The specialty pharmacy or Medication Therapy Management (MTM) company can register the patient for an adherence app when the drug is delivered:
- Pre-load the patient app and assign the prescription to the patient
- Register the patient for a patient app/portal
- Provide patient access to all care team members
- API and OAuth2.0 built into patient app
Unless the data collected from a patient app is shared in real-time, the data could be worthless. Using the new, interconnected portal system, a bleed event, for example, could trigger documentation to be sent to the care team coordinator to triage, thereby making data actionable in real-time.
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Since data is collected from multiple sources through API connections, there are new opportunities to use the data:
- A decrease or increase in activity level (Fitbit) could show the impact of a change of prescription or dose
- Performance-based or outcome-based contracts
- Incentivizing adherent patients with a reduction in premiums
- New sources of data for population health
- Private-label all portals and patient app
- Customize default apps with logos
- API connectivity and data feeds for any portal or app
- Framework and API to let digital agency build a user interface (UI)
- Dynamic Data Aggregator to collect and report data
- Connect current app into workflow with an API
The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.