Hello, everyone. This is Erica Spicer Mason with Becker's Healthcare. Thank you so much for tuning in to the Becker's Healthcare podcast series. So today, we're going to talk about how integrating specialty pharmacy into EHR workflows can support strategic objectives like improving care coordination, patient outcomes, and operational efficiency. And joining me for this discussion is Jim Blondin, the senior director of digital product strategy at Accredo Specialty Pharmacy.
Jim, welcome to the podcast. Thank you for being here today. Yeah. Thanks, Erica. Glad to be here. Just a little bit about myself. As you mentioned, I'm senior director of digital product at Accredo. I've been with the organization for about twenty
years. I originally am a pharmacist, spent a number of years across our, more complex therapies running branch operations, and have been in a variety of roles across operations and strategy over the last several years, most recently in digital product. Our team is ultimately responsible for all of our digital tools, all of the client facing, patient facing, prescriber facing tools, as well as prior off product improvements from a specialty pharmacy perspective.
Yeah. Fantastic. Jim, really appreciate the context. Super helpful to know. And so I know that EHRs really are kind of at the center of a lot of conversations in health care, whether that's digital transformation or or administrative burden. You know, e EHRs are oftentimes the center of a lot of initiatives that health
systems are deploying right now. But from your perspective, how are health care leaders' expectations changing when it comes to EHR functionality, especially in supporting more complex areas like specialty pharmacy? Yeah. Great great question. Yeah. Yeah. Due to the complexity of the specialty meds, there were a lot of required data elements to support care that go above and beyond the the ERX transaction or standard e prescription.
This ultimately results in delays and starts of care because as a pharmacy, you tend to get the prescription, but the supporting documentation isn't always there. So there's a lot of back and forth between the pharmacy and the prescriber to obtain labs, high way procedures, and and ultimately progress notes as well to support the therapy and clinically manage those patients.
Between health information exchange connections, direct EHR connections, and other connections to intermediaries, EHR data become in a critical piece of the care continuum, specifically for specialty pharmacy. And by leveraging this data, specialty pharmacy can improve the processing of the prescription, reducing start to, care time, as well as reducing what we call gaps in care for existing patients when they might have a prior auth that is due when their their renewal prescription is ready.
And, ultimately, leveraging this data can reduce the prescriber abrasion. Yeah. Prescriber abrasion. It's such a good term, Jim, and it's actually something I wanted to go a little bit deeper on here. You know, you mentioned some of the ways that that EHRs can certainly become more more complex when it comes
to specialty pharmacy. But what role does EHR integration play in reducing friction across specialty pharmacy workflows, and how does that translate into improved patient and provider experiences? Yeah. Oftentimes, especially meds have many clinical requirements such as weight or indication based dosing, titration based dosing to to make sure the patient's tolerant and response to therapy is correct. Labs and test results are typically needed to support therapy.
A lot of times DME or the pumps, orders, ancillary meds, and home nursing orders are all all needed to start therapy. And many of these, are require a form from the prescriber, in in current state. Those forms come in the form of prior auth forms, referral forms, REMS forms, HIPAA consents, patient assistant forms. So there's a variety of documents that pharmacies tend to get.
And Surescripts recently cited a study that that says prescribers spend about three hours per week filling out paperwork to get patients started on a specialty med, while their nurses, roughly 50% of those nurses spend about ten additional hours per week on what on top of what the prescriber is doing to get a patient on therapy or get patients on therapy.
And many of these fields on the forms are already present, present in the prescriber EMR, And, it's really a duplication of effort from the prescriber perspective as well as the pharmacy if you have access to that record. Therefore, you know, by obtaining access, you can reduce the friction and, again, reduce time to start a therapy and improve clinical management of these patients. Mhmm. Yeah. And I know as health systems are looking at any opportunity that they can to reduce
administrative burden for their team. So it sounds like certainly that duplication of forms is a a key area that you've identified. And I know that EHR capabilities, they are expanding. You know, we're seeing, some providers add, you know, AI and other functions to EHRs. And then at the same time, specialty pharmacy is growing very quickly in the health care ecosystem. So what strategies or tools or even new models are emerging to better support access adherence and care continuity?
