At the recent Asembia Specialty Pharmacy Summit, I had the chance to join RxNT, a leading EHR provider, to host a small-format session on the EHR workflow. In light of recent research from OptimizeRx showing that 69% of physicians rank starting a patient on specialty therapy as “very” or “extremely” difficult, we explored steps physicians take during a patient visit, challenges they face, and opportunities for pharma brand teams to support them in care delivery.
Intake and Diagnosis
Physicians begin a patient visit with a standard intake form—documenting a patient’s chief complaints, symptoms, current prescriptions, diagnostic results, and any current diagnoses or treatment plans. The EHR guides them through each step of the process, collecting and confirming all necessary information for the physician to make a treatment recommendation.
As physicians determine both the patient diagnosis and their preferred treatment options, pharma brand teams can engage and support providers with EHR-based content that helps physicians reach a diagnosis or treatment path more quickly – for example:
- Delivering banner messages with informational or branded content tailored to a patient’s profile, such as suggestions for a particular diagnostic test, initial medication, or step therapy.
- Providing direct access to field reps or MSLs through the EHR, making it easier for physicians to reach out with questions about a medication, and reducing reliance on office visits and face-to-face interactions.
- Drawing on both the data available within a patient’s medical record, as well as additional external real-world data sources which track a patient’s full journey, to maximize the relevance and timing of content, so information is immediately actionable by physicians.
Therapy Selection and Prescribing
Once the diagnosis is made, physicians typically move into an electronic prescribing workflow within the EHR, where they can search for and select their therapy of interest. They then review an overview summary of their selected prescription that automatically checks for potential drug interactions, displays a list of alternative therapies, and may also notify the physician of any prior authorization or specialty enrollment requirements.
As EHR-based technologies continue to evolve, pharma brand teams are in a unique position to support the care delivery process – helping patients start on their doctor-preferred therapies more efficiently.
While pharma’s ability to deliver brand content at the moment of prescribing is limited within EHR systems, this only makes it more critical to ensure physicians are aware of brand benefits earlier in the care journey, including:
- Highlighting therapeutic results and treatment benefits for patients.
- Raising awareness of financial assistance programs, formulary status changes or patients’ real-time insurance benefits, so patients and physicians can both be confident in the therapy choice.
- Prompting physicians to enroll patients in applicable support programs, such as text-based therapy onboarding workflows.
Prescription Fulfillment and Specialty Enrollment
The next step for the physician is to select a pharmacy to send the prescription to for fulfillment, leaving any relevant notes for the pharmacist. Following submission of the prescription, the physician then needs to complete and submit any required prior authorization (PA) or hub enrollment paperwork. Once the PA is approved, the pharmacy will fill the prescription.
It’s at this stage in the journey where patients are most likely to encounter challenges and delays in accessing their medication. Some of the most common causes for delay – especially for specialty brands – are limited distribution networks, PA delays, and hub enrollment requirements.
- Typically, for brands with limited distribution networks, a lack of awareness into fulfillment pathways on the part of the prescribing physician means that they are more likely to issue the patient’s prescription to a pharmacy that is unable to fill it, introducing needless delays and requiring the prescription to be reissued.
- PAs and hub enrollments not only require time-intensive initial paperwork requirements, but also can require multiple back-and-forth communications for successful acceptance.
While some complexity is unavoidable due to payer and distribution requirements, brand teams can minimize the time, effort and delays associated with these steps. Integrating electronic prior authorizations directly into EHR workflows; shifting to a “conversational”, digital approach to specialty enrollment; and automatically notifying physicians which pharmacies carry their brand are all concrete steps pharma teams can take to reduce complexity and avoid unnecessary delays in therapy start.
Investing in Innovation at the Digital Point-of-Care
Physicians’ need for more support in the EHR is clear, as is their demand and interest. For example, in a recent survey of 100+ specialty providers, we found that 60% of physicians do not have access to patients’ real-time insurance benefits, but 71% of those that do check it before writing a prescription. Similarly, 84% of physicians were highly interested in an EHR-based tool to file prior authorizations more easily, and 81% expressed similar interest in a tool to automate specialty or hub enrollment.
As EHR-based technologies continue to evolve, pharma brand teams are in a unique position to be able to invest in solutions that ease the prescribing journey, and help patients start on their doctor-preferred therapies. For example, we recently partnered with an autoimmune brand team to raise awareness of a favorable formulary status change directly in the EHR. Whether the focus is on better HCP engagement, increased medication access, or improving patient adherence, the best way to support providers is directly in their workflow.