A Patient-First Approach
Addressing Unique Needs of Specialty Drug Patients, Enhancing Care Quality, and Improving Outcomes
By Donovan Quill
Stakeholders looking to optimize the quality of care, impact the patient experience, and improve outcomes for the 30 million Americans living with a range of 7,000 rare or orphan diseases must take a patient-first approach. During the remaining months of the COVID-19 pandemic and beyond, pharmaceutical companies, pharmacists, physicians, and other members of the care team can better address compliance and adherence to treatment when the patient is at the center of all care coordination.
Because specialty patients require a high level of therapy adherence support, targeted programs and services that deliver specialized expertise can go well beyond the scope of capabilities provided by traditional care organizations that are simply built for scale.
A patient-first approach allows physicians, specialty pharmacy, patients, and care coordinators to connect effortlessly, rather than operating independently. This higher level of care continuity strengthens communication, yields rich data for more informed decision-making, and improves the overall patient experience. What’s more, dedicated clinical teams are empowered to seamlessly eliminate treatment gaps for the patient.
Specialty patients need a significant amount of assistance throughout the care continuum and have much to gain from high-touch service. For this reason, a patient-first strategy addresses all variables around collecting data, while maintaining frequent communication with patients and their families to ensure compliance and positive outcomes.
Ideally, this concentration of services depends upon a team of care coordinators, pharmacists, nurses, and other specialists who are fully dedicated to the disease state, patient community, and therapy. This is critical for overcoming the limitations of the standard specialty pharmacy and hub service provider, which rely too heavily on technology solutions that fail to encompass human needs and variability. In fact, when the focus is on the product rather than the patient, the pharmacy’s incentives tend to emphasize monthly profits. This prevents pharmacies from being truly patient-focused and able to deliver the best possible care.
Innovation enhances patient outreach
Now that telehealth has emerged as an important technology during the COVID-19 pandemic, more stakeholders understand how innovation can enable pharmacists to remain a constant part of the care team during disruptions in the continuity of care.
Patient-first models deliver customized care coordination and telehealth solutions as an added layer to a proactive, process-driven program that educates the patient on potential risks. This strategy fosters discussion between the patient and pharmacist, which is essential to understanding the patient’s needs, focusing on the drug’s impact, and monitoring the patient’s overall health. By incorporating assessments and predetermined touch points each month, the care team is able to stay ahead of side effects and capture real-world evidence around the therapy, the disorder, and the patient’s well-being.
Effective pharmacy telehealth and virtual care visits are particularly important for addressing the unique healthcare coordination needs of specialty patients and, more importantly, patients who have been newly diagnosed with a rare or orphan disease.
When tied to a particular specialty drug, a personalized care plan enables pharmacists to empower individuals and engage them in the care plan. This centers on providing the right plan to the right patient, including adherence tools specific to the patient’s needs. This gives the person a better chance to thrive and overcome any disruption and uncertainty brought on by unexpected emergencies.
By partnering with a patient-first organization that integrates specialty pharmacy services, product distribution, and patient management into a dedicated program, pharmacists enable patients to receive the intense care, outreach, and consistent support they require to ensure positive outcomes.
Choosing a patient management partner
The right specialty pharmacy and patient management organization strives to create a partnership for personalized care and offers a suite of comprehensive services tailored to maximize the therapeutic opportunities for the treatment of rare and orphan disorders. A patient-first approach outlines a trusted path for patients and everyone involved in the treatment journey. This level of critical support is essential for the patient’s family and caregivers, enabling them to become more engaged and take ownership, strengthening the partnership and leading to better patient care.
Stakeholders should look for a partner that offers a telehealth solution designed to streamline patient enrollment, maximize interaction with patients for adherence and compliance, and provide continuity of care to avoid lapses in therapy. The solution should rely upon dedicated team members who have expertise in every aspect of the patient’s drug and can address questions and concerns from patients, pharmacists, physicians, providers, and payers.
The best specialty partner demonstrates expertise in navigating the insurance landscape and prior authorization process, and knows how to monitor and encourage compliance. It’s also important to find a partner with dual accreditation from the Utilization Review Accreditation Commission (URAC) for compliance with specialty pharmacy and the Accreditation Commission for Health Care (ACHC) for specialty pharmacy services. This demonstrates commitment to providing quality care and services to these patient populations.
Ultimately, any specialty care management solution should meet the needs of everyone involved in the patient’s journey—from specialty drug manufacturers to pharmacists, caregivers, and physicians—with all services delivered from one central point of contact. Integrated solutions go the extra mile in achieving quality and maintaining safety for this vulnerable population that is often struggling with rare or orphan diseases.
Donovan Quill is president and CEO of Optime Care.