Yeah. It's HR capability expands or automation capabilities such as EHR data ingestion, parsing technology to help distill the relevant information out of that chart, to support the therapy. Prior auth automation, which sometimes includes AI, as you had mentioned, to improve benefit investigation, as well as enhanced partnerships with prescribers to leverage that EHR data, as well as the AI to facilitate prior auth requests more efficiently.
And when we have EHR data, we're seeing about a three to four day improvement in turnaround time for pharmacy prior auth and up to about seven day improvement in turnaround for prior auths related to medical covered therapies in our most complex therapy, groups when they're infused. So, we have that EHR data. We can significantly
reduce turnaround time. And, again, that that that's the back and forth between the prescriber obtaining data that we we we tend to have access to already within that EHR flow. So it's it's a much better experience. Mhmm. Yeah. Thanks, Jim. And I know that we've we've touched on prior authorization just a little bit already.
But can you elaborate on how enhanced EHR integration can help health plans improve the prior auth process efficiency and also reduce some of that admin burden for both patients and providers? Yeah. You know, I represent this this specialty pharmacy. This response is is kinda from my perspective and what I've seen in the market. But really through EHR data integration, the health plan can develop
insights in the patient's clinical journey. They better understand a complete picture of the pharmacy and medical claims data to support care. And by leveraging this info, many of the required PA elements can be automatically answered such as questions related to prescriber, especially the diagnosis for that therapy. Have they tried and failed therapies? Are they on concurrent therapies? And then as well as progress on therapy questions. All those things can be automated leveraging the
EHR data. So that that's a much improved process for us going back and forth to the prescriber to get that information or having the pharmacy intermediary. And again, this reduces, the burden we talked about earlier as well as improves the patient's experience. Mhmm. Yeah. Thanks, Jim. And I know that we've already talked a lot about the data capabilities within the EHR.
What role does EHR data transparency play in helping payers make more informed decisions around specialty drug management and care coordination? Yeah. Again, this is from the pharmacy lens. But although EHR data transparency could be instrumental or can be instrumental in supporting care for specialty drug management and care coordination. There's still plenty of work to do for payers to have more access to data and leverage.
In conception with the right connections, payers could help guide the clinical journey more proactively by approving care paths, associated therapies for those care paths at or before the time of prescribing versus the current state, which is typically retrospectively after the prescription is written. So it guides the prescriber through the the care journey, versus stopping stopping the process.
Additionally, there's significant opportunity, as you mentioned, to leverage AI to improve the process. We're aware of several tech companies. They're experimenting with embedding AI products into the EHR. These products tend to interpret the EHR data. They have ingested payer policies, and they can essentially embed the clinical data into the prior auth question set itself, essentially teeing it up for the prescriber to to submit.
And in future state, payers could really harness these AI products to capture these required data elements and guide guide care like I had mentioned earlier. And even if they can't guide care proactively, they certainly could automatically approve these PAs to improve care coordination. Yeah. And, Jim, I really appreciate the insights that
you've shared today. It sounds like there are so many opportunities within the EHR to really streamline a lot of these processes and specialty pharmacy, get patients the the treatments that they need more efficiently. And I can only imagine down the line the outcomes that could produce, in terms of care outcomes and costs. So thank you again so much
for all the insights today. Before we wrap, is there anything that we missed or any other final cusp of of really connecting the dots on EHR connectivity across the industry. There's a lot of stumbling blocks to them. There's certainly some competitive strategies that are out there. But, ultimately, the the more that we can connect data to the pharmacy, to the health plan, you you you can really improve the clinical
journey for our patients and prescribers. So, really excited about where some of this stuff goes including, as we talked about earlier, where AI will take us in the future. Yeah. Thanks, Jim. Really sounds like connectivity is key here. So thank you again for the time that you spent with us today and for all of your insights. Really appreciate it. Thanks very much. And we'd also like to thank our podcast
sponsor for today, Accredo Specialty Pharmacy. Accredo is a specialty pharmacy that serves patients with complex and chronic health conditions, including cancer, hepatitis c, HIV, bleeding disorders, and multiple sclerosis. Accredo understands the complexity of these conditions and treatments, and their specialty trained pharmacists and nurses are available to provide personalized care to patients.
Listeners, you can tune in to more podcasts from Becker's Healthcare by visiting our podcast page at beckershospitalreview.com.