How Data Aggregation, Sharing Improves Specialty Patient Outcomes

Patients create numerous data points throughout their healthcare journey, each contributing a piece to a patient’s overall picture of health. But the inability historically to bring these bits of data together has created fragmentation that has contributed to duplicative services, increased costs, and poor health outcomes.

As an intermediary between providers, payers, and pharmaceutical companies and a trusted resource within the community, the specialty pharmacy can play an integral role in turning disparate data sources into actionable information that benefits the individual patient and the healthcare system as a whole.

“There is data behind each touchpoint with a patient and a person behind the patient,” says Stacy Ward-Charlerie, Director of Product Development Solutions at AllianceRx Walgreens Prime. “Given the number of touchpoints specialty pharmacies have with patients and the level of personal engagement, we have great insight into their individual needs and the unique ability to function as a connector for data sharing with all the stakeholders we work with.”

Data supplementation to streamline care

Specialty pharmacies already coordinate with providers and payers to ensure patients can access and afford their medications. And thanks to advancements in information technology, specialty pharmacists are now equipped to fill in potential data gaps that could support more effective clinical interventions through data supplementation.

“Although we have good data on the patients, we also have some blind spots,” Ward-Charlerie observes. “So, we must continue to look for partners and ways we can bring in additional data to supplement what we have.”

Through a partnership with Inovalon, AllianceRx Walgreens Prime staff can view a patient’s medical history, list of present and current medications, lab results, and other data points to understand each patient’s specific needs. Using health data exchange standards — such as the specification and application programming interface (API) that comprise the Fast Healthcare Interoperability Resources (FHIR) — specialty pharmacists can integrate data in a HIPAA-compliant fashion from proprietary data stores, connected partners, electronic health records, and health information exchanges.

Equipped with real-time data supplementation technology, pharmacies can recognize and intervene when gaps in treatment could negatively impact a patient’s health. For example, physicians often do not have visibility into a patient’s complete medication list and are unaware of potential interactions between prescribed drugs and over-the-counter medications. Through data supplementation, pharmacists become aware and communicate that back to the provider.

Other examples include accessing existing lab results which enables pharmacists to evaluate efficacy and side effects as well as to make recommendations to the provider to monitor the patient when lab values are missing. By connecting data points, specialty pharmacies can ensure timely clinical interventions take place and important information is shared with key stakeholders.

Patient-generated data to drive adherence

During the height of the pandemic in 2020, AllianceRx Walgreens Prime unveiled a digital clinical assessment tool for patients to use when refilling their specialty prescriptions that leverages a proprietary algorithm to identify specific needs for individuals, such as those new to therapy or those requiring more assistance. With a growing number of specialty patients using the tool, specialty pharmacies were able to focus on their engagement via omnichannel outreach to drive medication adherence.

These assessments continue to be particularly helpful as the pandemic brought to light numerous social determinants of health (SDOH) preventing patients from accessing and taking medications as prescribed.

“Everyone cares that the patient’s taking their medication because if they don’t, it results in assumptions about the efficacy of a medication and the possibility of trying another treatment,” Ward-Charlerie. “Non-adherence can also lead to hospitalizations and assumptions about disease progression that is fact a result of a patient not taking a medication as prescribed.”

With most of a patient’s health depending on non-clinical factors, integrating and expanding patient-generated data such as SDOH assessments into the complete picture of a patient allows for interventions well-tailored to the unique needs of individuals.

Data reporting to drive care management

Data supplementation and self-assessments provide vital information to specialty pharmacies to help providers and patients, but these pharmacies also have a role to play in helping payers by sharing key data about care and cost management to drive improved medication adherence and health outcomes relative to specialty medications. This function is especially important considering that 60 percent of total medication spend comes from specialty drugs.

Industry leaders in the specialty pharmacy space assist their payer clients by organizing data and creating visualization tools to provide information on patient trends, spending, and other metrics of care. This data reporting gives payers visibility in the status of open referrals that allow for efficient responses to member needs and interventions by care managers.

By building a data platform based on timely and accurate data, specialty pharmacies can pave the way for the future use of emerging technologies (e.g., artificial intelligence) to identify and eliminate gaps in care or information that could lead to adverse outcomes for patients and avoidable costs. But more immediately and importantly, they can ensure that patients receive adequate care along their healthcare journey.