Driving health outcomes through pharmacy-based services Vijay Garg Somraj Choudhary

Transcription

1 Driving health outcomes through pharmacy-based services Vijay Garg Somraj Choudhary

2 Table of Contents Introduction Want Better Medical Adherence? Drive Quality Of Care Trends in Pharmacy Services Thrust on Quality and Safety The Next Generation Retail Pharmacy Integrated Services, Personalized Care An Example - Universal Medication Schedule Conclusion About the Authors About Wipro Ltd.

3 Introduction Pharmacies are under mounting pressure to transform into preferred destinations for prevention and management of chronic diseases, freeing up much needed bandwidth for other healthcare providers. What has been lacking is a cohesive approach to influence outcomes as well as the adoption of some of these measures on a large scale. The approach to better health lies in connecting with patients ecosystem and enabling a superior experience through personalization. According to the Centers for Disease Control and Prevention (CDC), almost half of all Americans, approximately 133 million people, live with at least one chronic disease [1] Technology advances in wearable devices, artificial intelligence and cognitive computing coupled with opportunities in the current business environment have unlocked new possibilities to drive health outcomes through pharmacy-based services. These can be done by implementing various patient-centric services like Universal Medication Schedule, Smart Pharmacy and Health Coach. This paper discusses some of the trends in the pharmacy market that are driving a service and outcome oriented model, and lays out a few quick wins that can enable pharmacies to move on that journey. Want Better Medical Adherence? Drive Quality of Care Medical Adherence is one of the perennial problems of the healthcare industry. In the US alone, research suggests that the health industry loses around $290bn annually in avoidable medical costs due to non-adherence [2, 3]. A large part of the adherence problem is behavioral and requires the right intervention at the right time. The quality of care at pharmacies today is transactional and though patients have a long term informal relationships with the pharmacist, much of this is based on point of care health data and not based on a comprehensive counseling session engaging the patient. While this approach has been changing with the Medication Therapy Management (MTM) initiatives and better counseling, pharmacies still need to adapt a set of guidelines and best practices to provide services beyond the scope of a dispensing transaction. Given that the percentage of Americans taking five or more prescriptions has almost doubled over the past decade and that about 40 percent of older adults use at least five medications [4], it is imperative to accelerate the adoption of patient centricity to provide better quality of care. In order for this accelerated adoption, we need to have the right mix of trained people, operating procedures, tools and technologies. Organizations that fail to embrace the opportunities that these technologies are creating will become increasingly marginalized in a challenging and competitive marketplace. The new generation of Gen Y shoppers are addicted to a connected and value-added environment and do not appreciate the transactional method especially when it comes to health choices. 3

4 Trends in Pharmacy Services Thrust on Quality and Safety Pharmacies are adopting different strategies to move to a servicesbased model, depending on their competitive advantage and patient demands. The range of steps differ from targeted MTM to establishing a comprehensive connected health platform. Here are a few trends in the market that are driving movement to a patient-centric culture. A seamlessly connected enterprise is best positioned to take advantage of the rapidly changing business environments. Hence, it is essential that the integration technologies and products of an enterprise stay in good shape. For decades, enterprises have been using legacy data transfer applications due to lack of options. However, the legacy methods of transferring data have been posing several challenges such as homegrown applications are difficult to manage, time-to-market also goes up. Thus, choice of the right data synchronization products becomes crucial for businesses to streamline operations. Trends Driving the need for Next Gen Pharmacy Medication non-adherence is a growing issue The Next Generation Retail Pharmacy Integrated Services, Personalized Care The next generation Retail Pharmacy would be equipped to provide effective, reliable, economical and personalized services to patients and help the healthcare industry to address critical point of care challenges. This will take significant pressure off the healthcare system and lower the cost of care across the value chain. From a technology perspective, the high penetration of smart devices, adoption of wearable devices/sensors and the ability to process the data in real time, will redefine the patient engagement and quality of care. Operationally speaking, repetitive tasks can be automated by adopting dynamic patient profiling, tracking patient s history, real time monitoring and providing support on day-to-day basis. Here are a few concepts that can be implemented today at a relatively low investment that will enable pharmacies to move to a next generation model: 1. Universal Medication Schedule - Simplifying the instructions The current standards in writing prescription instructions (also known as Sigs) are very well known to pharmacy employees. The simplification of prescription instructions should provide many benefits to patients, caregivers and pharmacies, including increase in adherence and health for the patient and efficiencies in prescribing and dispensing medications. [5] 2. Smart Pharmacy Continuous Engagement High cost of health care Dramatic shortage of pharmacists on the horizon Information explosion: Physicians and pharmacists are being overwhelmed by information Ubiquity of the smartphone across all socioeconomic and cultural groups The increasing sophistication of man-machine interfaces, artificial intelligence, cognitive computing and natural language processing Small variations in patients adherence has big impact on the overall health outcomes. To prevent these deviations, it is necessary to continuously engage with patients using their preferred medium of engagement. There are a bunch of technology-driven solutions, like apps, pill reminder systems and smart medication bottles. Though effective in a limited scenario, these solutions need to go further like providing a dosage calendar with inbuilt alerts, tracking medication schedules and delivery of medication and services across various platforms. In addition, pharmacies can enable social support groups where patients can converse with other people with a similar health profile and set common goals and a shared concern. 3. Health Partnerships - Integration across the Healthcare Value Chain There are already a lot of initiatives to integrate health approaches across the value chain like closed networks, PBM driven initiatives and provider partnerships. However, there is an increasing need to share a patient s health profile across the value chain to enable interventions by all entities, while at the same time hiding competitive information like price and margins. 4

