Utilizing Technology and Data to Improve Care for Patients With Complex Needs

Patients with complex needs may need more complex solutions to manage their health issues. Innovations in technology and integration of data have made it possible to improve patient interactions with the pharmacy to better manage their diseases.

The American Journal of Managed Care^® (AJMC^®) recently spoke with Christine Sawicki, senior director, specialty product development and innovation, CVS Health, about the impact new technology can have on patient experience, health outcomes, and drug spending.

On September 10, Sawicki will also discuss “Improving Patient Care Through Data and Devices” at the Pharmacy Benefit Management Institute’s Specialty Rx Forum.

AJMC^®: Has the introduction of connected consumer-facing devices helped improve patient adherence?

Sawicki: At CVS Specialty, we are using consumer-centric technology in a number of ways to help improve the specialty patient experience and enable more convenient, complete patient care.

One way we are doing this is through our clinical secure messaging program to help put a nurse or pharmacist at the patient’s fingertips. This works via a proprietary, company-built tool loaded with therapy- and indication-specific clinical information. Patients opt in to receive personalized message alerts via their mobile phone with information about manageable symptoms, potential side effects, lab tests, and condition management. The messages are based on clinical trial data, the drug’s label, and feedback from other patients, and they are timed to reach the patient when they are most likely to experience a specific situation. The message also includes a link to enable the patient to ask a medication-related question.

Starting in 2016, we introduced this capability in a group of patients with chronic myeloid leukemia and saw both high engagement and improved medication adherence. We have since expanded to patients with rheumatoid arthritis and other chronic conditions and have seen very promising results.

Specifically, patients who receive the customized, secure clinical messages on topics including adherence, condition management, or side effect management are more likely to refill their prescription(s) and achieve significantly higher medication adherence than those who do not use the clinical secure messaging program. (Note: specific results here: https://cvshealth.com/thought-leadership/clinical-secure-messaging-helps-improve-medication-adherence.)

Currently, more than 80% of our patients have enrolled in secure messaging.

In addition, we are also exploring the use of wearable technology like the Apple Watch in specialty condition management.

AJMC^®: How are providers and pharmacists handling the data coming at them from patient devices?

Sawicki: For our secure messaging program, the information from the patient is fed directly to a CVS Health clinician—either a pharmacist or a nurse—who can help provide information or support (depending on the nature of the patient query). In addition, notes from that interaction are also shared—via secured connection—with the patient’s provider to help ensure continuity of care and provide the patient’s doctor with information about interventions or any challenges with disease management in between their regular visits.

AJMC^®: With patients who have complex needs or rare conditions, how can new technology help provide better care management?

Sawicki: In addition to enabling more holistic patient care and facilitating improved adherence, technology can also help create more opportunities for connected care. For example, over the past few years, we have been integrating Epic into our system and are connected to 90% of electronic health records (EHRs) with hundreds of thousands of patient records exchanged. This helps connect patient care and improve healthcare decision making as, for example, our CVS Specialty providers can access important patient health history and information and also input information into the patient’s EHR that the physician can access at their next visit. We are also in the process of expanding access to additional electronic medical record systems to support the same experience for those who may not be on the Epic platform.

In addition, we recently launched something we’re calling Specialty Expedite, which helps streamline the benefits verification and the prior authorization process in accordance with payer requirements and can help patients get started on therapies faster. The traditional prior authorization process for specialty therapies is complex and time consuming, requiring multiple faxes and phone calls to ensure the specialty pharmacy has the necessary patient information and can take up to 21 days for patients to receive their medication. Through Specialty Expedite, the patient onboarding process can be shortened to as little as 3 days.

AJMC^®: Are we seeing that better integration and smarter devices are able to deliver care to patients in more appropriate settings without having to go into the hospital?

Sawicki: At CVS Specialty, we are working to innovate and evolve the specialty pharmacy patient experience and are using technology in new ways to help deliver on that promise. As such, our programs and services are aimed at helping CVS Specialty patients start and stay on their prescriptions and provide a high-touch patient experience that altogether aim to improve clinical outcomes and avoid, often costly, healthcare inventions such as hospitalizations.

AJMC^®: What role do these tools play in managing costs of expensive treatments or disease states?Sawicki: In addition to helping to improve the patient experience for our CVS Specialty patients, we are also working to help lower costs for both payers and patients. One of the ways that we do this is by helping to ensure patients start on the most clinically and cost-effective medications.

An example of one of CVS Health’s tools is the real-time benefits capability of the pharmacy benefit management company (CVS Caremark), helps provide lower-cost drug alternatives via the patient’s electronic health record. That way, a prescriber can find an on-benefit and affordable drug option before writing a prescription, and there is greater cost transparency for patients before they head to the pharmacy.