Data in Specialty Pharmacy: Using the Past to Predict the Future

Once upon a time, there was a profession that involved a patient, a pharmacist, a dispense, and a signature. Every so often, the patient would ask their friendly pharmacist about possible side effects, drug-drug interactions, or how to take their medicine. The pharmacist would provide their clinical expertise and then out the door would go a satisfied patient.
 
Throughout the course of therapy, the patient may have called the pharmacy seeking additional guidance. Anything from reassurance on how to administer the medication to side effect management. Nonetheless, the pharmacist was always able to provide the most appropriate counseling.  
 
After the call, the pharmacist continued on with the task at hand. There wasn’t a need to document the call or flag the patient for follow up. Once upon a time, there was a profession that did not require a patient to answer questions about their disease, medication, and general wellbeing, before they could refill their medication. 
 
What happened to that profession?
 
The answer is, nothing. This environment still exists within our profession. However, our profession has grown, evolved, and become more advanced, all thanks to a small phenomenon called specialty pharmacy. 
 
Pharmacy is still pharmacy—the art of preparing, storing, sometimes compounding, and dispensing medications—is still present, no matter how you try to dissect it.
 
When we think about the medications that dominated the once upon a time profession, they were mostly small molecule compounds that were simple to store, easy to administer, and relatively inexpensive. 
 
The only documenting that was required, post data entry, was a patient signature in the HIPAA log acknowledging or declining counseling. Even if the patient requested counseling, the details of the conversation that ensued did not have to be documented. 
 
For example: “Hi Ms Jones, make sure that you take this pill once a day, in the morning. It can be taken with or without food and be sure to limit sun exposure while you’re on it.” 
 
Yeah, not much to document, nor would it provide much value.
 
Medications in the specialty pharmacy space are a completely different endeavor though. These large, complex molecules possess the capability to change lives for the better and sometimes the worse. Their storage and administration requirements also present additional challenges.  
 
Additionally, the level of clinical management needed to mitigate risks and improve outcomes is far greater than with any other types of medications to date.
 
So, what does this have to do with data then?   
 
As the specialty pharmacist, it is my duty to ensure that each patient is receiving an optimal level of care. With that comes the need to educate all patients about their respective medication therapies. Education includes therapy/disease state counseling, medication handling and storage, and risk mitigation.
 
This process is facilitated through the use of clinical programs, which offer predefined questions. When the pharmacist provides answers to the questions, this information is stored. Additionally, specialty pharmacy information systems allow for free text documenting in a patient’s chart.
 
These two features are heavily utilized by a pharmacist as a means to build a patient story, documenting every interaction and producing a trail of information. A trail of information called data.
 
As the specialty pharmacy’s clinical program manager, I am interested in knowing whether the clinical programs being used are adequate. I am cognizant of the fact that every specialty medication has a different monitoring requirement. For the betterment of our patients, I need to ensure that the right questions are being asked. 
 
Are we capturing the correct information that can enhance our current programs to drive unparalleled care?  Do our programs meet the requirements from the manufacturers? Are we able to report on the information that we capture?
 
Once the information is captured from one patient to the next, are we able to easily aggregate and manipulate it? If so, do we understand what it tells us? How can we use it to our competitive advantage?
 
All the information that we capture in the normal course of conversation with patients is more than what meets the eye. Therefore, the next time you are documenting that individual patient story in your specialty pharmacy, know that your data is meaningful to predict the future of patient care.
 
About the Author
Joe Thomas earned his Doctor of Pharmacy degree from Duquesne University and is currently enrolled in the Masters of Science in Pharmacy Business Administration (MSPBA) program at the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines.  He has spent the past several years working across several specialty pharmacies, integrated in both staff- and corporate-experiences.


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