Digital Health, Accreditation Among Areas to Watch in Specialty

Health care industry trends affecting specialty pharmacy were the focus of a presentation on Monday at Asembia’s 2018 Specialty Pharmacy Summit. Presenter John Cervione, a managing partner of Blue Fin Group, highlighted several areas to watch in specialty, such as accreditation, digital health, and contract pharmacy’s role in integrated care.

ACCREDITATION

“If you’re a payer or if you’re a manufacturer that takes these accreditations really, really serious, whether you’re going out into the market for an RFP [request for proposal] for a limited network, relooking at your limited network, or doing your business reviews, there are some critical takeaways with what’s happening with accreditation,” he said.

Accreditation is especially poised to make a big impact, according to Cervione.

“We’re doing a major overhaul of RFP,” he said.

Accreditation agencies are on the rise, with health care providers such as hospitals, health systems, and physician practices representing the fastest-growing segment. This growth expands accreditation well beyond the independent pharmacies that comprise the majority of accredited organizations. Accrediting organizations are also finding ways to differentiate the marketplace and to allow specialty pharmacy providers to identify as experts in specialized areas such as oncology, HIV, and multiple sclerosis.

DIGITAL HEALTH

Digital health is becoming more integrated with specialty pharmacy. In competitive markets, more patient support services are providing differentiated services. New technologies offer potential in addressing some of the challenges that are persistent in specialty pharmacy, including abandonment, adherence, cost, financial transparency, and diagnostic errors.

“More and more manufacturers in their requests for proposals or in their requests for information are asking about details relative to where specialty pharmacy is tracking for some of these enhanced differentiated services,” Cervione said.

Gene editing, stem cell regrowth, and consumer tools for self-testing and diagnosing are among areas of growth. As an example, Cervione mentioned a smart toilet that can tell a patient which foods are needed in a diet to produce more energy and to reduce the risk of disease.

In addition, interest is increasing for blockchain technology use with health records that would provide patients more access and control over their data. “We’re seeing that now in 2018, and we’ll see it in the near future,” Cervione said. Meanwhile, the use of artificial intelligence (AI) in health care is accelerating. Cervione noted that 106 start-ups are working on AI technologies for health care professionals that could potentially improve efficiency and reduce errors.

“Do nurses and AI become the doctors of the future? Combining an RN [registered nurse] with all the power of the data to become the doctors of the future,” he said.

In AI, Cervione noted Abilify MyCite, a tablet with a sensor that records health data. The product, which patients swallow, is expected to become available this year. “There is interest in AI, and we’ll see continued interest in funding for AI,” he said.

INTEGRATED CARE

Dedicated pharmacy liaisons embedded into specialty clinics are becoming more common, often acting as contract pharmacies. They are interacting directly with patients and provider teams to assist with enrollment forms and prior authorizations in all clinics, not only hospitals.

A centralized board-certified specialty pharmacy team is supporting clinical management and adherence programs for all hospital partner sites and augmenting prior authorizations, benefits verifications, and financial assistance.

Cervione said the liaisons are helping to streamline and hasten the process of providing services with same-day prescription fills, which he said can otherwise take up to 3 to 5 days.

The centralized team allows for access to systems and data across the continuum of care. In addition to speed, the increasing use of integrated care offers better customer satisfaction, decreased financial toxicity, and increased persistency and adherence.