5 4. Personalized Health Choices Just for YOU The essence of all the services, messages and interventions will be lost on the patient if they do not connect with his/her ecosystem or are at odds with his/her state of mind. Consumers today appreciate services only if they are tailored for them. The solution is to engage the customer at a time and place of his/her choice and tailor the messages to his/her state of mind. A combination of behavioral analytics and cognitive computing will provide a great platform for this. An Example - Universal Medication Schedule Conclusion In the challenging, highly regulated and competitive world of retail pharmacies, it is necessary to move towards a patient-centric services model. This will require alignment to new technologies, a modified and flexible business model, unconventional partnerships and a relook at ways to win and retain customers. Pharmacies as the neighborhood Point of Care should play a larger part in driving outcomes and influencing behavior. The technology to enable this change is available and affordable. So why wait for a disruptive change led by the technology giants to revolutionize the delivery model. The time to take proactive steps is right now. The idea of Universal Medication Schedule is to interpret the prescription instructions (also known as Sigs) to convert them to a standardized meaningful set of data elements that can enable visual representation as calendars and time slots, help in monitoring the patient s adherence to that data and create new opportunities for engagement. The following components are envisaged for next generation Retail Pharmacy: 1. Self-learning UMS Engine that interprets the free form sig based on artificial Intelligence, natural language processing, subject matter relationships and a decision engine. These will enable the ability to make decisions based on past experience or insufficient, incorrect or conflicting information. 2. Health Coach will act as an agent, designed to build and maintain long-term, social-emotional relationships with a patient. This can be a personalized, mobile, virtual service agent engaging the patient in all aspects of his health and interfacing with the pharmacy or provider for critical aspects of care. The coach can answer questions, plan the regimen based on recent past, notify providers, interface with providers for additional information and remind users of how their behavior can lead to adverse effects. This will enable patient education and behavioral changes through concepts like gamification. 3. Provider Dashboard will enable monitoring and tracking for the patient. This can be used for pharmacist interventions and shared with partners for a more holistic approach. 5

6 References 1. CDC - Chronic Diseases - The Power to Prevent, the Call to Control - At A Glance 2009, NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION 2. Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease, A NEHI Research Brief August Improving Patient - Medication Adherence: A $290 Billion Opportunity, Medication_Adherence_Brief.pdf 4. Prescription Drug Use Continues to Increase: U.S. Prescription Drug Data for , NCHS Data Brief, No. 42, September 2010,

7 About the Authors Vijay Garg drives the innovations under Human Machine Interface initiative for Wipro CTO. He has overall 17 years of industry experience. He specializes in Mobility, Cognitive Computing and providing innovative solutions applying intersection of emerging technologies. Somraj Choudhary leads the Health and Wellness consulting practice for Wipro Retail. He has over 10 years of experience working with leading pharmacy retailers and benefit managers. He specializes in designing strategic, innovative solutions for health and wellness retailers across the globe. About Wipro Ltd. Wipro Ltd. (NYSE:WIT) is a leading Information Technology, Consulting and Business Process Services company that delivers solutions to enable its clients do business better. Wipro delivers winning business outcomes through its deep industry experience and a 360 degree view of Business through Technology - helping clients create successful and adaptive businesses. A company recognized globally for its comprehensive portfolio of services, a practitioner s approach to delivering innovation, and an organization wide commitment to sustainability, Wipro has a workforce of over 150,000, serving clients in 175+ cities across 6 continents. For more information, please visit 7

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