How Software Can Help You Meet Your Independent Specialty Pharmacy Goals
A positive response to Specialty Pharmacy Times’ article, “What Defines an Independent Specialty Pharmacy?” authored by Stephanie Lapointe, PharmD; Cheryl Allen, RPH, BSPharm, MBA; Gary Rice, RPH, MS, MBA, CSP. Full article: http://www.specialtypharmacytimes.com/publications/specialty-pharmacy-times/2016/april-2016/What-Defines-an-Independent-Specialty-Pharmacy
Specialty Pharmacy Times published their article earlier this year, and it inspired us (KeyCentrix) to reflect on points they presented with how pharmacy management software systems can assist in a specialty environment. The information from Specialty Pharmacy Times (SPT) is in bold, followed by the KeyCentrix reflection in regular font.
- “[Specialty pharmacies value innovative service initiatives and partnership resources, allowing a singular focus on specialty pharmacy management by providing patient-centric, high-touch care models individualized to the patient.]” “Independent specialty pharmacies also foster industry collaborations and the development of innovative services and programs that demonstrate both a patient-caring and entrepreneurial business philosophy, [i.e. a simplified, patient-centric workflow model]:” -SPT
Pharmacy software workflows can be configured to enforce the checks & balances needed for specialty prescriptions. The costs of misfiling a specialty drug or not appropriately complying with the REMS reporting requirements are high, which is why a configurable workflow is critical for success in the venture of specialty. Business rules can provide guaranteed exceptions for managing specialty high-cost medications by enforcing that the pharmacy has been appropriately reimbursed, the pharmacy is in compliance with the necessary protocols, or the pharmacy has tracked the necessary steps before the drug can leave the pharmacy.
With business rules, a specialty prescription can be forced to stop prior to the dispensing stage to allow and/or require a patient touchpoint prior to dispensing. This stage prior to dispensing, sometimes referred to as “Scheduling,” can also be used to confirm patient availability for deliveries, which is particularly important for medications that require special handling, such as refrigeration.
Software with interfaces to third-party adherence and therapy management tools including TherigySTM, Asembia1, and/or Prescribe Wellness are also helpful. Clinical assessments for managing specialty therapies can be integrated directly into your workflow to ensure that your high-touch requirements are maintained throughout therapy.
- “[When it comes to innovative service initiatives and the patient-centric delivery of care, the] care provided by independent specialty pharmacies is primarily focused on the individual patient. A more thoughtful approach to patient care is demonstrated by independent specialty pharmacies that individualize specialty management.” “One advantage independent specialty pharmacies possess is that they do not have a formulary to which they must adhere, but instead, follow the prescriber’s recommendation which allows patient care to be individualized. Independent specialty pharmacies also help both the patient and physician with medication-access needs by assisting with prior authorizations, appeals, and securing financial support.” -SPT
Software with built-in prior approvals with companies like CoverMyMeds and ApproveRx are crucial tools to have integrated into your pharmacy workflow. Built-in payer management is another important tool to help investigate and automatically apply the resources needed to help patients afford their specialty medications.
Some software also gives you the ability to collect payment before you dispense any prescription. Take on the accounting role with a built-in Accounts Receivable (A/R) feature to organize payments. Not only can you store and process multiple credit cards, but you could also have the ability to auto-charge the A/R account that goes into immediate effect after the claim has been properly adjudicated, without having to contact the patient for authorization each time.
Within your workflow, you could manage each patient’s A/R account with specific credit limits based upon the pharmacy’s or patient’s discretion. These limits can provide hard stops that act as alerts to users to initiate contact with the patient in regards to their current copay or balance on the A/R account. Additionally, you can place hard stops on any prescriptions that process through as paid under cost to ensure adequate patient reimbursement.
- “A specialty pharmacy’s ability to deliver timely, accurate, and complete data should be a key consideration in a commercialization plan. With the increasing need to describe the patient experience, independent specialty pharmacies are uniquely situated to report on important factors, such as adverse events, patient-reported outcomes, compliance measures, and patient durability.” “By selecting a patient-centric, high-touch panel of independent specialty pharmacies for product management and distribution, manufacturers can leverage the innovative service initiatives of these pharmacies to maximize their drug product launch. For some specialty products, a manufacturer may select an exclusive specialty pharmacy to service the needs of patients and prescribers.” “In many instances, manufacturers have selected an independent specialty pharmacy as the exclusive distributor due to the need for a high-touch program that supports stakeholder needs.” -SPT
Even if a pharmacy is not under review to become a manufacturer’s distribution partner, reporting is one of the utmost requirements in any pharmacy environment. Although most pharmacy management systems have some degree of reporting available, a software system that provides full reporting compliance by having easily accessible, exportable, and printable reports along with the necessary tools to manage them on command is crucial.
In conjunction with built-in stock reports, you should also have the ability to create your own reports with a built-in tool. These reports could be based off of user-defined fields, in which you’d have the ability to create your own text fields and groups for information you need to collect based on patient, prescribers, drugs, and even third parties. Since every report presents different highly-detailed data, your software will need to possess the ability to pull specific data through various filters for each report to eliminate any irrelevant information on reports that are needed for auditors, third parties, manufacturers, etc.
- “Independent specialty pharmacies often reference data from patient and prescriber satisfaction surveys for performance indicators [as a measurement of success.]” In their article, Specialty Pharmacy Times also mentioned that some specialty pharmacies offer staff and/or patient education classes. In the example they shared, “[the Education and Training department] evolved from performing only internal employee orientation and training to acting as an industry educational and consultative forefront.” “From a quality perspective, this department is responsible for continuous quality improvement, with an emphasis on patient safety and optimizing the patient’s therapy experience.” -SPT
Software messaging features can be used to communicate surveys with patients and prescribers. It is also a way to communicate education and training opportunities either internally for staff, or externally to patients.
Independent specialty pharmacy is a representation of the evolution in the pharmacy industry, changing due to the growth of disease state and chronic patient management. To manage the high-touch needs of today’s patients, a pharmacy platform to perform these actions is required; you may need to consider updating your pharmacy system so you can handle the specialty needs of these high-risk and high-cost patients. If you are interested in learning more about specialty pharmacy, many resources exist like Specialty Pharmacy Times for resources and information, and KeyCentrix for software guidance.
Lapointe, Stephanie, PharmD, Cheryl Allen, RPH, BSPharm, MBA, and Gary Rice, RPH, MS, MBA, CSP. “What Defines an Independent Specialty Pharmacy?” What Defines an Independent Specialty Pharmacy? Specialty Pharmacy Times, 12 Apr. 2016. Web. 6 June 2016.