Innovation Future Specialist
This presents the benefits and opportunities available to users.
The patient benefits by getting real-time updates on the status of their prescription.
This is available to a wide range of people as the service can be provided via the Internet (email and web) and via telephone.
Patients can specify the level of privacy and security they want in terms of: accessing the system (e.g. the option to use PINs and passwords); fields available for data analysis by third parties; and the extent to which their feedback is disseminated.
Incentives to share data could include offering willing patients access to more details, data, services and functionality. See the Privacy page for examples of potential incentives and benefits.
They also get a clear explanation of the process (and realistic estimations of the duration between steps):
» Insurance Check (PA)
» Send Prescription to Specialty Pharmacy
» Benefits Investigation
» Check Patient Availability
» Dispense Dose
This means patients are more likely to adhere to the process, and get better outcomes.
The doctor benefits from a quick and easy to use system and knowlegde that the patient will benefit from the system too. The doctor may be given the opportunity to access summary data indicating the effectiveness and efficiency of the overall system, the efficacy (and side-effects) of the prescribed medication, and feedback provided by their patients. If an intelligent system [possibly using AI] is developed then the doctor can also benefit from proactive suggestions in terms of prescribing medication, dosage, duration, service providers (e.g. pharmacies), and useful complementary patient support services.
The staff of the health care provider benefit from an efficient and effective system that has the potential to reduce their workload (per patient). Workflows can be used to simplify and automate parts of the process (contacting insurers and specialty pharmacies). Their workload is also reduced by removing the need for patients to contact them about the process and the progress of their prescription. If the HCP is given summary data from the system then they can select the most appropriate organisations to work with based on their efficiency and effectiveness, and patient satisfaction. Similarly they can determine the best medication, dose and duration for given patient scenarios.
The pharmacy benefits from an efficient and effective system that has the potential to reduce their workload (per patient). Workflows can be used to simplify and automate parts of the process (contacting HCPs, insurers, patients, and couriers). If the pharmacy is given summary data from the system then they can select the most appropriate organisations to work with based on their efficiency and effectiveness, and patient satisfaction. Similarly they can determine the best medication, dose and duration for given patient scenarios. Specialty pharmacies may also choose to benefit from the following opportunities...
Conventional software can be used to provide workflows that automate tasks and improve efficiency and effectiveness. All parties have an opportunity to gain benefits from this for inter-organisational and intra-organisational tasks. They also have the opportunity to use this approach to improve other processes within their organisation, whether they be related to the prescription process or some other process.
Removing time wasted waiting on the phone can be a big efficiency gain - thanks to automation.
There are opportunities to include the use of artificial intelligence (AI) to enhance efficiency, effectiveness, data analysis, and communications (via text and speech). AI has now matured sufficiently to handle direct communications with patients, including booking delivery dates for their medication.
This approach allows for a greater volume of detailed data to be collected and analysed. In addition to existing revenue streams from specialty pharmacy data, potentially valuable data exists in the form of:
» the effectiveness and efficiency of each service provider in the system
» the efficacy and side-effects of prescribed medications
» patient satisfaction (with their medication and service)
» patient compliance and retention
» patient demand for supporting services (via services opted into, and via feedback questionnaire)
» suggestions for improvement; and
» supporting data for research into experimental medications and methods of dose delivery.
This approach offers a flexible ecosystem to support future innovations within the sector, and flexible methods of service delivery. It supports contemporary approaches, organisations that want to delegate parts of their existing process to others, organisations that want to take on more of the process, and organisations that offer new supporting roles.
Some HCPs delegate insurance checks and contacting specialty pharmacies (SP) to others.
Some SPs take on more of the process (prior authorisation checks).
Organisations offer a comprehensive all-in-one service (insurance checks, financial assistance, SP, patient support, and fulfilment).
IT support from organisations: development of custom workflows to improve the efficiency of service providers.
New or existing organisations developing and sharing help guides across the system.
There are opportunities for specialised clinical support (perhaps via additional third parties or extra services from existing providers) to help patients while they are on their prescribed medication. This may help patients to stick with the process and deliver better outcomes.
Similarly, there are opportunities for services that provide financial assistance to patients.
Future innovations could disrupt the current model and deliver extra benefits: reduced operational costs; increased availability of biologic medication; growth in the biologic marketplace; and increased profits. For example, innovations that enable the delivery of biologic medications that do not require refrigeration would drive these benefits. Similarly, 3D printing of innovative dose packaging and patient delivery devices might offer potential benefits. The approach described here is future proof - it will support radical innovations, as the messaging system is role / task based rather than organisationally based.