logo

Innovation Future Specialist

Links: Home | Introduction

Patient Updates: Phone

This scenario shows how patients with access to a phone get updates on the progress of their prescription.

Patient Visit

The patient visits the doctor to discuss their medical condition and treatment.

Doctor

The doctor initiates a prescription for biologic medication. The following are noted:

» Doctor

» Patient

» Medication name, dose, frequency, and duration

» Optional notes

Patient and HCP Staff

The patient goes to a member of the health care provider staff to get details about the prescription process:

» Booklet describing the process and contact options

» Phone service telephone number

» Health care provider (HCP) number

» Prescription number*

» PIN [if required]

[The concept could be developed to use prescription numbers or patient numbers. If the latter is chosen then the systems would prompt with a list of pending prescriptions and allow the user to select which one they require details about.]

HCP Insurance Check

The health care provider staff initiate a check with the insurer to see if prior authorisation (PA) will be given for this patient and prescription.

Notification: Insurance Check

At this point a notification is available for the patient. The patient can dial the service number to get this notification about the progress of their prescription.

The patient dials the service (e.g. 555 123-7341).

An automated voice prompt says "please enter your HCP number", and the patient enters the number (e.g. 7841).

It then prompts "please enter your prescription number", and the patient enters the number (e.g. 7071).

It replies "on the 19th of February 2021 your health care provider initiated a check with your insurer to see if prior authorisation will be given for this prescription".

[Note that no personal details were released by the phone service, in the above example. If the concept was developed such that the phone service was allowed to provide personal details then the patients could be provided with a personal identification number (PIN).]

Insurance: Prior Authorisation

The insurer grants prior authorisation for this patient and prescription.

Notification: Prior Authorisation Granted

At this point a notification is available for the patient. The patient can dial the service number to get this notification about the progress of their prescription.

Prescription Sent to Specialty Pharmacy

The prescription is sent to the specialty pharmacy.

A notification of this is available to the patient (as before).

Benefits Investigation

The pharmacy checks with the insurer that the insurance covers the patient for this prescription.

A notification of this is available to the patient (as before).

Prescription Approved

The insurer approves the patient for this prescription.

A notification of this is available to the patient (as before).

Check Patient Availability

The patient is contacted (by phone) to discuss when they are available to receive the medication:

» date and

» time range.

The call to the patient can be made manually, or automatically. In the latter case, standard voice-computer technology could be used with a menu driven approach and the patient responding by pressing buttons on the phone. Alternatively, an artificial intelligence (natural language processing) system could be used. [Intelligent AI appointment booking has already been demonstrated.]

(A confirmatory check may be made on the delivery address - checking that the patient will be at this address.)

If the patient later rings the telephone service it will remind them of the agreed delivery details.

Dispense Dose

The pharmacy prepares the dose, and notifies the courier that the package is ready for delivery.

The courier has the following information:

» delivery date and time range

» delivery address

» patient name and phone number

Delivery

The courier handles the final stage of the fulfilment process to ensure the package arrives with the patient. Industry standard tracking information is available to the patient.

On ringing the service (as before) the patient hears:

"Your medication has been dispatched from the pharmacy. It is currently at <location> and should arrive at the agreed time today between three and four PM."

The system would be notified of the actual time of delivery.

Feedback

The patient has the opportunity to provide potentially valuable feedback on the entire process. This could be initiated by the patient dialling the service, or an automated call asking for feedback. Aspects of the feedback might address the following:

» The service from the health care provider

» Insurance aspects

» The service from the specialty pharmacy

» The efficacy and side-effects of the medication

» Delivery aspects

» Suggestions for improvement

» Other points of interest to key stakeholders

Feedback can also be collected from others (HCP, SP, etc.) to improve the effectiveness and efficiency of the entire process.

Repeat Doses

If the prescription allowed for repeat doses then the pharmacy would repeat the process as and when required (starting at Check Patient Availability).

Next

Links: Home | Introduction