Accelerate Time to Specialty Pharmacy Therapy with Digital Options

The journey of the specialty pharmacy patient is a complex and expensive process, as most participants in hub services know. Due to skyrocketing costs and use of specialty meds, patients experience any number of hurdles to initiate therapy.

Satisfying insurance requirements for prescription enrollment and payment, the soaring cost of medication nonadherence, outdated enrollment modes, countless touchpoints, and other barriers can result in significantly higher risks of complications, negative impacts on clinical outcomes, and mortality. Even with the assistance of hub intermediaries, manual processes and minimal standards exist.

Hub services companies face their own unique challenges to help physicians and patients effectively navigate the specialty approval and fulfillment process. Digitizing hub processes can create an efficient and effective tech-driven patient access strategy speeding access to lifesaving therapies.

The following use case examples illustrate how artificial intelligence (AI)-powered tools support the patient’s journey throughout the hub. Digital engagement conversational chatbots, virtual visits, and 2-way secure chat accelerate throughput and streamline multi-layered communication across the various hub service participants.

Engage patients digitally

• Automate routine administrative tasks that allow contact center agents to solve higher level, complex problems. For example, the use of chatbots can trigger campaign outreach upon the patient’s enrollment in your portal to automatically and initiate engagement early.
• Speed entry into patient assistance programs.
• Use digital outreach to obtain consent and provide program information.
• Offer guided assistance to relevant patient education materials.
• Provide multimedia options to reinforce a patient’s understanding and self-care.
• Distribute branded welcome packets.
• Automatically provide digital content.
• Update insurance information and enable patients to scan their current health plan card.
• Capture missing patient consent to close gaps in missing documentation.
• Deliver branded coupons or co-pay offers and supplement with accessible digital material.
• Enroll in therapy support programs and provide information about relevant support groups.

Reduce provider burden

• Capture missing physician signatures.
• Send physician education materials to high-volume specialty physicians.
• Replace phone tag with secure 2-way text messaging.
• Automate payer authorization requests for additional information.

Speed up the prior authorization process

• Close gaps in documentation with physicians or patients.
• Enable patients to self-schedule discussions about urgent concerns to live agents.

Enhance data capture and quality

• Automatically trigger outreach to identify and close gaps in documentation.

Provide opportunities for convenient patient self-service options

There is no shortage of operative ways for specialty pharmacy hub services to automate the many manual touch points, transactions, and handoffs to fast track a patient’s access to life-saving specialty medications. When engaging patients digitally at every step of the experience, hubs can:

• Enable redirection of inbound calls to powerful conversational digital and self-service channels. Callers can interact naturally with human-centered chatbots 24/7 at their convenience. This fast and affordable high-touch, self-service engagement creates a more individual-centric, concierge experience.¹
• Reduce inbound waiting times, dramatically decrease call volumes and frustrations, and free up hub specialists to focus on more complex priority tasks.
• Disseminate information about the specialty medication and program. The chatbot can include the option to escalate the interaction to a virtual visit if the patient desires to speak with a knowledgeable resource.
• Collect a patient’s co-pay while offering accessible instructional materials, clinical support and patient support programs.

Humanizing the patient experience is in your hands

Every patient’s journey is unique and full of unknown and distinct interactions that can, for better or worse, influence the outcome of their treatment. Hub services play an important role helping the patient navigate logistical complexities and eliminate confusion to encourage adherence.

As the digital footprint deepens in health care, hubs are at the forefront of new tech-driven strategies that can help provide a superior level of human-centered services to these patients who are already in distress. Giving the patient the best channel and personalized, convenient, end-to-end support possible will drive the best health outcome.

Reference

Jim Banigan, C. (2022) Hub programs from Patient Perspective, Pharmaceutical Commerce. Pharmaceutical Commerce. Available at www.pharmaceuticalcommerce.com/view/hub-programs-from-patient-perspective. Accessed January 10, 2023.

About the Author

Krishna Kurapati is the founder and CEO of QliqSOFT. He has more than 2 decades of technology entrepreneurship experience. Kurapati started QliqSOFT with the strong desire to solve clinical collaboration and workflow challenges using AI-powered digital technologies across the US health care system. He is actively involved in early-stage financing of startups in both the United States and India.