The Industry's Dirty Secret: The Data Are Inaccurate

Patient satisfaction may be increasingly important in healthcare, but the industry hasn’t made the appropriate changes yet, 2 employees from Prime Therapeutics said in back-to-back sessions at the 64th Annual Roy A. Bowers Pharmaceutical Conference held by Rutgers University.

Ingrid Lindberg, chief customer experience officer at Prime, explained that for many people, their first experience with the company is when they hear someone else complaining that they didn’t receive their medication or that the process was too difficult.

“The consumer is king,” Ms Lindberg said. “And if you think that the consumer is not going to be king, then you are outdated.”

Her colleague, Cory Busse, senior director of clinical product management, discussed that one reason patients are unhappy is because of the lack of interoperability among health information systems. In recent years, so many electronic health record (EHR) vendors have popped up that they, intentionally or not, have created systems that don’t speak to one another.

“[At Prime] we don’t talk about data in terms of big data and small data; we talk about data in terms of dumb data and smart data,” he said. “We recognize that our role … is to take dumb data, make it smarter, and then put it back into the hands of people who can do something about it, which is mainly doctors and pharmacists, but increasingly members, who have the greatest stake in their overall healthcare to begin with.”

He explained the dichotomy that exists between the doctor and the pharmacist. While the doctor has a comprehensive view of the patient, he or she has no idea what the drug will cost or what is on the formulary. In contrast, the pharmacist knows the formulary and the copay information, but is not privy to a holistic view of the patient’s medical data.

Ideally, Mr Busse said, providers would be able to see formulary and copayment information at the plan level, specific to the member. Instead, they only see that the patient is potentially covered for a drug, and the worst case scenario for how much it could cost a patient. He used Abilify as an example and described that in the EHR, physicians would see that the patient could be responsible for up to $10 billion.

“This is the dirty little secret of our industry: the data are not accurate,” Mr Busse said.