By: Jack Pinney, MD
From: kevinmd.com
We’ve all heard about the importance of greater stakeholder collaboration in health care. It’s the premise of current movements aimed at improving the outlook on some of the most costly, chronic conditions.
Like most physicians today, I maintain a tight work schedule to keep bottom-line margins in the black. On a daily basis, I see between 25 and 30 patients while also serving as the medical director of employee health for a multi-hospital health care system with approximately 7,800 employees.
Amid multiplying industry pressures that include value-based reimbursement models, it’s safe to say industry collaboration does not always come easy. Consequently, it’s important to look for the low-hanging fruit—those places where partnering with other stakeholders will produce the most impact on quality patient outcomes.
Any physician working on the frontlines of care knows that medication affordability and adherence are both notable barriers to success with individual patient outcomes as well as population health initiatives. It’s a non-negotiable, and patients must be engaged in the process. I can write prescriptions all day long that will dramatically impact the quality of life for my patients, but if they can’t afford to pick them up, it’s nothing more than going through the motions of care delivery.
That’s why physician-pharma collaboration is more important than ever. We are finding that direct communication lines that enable drug savings opportunities and clinical education to be embedded into EHR workflows are driving notable improvements in medication adherence. In addition, communication links that bring together pharma, providers and patients are driving more proactive care that promotes sustainable outcomes improvement and lower costs.
Here are three significant ways this collaboration is impacting quality of care.
1. Medication affordability
Rising drug costs are a sizeable industry challenge. For many patients, high deductible health plans (HDHPs) equate to no insurance at all as they must pay full price for medications. Even when insurance covers a percentage of drug costs, trends reveal that copays are rising. Further exacerbating the cost challenge is a dwindling supply of lower-cost generic brands.
While there is an ongoing industry debate regarding use of drug coupons and vouchers, the reality is that many patients depend on these offerings to afford their medications. My goal as a physician is to equip patients with the tools available to successfully follow-through with care plans and achieve the best outcomes. And while the coupon-voucher debate will likely continue in the years to come, my reality is — how can I help my patients achieve the best outcomes today. Consequently, I want to know what offerings are out there now. Like most physicians, however, I don’t have time to research all available options at the point of care.
The unfortunate reality is that billions in savings go unclaimed each year because providers and patients are simply unaware of available offerings. Through a direct communication line that connects pharmaceutical manufacturers, health care providers now have real-time access to savings opportunities that are embedded directly into ePrescribing workflows. Physicians continue to choose the most appropriate treatment strategies for their patients, following which they are alerted to the availability of coupons and vouchers, which can be immediately printed and handed to patients for use at a retail pharmacy. Or, physicians can search for a brand name drug within the EHR and receive the needed product information in near real-time.
2. Medication adherence
There is a reason that medication adherence has become a focal point of industry performance improvement efforts — it’s a rampant problem that is connected to billions in health care costs annually due to poor outcomes and disease progression.
Simply put, it’s the low hanging fruit. Most physicians know that if they can get ahead of the medication non-adherence problem, individual and population health outcomes should naturally improve.
High drug costs and non-adherence go hand in hand. Industry research reveals that drug affordability is a primary contributing factor to the problem. In addition, some patients are just skeptical about medications in general or they lack understanding of how to properly take their prescriptions.
While greater access to coupons and vouchers can certainly improve patient medication adherence, we also find that the availability of integrated content from our pharmaceutical partners helps physicians educate patients on how to properly take their medications.
3. Patient engagement
The age of consumerism is here in health care. That means that providers must partner with patients and empower them to achieve better outcomes. My patients increasingly look to me to help them better understand not just their clinical options but also the individual financial impact of these options. Having access to this information in my natural EHR workflow — where I spend a large share of time — expedites my ability to provide answers. I can provide patients with a transparent view of price and offer insights into new evidence and treatment options made available through our pharmaceutical partners.
A significant development, this direct line of communication also empowers health care providers with a critical piece of information: confirmation that a patient picked up their prescription or refill. When we learn that a patient is not following a medication plan, outreach is initiated to find out the reason and close this important care gap. In addition, a direct link between our pharmaceutical partners and patients enables reminders to be initiated for refills.
Physicians are working hard to balance costs, quality initiatives, consumerism, and workflow. We all need a line of sight into simple, efficient solutions that can have significant impact. In terms of drug affordability, medication adherence, and patient engagement, physicians can extract a lot of value through stronger partnerships and direct communication lines with our pharma partners.
Jack Pinney is a family physician and medical director.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.