Patient Care Processing Applications for Specialty Pharmacy

Customizable processing applications support the specific needs of specialty pharmacy.

Traditional commercial pharmacy dispensing systems do a great job storing a patient’s demographic and prescription data, adjudicating claims with the insurance company, and checking for drug—drug interactions.

However, specialty pharmacies have different needs when it comes to supporting the patient and fulfilling drug contract requirements with pharmaceutical manufacturers. While there are some commercial applications that have limited work flow and clinical content, most still have big gaps and are inflexible when it comes to running your specialty pharmacy business your way.

That’s where customizable patient care processing applications come in. Integrated with your pharmacy dispensing system, patient care processing applications enable efficient, high-touch patient and prescription processing that generates the key data doctors and pharmaceutical manufacturers need.

Some of the key features of patient care processing applications to support specialty pharmacies include:

• Customizable work queues that are tailored to your work flow and team structure
• Work flow processing content for prescription intake, patient onboarding, support program enrollment, injection training support, pharmacist verification 1 reviews, prior authorization processing, funding support processing, side effects and depression screening, health assessment questionnaire II and other surveys, refill processing, pharmacist/nurse consults, scheduling delivery and shipping
• Electronic medical record tabs to provide an efficient synopsis of the patient’s overall condition
• Medication possession ratio and proportion of days covered value displays
• Prescription and patient status features for flexible processing and exception handling
• Patient e-document status communication tools
• Management reports for prescription sales, prescription status, and operations

Patient care processing applications can also be integrated with your e-fax, credit card processing, and shipping systems for maximum efficiency and visibility, while data warehouse and reporting tools enable support of potential reporting needs.

Being Web-based, the applications can also facilitate remote limited access portals for stakeholders, including insurance companies, health care providers, and sales representatives. Additionally, e-fill portals allow patients to indicate their readiness to refill their prescriptions and answer some online screening questions.

These applications are enablers for the specialty pharmacy, allowing them to quickly take on any drug while providing powerful high-touch care, prescription processing, and reporting that is a win-win for all stakeholders in the specialty pharmacy landscape.

Evaluating these applications may lead you the inevitable buy-versus-build dilemma, in which your choices are to invest a lot of time and money to build your own application or to pay high licensing fees for an existing product, whereby you must live with its limitations and your inability to modify it. The good news is there are hybrid options out there. Some specialty pharmacy software development firms provide a core patient care processing application that you can modify to fit your specific business, work flow, and reporting needs. Contact a custom software development firm to identify options that will fit your needs. SPT

About the Author

Paul Sipes serves as vice president of Spud Software in Grand Blanc, MI. He designed the first patient care system for Diplomat and has extensive expertise in specialty pharmacy business. Paul spent 20 years as a regional director with MSX International, a global provider of technical services, where he was on the cutting edge of digital solutions for US Customs, and for automotive and retail clients. He transitioned this experience to Spud Software and the health care sector in 2007, where he has been providing digital solutions for improving patient outcomes and patient processing efficiency.